Please watch this video which provides insight into one female and her experience with schizophrenia: https://www.youtube.com/watch?v=tuv3R5uYm8s
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After watching the video, please discuss how representative she is of patients with schizophrenia. How is she different? How is she similar?
Her comments about use of restraints are very negative, but are there reasons why and conditions in which they should be used?
She is able to function quite well in society, and discusses three reasons for her improvement, the first of which is treatment. Given that beyond hospitalization, she had psychotherapy four times a week at times, how reasonable is it to use her case as a model for others?
How should expensive psychiatric care be funded?
She discusses the criminalization of psychiatric patients, and discusses the reality that many patients end up in prisons. How can this be prevented or reduced?
You must post an initial entry, and respond to at least two students.
Student 1: Zachary
The speaker does display symptoms of a mental illness however, without it being identified to us I believe it would be hard to determine that she has schizophrenia. In fact, she stated that “it wasn’t until later in life that I revealed my mental illness to my public life.” She can represent very well with patients when discussing experiences suffering from schizophreina. She has suffered from multiple episodes of schizophrenia, she has been hospitalized due to these episodes, she has been restrained and mistreated and she has faced social conflict with her mental illness. When she described her first episode, she stated that her peers said “you’re scaring us” and “are you on drugs,” I can’t imagine how that may have felt for her and other patients who suffer from shizophrenia. I believe restraints are over used and a common way to abuse power however, there are situations where a mental illness can create a danger to a persons self or others. Restraints should be used for these patients accordingly until everyone is safe. Her treatment is very extensive and closely managed, after decades of work she is still experiencing a lot of treatment which seems greatly successful. This does not seem to be a very practical approach for all patients, I believe people suffer differently and sometimes it developes early or isn’t noticed. She seems to have found great success in her efforts to manage her mental illness and I hope she can inspire more people to aid or work through these mental illnesses, however I feel it’s a matter of both opportunity and effort. Whenever I stop to think of where funding for these social issues could come from, I can’t help but to remember that the U.S. NAVY has the worlds second largest Air Force. In fact, the only Air Force that is larger in the entire world, is the official U.S. Air Force. Surely our government could spend less money on our military and more to aid the fight against mental and physical illness in the untied states. I agree a strong military is great protection however, we have gone overboard and lost focus on the people themselves. Many people suffering from mental illness are misunderstood and this often leads to mistreatment. I feel that our law enforcement and medical professionals should be better trained to understand and handle these patients. My mother works with adults suffering from severe mental illness and is trained to handle patents and also protect herself from patients twice her size and weight without hurting any patients at all. I would like to see that the law enforcement handle patients with a better approach and understand what accommodation’s they require. The police are meant to enforce laws properly and serve and protect everyone, if everyone is different including many of the social problems we’ve discussed, is it not the responsibility of the officers to understand who they’re “serving and protecting.”
Student 2: Nicholas
Elyn Saks is Associate Dean and Orrin B. Evans Professor of Law, Psychology, and Psychiatry and the Behavioral Sciences at the University of Southern California Gould Law School. She received her J.D. from Yale Law School and her Ph.D in psychoanalytic science from the New Center for Psychoanalysis. In the video A Tale of Mental Illness, Dr. Saks talks about her experience with schizophrenia.
She explains that as a child she was hospitalized and sought help for her mental illness on three separate occasions, but the worst started during her first semester of law school. She said that during this time she started portraying signs of word salad when she was working on homework assignments with her fellow students. This is a confused or unintelligible mixture of seemingly random words and phrases. Following this experience she stated that she began to shut out the world and sought solitude in her apartment. She said that during the middle of the day that her apartment would be completely dark because she closed all the curtains, thus blocking out all the light. She also stated that she began to experience delusions and hallucinations. Delusions are beliefs or altered reality that is persistently held despite evidence or agreement to the contrary. An example often used is thinking of oneself as God or being stalked by the government. Hallucinations, on the other hand, are perceptions of having seen, heard, touched, tasted, or smelled something that wasn’t actually there. In Dr. Saks case, she explained that she once thought that there was a knife-wielding person behind her. She goes on to tell that once she spoke about her problems to her colleagues, she was hospitalized and restrained. Eventually, she states that with proper psychiatric care, including psychotherapy four times a week, she was able to reasonably accommodate her mental illness.
Dr. Elyn Saks is very representative of people with schizophrenia in many ways. She experienced many of the symptoms most often associated with the disorder and it had a profound impact on her life. However, unlike many who deal with schizophrenia, Dr. Saks was eventually able to live a productive, albeit sometimes difficult, life. For those who are eventually able to live reasonably good lives, their experience is often similar to Dr. Saks. They have tremendous difficulty near the onset of the illness, but with proper attention they are able to deal with it. A good comparison is Nobel Prize laureate and mathematician John Nash. He had a similar experience as Dr. Saks, which is outlined in the movie A Beautiful Mind.
