In the aftermath of the Virginia Tech shootings and the revelation that the culprit had been hospitalized in the past for profound depression, the conversation has turned to the various ways we treat mental illness. Some have called for draconian measures. Jill at Feministe provides this quote from someone named Beth:
If you ask me, if we are going to let these crazies run free, not forcing them to be institutionalized, then we need to goddamn well do a better job of protecting the public from them. There’s a reason why they used to be locked up, and it was to protect society. Virginia Tech totally dropped the goddamn ball with this guy; there’s no reason why they should have to educate dangerous people. I know, it’s all about wishy-washy liberal ideals–can’t deny someone with mental illness their “right†to a college education…
I have only occasionally touched on my own battles with mental illness. (See here, here, here, here).
I was first diagnosed with mental illness in college, back in the spring of 1987. After a very violent episode of “cutting”, I was placed on the first of what would be many “5150s”. A 5150 takes its name from the California code that allows 72-hour involuntary “holds” in locked psychiatric facilities for those who are considered a danger to themselves or others. I was 5150ed in April 1987, April 1990, June 1996 (two separate occasions) and June 1998. I was a voluntary admit in June 1989. It totals half-a-dozen stays in locked facilities. (My worst time of the year has always been spring; I tend to be at my lowest between the spring equinox and the summer solstice. I have many theories why, but this ain’t the time.)
I was lucky, so lucky: all the hospitals I was locked up in (both in Berkeley and Los Angeles) were private. They were good places, for the most part. In most I stayed only a few days, but in June 1996 (after two suicide attempts three weeks apart, the second nearly successful) I was placed on an “extended” fourteen-day hold. I talked about my various diagnoses in this post; as I said then I was usually described as having a heavy-duty case of “cluster B’ disorders: Narcissistic, Antisocial, and above all, Borderline Personality Disorder… Doctors frequently added phrases I remember vividly, like “with psychotic features or “prone to micro-psychotic episodes.”
At Feministe, a reader named Psyche wrote:
The real problem is that there aren’t really intermediate states between involuntary commitment (the experience of which, at least the way our mental health systems works now) is comparable to being arrested in terms of humiliation and unpleasantness. Perhaps worse in terms of the dehumanization and total loss of agency. And locked wards in mental hospitals, even the best ones that money can give you access to, are pretty much the last places you want to spend any time, especially if you’re a borderline functional person, you’re surrounded by people who are by and large incapable of sustained social interaction, in an environment with very few distractions, and with no privacy and no control over how you spend your time.
Well, yes and no. Mostly “no.” The locked wards I’ve been on (for, as I said, as long as a few weeks at a time) weren’t Club Med. But they weren’t prisons, either. I’ve spent time in five different locked facilities (I was only hospitalized in one place twice), and I was always thrilled to leave. But while I was there I generally felt safe, cared for. Each time I was locked up, it was after an episode where I had done something so self-destructive that it was obvious to me (and to everyone else) I couldn’t care for myself. Yes, these “psychotic episodes” were brief in my case; I was able to return to functioning (including working on a dissertation and teaching) within a short period of time after release. (I even wrote a paper in one psych ward.) Though I was fortunate in the sense that my illness was more episodic than chronic, I am also clear that all five of the locked wards on which I found myself were places where I got good, competent, even loving care.
I can still remember the faces of the various psych nurses who took care of me. I often ended up in the wards with physical injuries that needed attention (usually cuts or burns); once it seemed likely I had damaged my heart and my kidneys and my liver with one particularly nasty overdose that led to an extensive stay in the ICU before being “released” onto a 5150. (A whole lot of Ritalin and Anafranil and Klonipin, if you’re keeping tabs — quite a cocktail of about 100 pills. I’ve had my stomach pumped three times, and vomited up that charcoal stuff they give you another time or four.) The nurses who took care of me were sometimes loving, sometimes brisk, but always, always, they made me feel safe.
I ate a lot of fruit cocktail (always served in locked wards, it’s a staple.) I made moccasins in occupational therapy. I sat in community meetings with the paranoid schizophrenics and the bipolars in the full bloom of their manic episodes. I read back issues of Reader’s Digest and National Geographic. Two years apart, I watched England lose two heartbreaking matches (to Germany in Euro ’96 and Argentina in the ’98 World Cup); I was hospitalized for both. I was in a locked ward for Tiananmen Square in 1989, and watched the coverage of Khomeini’s funeral. (I was lucky — most of the wards had cable.) I read all of Davies’ “Deptford Trilogy”; even now, rereading it as I have a couple of times, it brings back those days. And oh my, did I smoke. I had my visitors load me up with packs of Parliaments and Marlboro Reds (and once, a few Djarums.) I haven’t smoked in years, but I puffed away with the best of them every time I went behind the locked doors.
I know I was lucky in many ways. I was a young white, not unattractive male with insurance. I was well-spoken and articulate, and tried always to be polite. (Once, when I was in restraints, I apologized profusely to the nurses who catheterized me, saying that I felt “dreadful” that they had to do this for me.) I was also obviously no danger to anyone other than myself. When I was in Northridge Hospital in 1998, I wandered the halls in Tigger slippers which the staff seemed to find cute and endearing. My illness often made me pathetic, but it rarely made me nasty when I was in the acute stages. (Outside the hospital, I could be very antisocial.)
I was lucky too, in a sense, that when I was “in an episode” my behavior was so bizarre and dangerous that I was instantly 5150ed. Had my illness been less obviously destructive, I might have resisted voluntary hospitalization (something I only consented to once). I know many people struggle with family members who refuse to seek help; I am so fortunate that my disease left me with no illusion that I could function or survive without treatment!
I am grateful that privacy laws kept my condition from Cal when I was an undergrad, UCLA when I was a grad student, and PCC when I was a professor. I can disclose my medical history now because I have been healthy for nigh on nine years, with little fear of the darkness returning. I am very concerned that the reaction to the Cho Seung-Hui situation may lead to calls to deprive those who seek treatment for mental illness of these basic and essential rights. What good would it have done to have me removed from school, fired from my teaching position, held longer than minimally necessary? Am I more of service here where I am or rotting in an institution? After eleven years and six hospitalizations, I might well have been considered a prime candidate for long-term commitment to a mental facility. Blessedly, the system allowed me to return to my life, to my family, to my duties as soon as I was able to do so. In my case, folks, the system really worked.
Medication, intensive therapy (including a couple years of analysis on a couch), growing older, and a Twelve Step program (or three): all of these played vital roles in my recovery. God’s grace allowed me to get still enough to make use of these tools. My story turned out very differently than that of Cho Seung-Hui. But if he is the face of where the system failed, let mine — for those who know me — be the face of where it worked.