Returning to Dr. Saks mentioning of restraints, she speaks of them in a very negative manner. On this subject, I am very much in agreement with her, however I can understand why some medical professionals may believe they are necessary. In most cases, the mentally ill have no desire to hurt others, yet they may still unintentionally pose a threat to others, or more likely themselves. Imagine that a person is experiencing a delusion. They might believe that a friend, relative, or bystander is plotting to kill them or that the government (or some other entity) implanted a microchip under their skin. The person experiencing the delusions may attempt to preemptively stop the person they suspect of wanting to kill them or they may try to cut out the microchip that they believe is implanted under their skin. In these scenarios, the person poses a direct threat to others or themselves, even though their actions seem perfectly rational to themselves. Referencing the movie A Beautiful Mind again, while experiencing a hallucination, John Nash nearly allows his baby to drown in the bathtub. These are just some examples that justify the use of restraints. However, like I mentioned previously, I agree with Dr. Saks’ negative take on restraints. She says that not a single person that she has asked who has been restrained has said that they have been comforted by it. I think a middle road has to be taken when we address these situations. It needs to be one that prevents the person who poses a threat to themselves or others from completely losing their physical autonomy, yet it must still address the issue at hand. Maybe it could take the form of removing objects that the person could injure themselves with from the vicinity or monitoring them when around others. This is an issue that is difficult for me to find a solution to because I support maximum individual autonomy, yet I realize that in some cases an individual’s complete autonomy poses a direct threat to others, or possibly themselves.
On the topic of Dr. Elyn Saks being a case model for schizophrenia, I do not think that this would be a good idea. Even though Dr. Saks, at first, experienced schizophrenia like most, she eventually received treatment and is able to function quite well today. This is not the case for most people with schizophrenia. Many do not seek treatment, and in many cases, especially those experiencing paranoia, actively try to avoid it. They do not believe that there is anything wrong with them. It is only through a support network that people with schizophrenia can receive proper treatment. Dr. Saks goes to psychotherapy four times a week. Many with schizophrenia receive no therapy whatsoever. One of the reasons for this is cost and the question of how to fund psychiatric care arises.
This is also an issue that I am divided on, but one in which I think I can propose a reasonable solution. I ultimately believe that a private healthcare system, based on the market economy, will provide for the best doctors and medicine for patients, by stimulating the economy, and, in hand, research. Yet, I also realize that not everyone can afford private healthcare and these people should not be completely neglected. This is where I would suggest a public universal healthcare system. It would likely not be nearly as efficient or good as the private system, but it will at least provide some healthcare for the poor. Everyone would be covered by the universal healthcare system, but they would have the option to opt out of it in favor of private healthcare at a greater cost. The only pushback that I can see on this issue will likely come from fellow conservatives, who will say, why should those paying for private healthcare also have to pay into public universal healthcare. To argue this, I suppose I could compare it to something like roads and driveways. We all have to pay taxes that help to maintain roads that we all use, but when it comes to our driveways we are free to spend as much or as little as we would like for its upkeep, for our driveways only benefit ourselves.
Lastly, Dr. Saks discusses the criminalization of many psychiatric patients. I believe this happens because it appears to be the easiest way to deal with the problem, especially among the low socioeconomic levels. If someone is considered a hindrance on society’s smooth functioning, and they either do not seek treatment or can not afford treatment, then the easiest way to deal with them is to get rid of them. Locking them up may seem economically disadvantageous at first, but when considering the high costs of medical care and psychiatric therapy used to treat mental illness, the cost of housing these people in prison is not that much. And when addressing the question of how to reduce the number of these people who end up in prison, I believe, from a societal perspective, that the only way is to do exactly what society at-large is not doing. That is, provide them with medical, specifically psychiatric, care. But this takes us back to the issue of how to pay for treatment and who should receive it. Various ideologies will have very different opinions and no one will ever be truly correct, no matter what action or inaction is taken.
In conclusion, I would like to state my opinion on mental illness as a whole. While I believe that there is definitely an inconsistency with mainstream society, when it comes to those with mental illness, I do not believe that it is an actual illness. Typically, I tend to favor an evolutionary and/or biological approach when addressing social or psychological issues, however, on the topic of mental illness, while it may be able to be explained evolutionarily to a degree, I think that it is almost entirely a social construct and can not be adequately explained from the biological perspective. Now, I know that I argued in previous posts that the appeal to authority is a poor strategy to base an argument off of, but to simply provide some credibility, I have taken courses in general psychology, human growth and development psychology, adolescent psychology, abnormal psychology, and educational psychology, along with introduction to sociology, marriage and families sociology, and criminology. I am aware of the efforts of biological psychology and behavioral neuroscience, but I think these play a lesser role in explaining the observant behavior of individuals thought to be experiencing mental illness. So to explain my idea that mental illness is primarily, and almost entirely, a social construct, let us first look at religion.
I think that religion plays a very important role in people’s lives. But many characteristics and traditions commonly found in many religions could be equated to mental illness if viewed from a different perspective. Let’s take a Catholic monk, maybe a Fransican, for example. If this person were to say they talk with God or were to fast, both of which they commonly do, they would not be thought of as having a mental disorder. Yet, if someone who is not a Franciscan monk were to not eat or drink during times when food was otherwise abundant or were to talk to an entity that they could not systematically prove the existence of, they would likely be thought of as anorexic or schizophrenic. And we can use relatively the same comparison for multiple religions. For example, we could also use Muslims and Ramadan.
Furthermore, in society there exists a thin line between what is considered genius and what is considered insane. If a person proposes a new, revolutionary idea and it is generally accepted by society, he is a genius. However if a person proposes a new, revolutionary idea and it is not generally accepted by society, he is labeled as insane. And once one is labeled as insane, anything they say, no matter how rational they are, will always be considered insane. I will provide a link to a TED Talk on this subject below. Essentially, we are free to do whatever we please, so long as it is unimportant, but when something we want to do is important and may disrupt the status quo or the traditional way of thinking, we are no longer free. And one of the ways one loses freedom and power (that is their influence/control on others) is to be labeled as mentally ill, for reasons described above.