Again, the names, locations, and quotes relating to where I spent the latter half of February are fudged in order to protect identities. Since they have a policy of there being no photographic equipment being allowed on the ward to protect the privacy of the patients, I have to respect that.
During X-Men: First Class, one of the many accusing-sounding things that Mystique (Jennifer Lawrence) says to Professor X (James McAvoy) is that she guesses pets are always cuter when they are little. That, in a nutshell, sums up the reality for autistic or mentally ill adults in today’s “enlightened” society. They spend literally billions of dollars advertising initiatives to “help” the children or adolescents. Sometimes they even throw a dollar or two in the direction of those services or initiatives. And when the initiatives that were too ignorant or cash-strapped to use the right approach inevitably fail, it is the children and adolescents they were supposed to serve, who end up bearing the real cost. As the failure progresses and those children or adolescents become adults, the costs mount. And in cases of severe failure, such as the failure to properly diagnose an individual before their twenty-fifth birthday, the costs borne by the patient become so high that it makes the value of life very difficult to see.
Pets are always cuter when they are little.
Mind you, the Australian Silky Terrier that my mother adopted when I was in my early to mid teens, Doc, was cute from adoption to death. But anyone who knows anything about Silkies knows the reason for that. They are born little, and they only get slightly less little. But during the last years of his life, even Doc had to contend with losing some of his cuteness factor. After all, when a living creature stumbles about like an elderly drunk during a brief walk between rooms, one ceases to think how cute they are and starts to wonder if perhaps they should be put down.
Some Humans, like myself, often ask why they cannot just be put down. I think this really does illustrate the inhumanity Humans have toward one another. When we see an animal ailing so badly that we do not believe they can be saved, we try as gently as possible to put them out of their misery. Yes, cost and resources are also a factor, but we also tell ourselves that we are doing this because it is the right thing to do. The Humane thing to do, as we say.
We Humans make decisions on the behalf of other species all the time. A literal day in, day out thing, as it were. We decide what they should eat, what they should do with their time, and even when they should die. Sometimes those decisions are, so far as I am able to tell, good ones. Sometimes, not so much. People in positions of authority or power over other Human beings also make decisions on the behalf of those Human beings, and with great frequency at that.
One of the biggest problems with the authority to make decisions on the behalf of others is that it is like money. That is, when it does not circulate in some fashion, it stagnates. And unfortunately, this stagnation of power is very prevalent in the process by which decisions are made on behalf of the autistic and mentally ill.
It is incredibly difficult to communicate with mental health clinicians, especially when one dislikes them or feels their (the clinician’s, I mean) line of thought is in error. Part of the problem lies in the fact that how a patient sees themselves and how the clinician sees the patient are frequently two very different things.
Not helping matters at all is the fact that clinicians, especially the variety one meets in residential mental health facilities, are close to being right about their patients nine times out of ten. During my stay in one acute-care facility last month, I met close to three dozen different people. One behaved in a manner that strongly suggested he should have been in prison. One behaved in such a manner that I honestly thought drugs had relieved him of about fifty IQ points. And then the clinicians have to contend with the like of me. A wounded-puppy type character who wants to cooperate, but is so frightened that the clinicians will abuse their power that he has to be convinced at length of the value of their decisions.
As I said before, pets are cuter when they are little.
I likely have already mentioned that my visit to this acute-care facility was the result of communications between a friend and the mental health service in her residential area. Some, including herself, may have mistaken the repetition of this fact for resentment or anger. This is not true. Whilst the timing was not exactly convenient, stays in residential mental health care facilities rarely are.
I think a point that may have been lost in my previous writing on the subject is that critics of the existing mental health system seem to have created a straw-man of it in their minds in which it is an all-encompassing single-headed entity where one person can confine another on a whim. The reality is a polar opposite to this, and that is both a good and bad thing from opposed points of view.
The good thing is that getting into a residential mental health care facility as a patient is a bit difficult. One has to convince health professionals that they are, in the words clinicians generally use, a threat to themselves or others. There are short-cuts that one can use to convince a clinician of this, and you had better believe that the conversational part of my brain knows them all. But the manner in which one repeats them also makes a big difference. If you openly declare without any lead-in, for example, that you want to kill every living thing in a hick bum-fukk town within Queensland (like there is a distinction), then hick bum-fukk doctor will be filling out the paperwork so fast you will hardly have time to blink.
It should be noted that this is not a problem with Queensland doctors, per se. Doctors in hick bum-fukk towns everywhere react with panic to things that would not slightly faze their equivalents in places like New York. This is because clinicans in these hick bum-fukk towns often find themselves wanting for things to do, and if they are really, particularly the sort to fit in in such places, they generally will not have much experience of the rich variety of Humans out there. Often, the idea that someone could be forced into a “life” within their bum-fukk town or district and not be happy about it never even enters their mind. Clinicians within more populated areas, however, know that the old line about how the world does not move to the beat of just one drum is not merely a cool song lyric, but rather one of the most fundamental truths of the Human specie.
Getting back to the point, however, one reason why the nebulous nature of mental health clinicians and their decision-making system can be thought of as bad is that the decision-making process is slow, confused, and often contradictory. And Odin forbid you might have more complex needs than either category of clinician expects. Having diabetes, being autistic, and presenting with complicating (not to mention complicated) mental health issues is, to quote many folk I would not normally quote here, the pits.
So, a little while ago, I had a meeting with the doctor who was nominally “in charge” whilst I was in the hospital. This illustrates what I just mentioned, but in a different aspect. A big problem with dealing with multiple doctors who all confer to make decisions regarding your care is that not only do the doctors often have different ideas to their patients concerning what to do and why, they often have different ideas from one another. And their manner of dealing with a given patient varies from doctor to doctor.
The head doctor, as I will call him in future, mentioned Doctor Why in passing. And that just raised the spectre of how I tend to latch on to people I have positive experiences with, at least in a sensory-emotional manner of speaking. At least, I think it is a latching on to people that I have positive experiences with. It could just be that I am so starved for interaction with intelligent people that I will walk away from such conversations with the serotonin receptors in my brain going bananas. But really, it was more than just that with Doctor Why. Being able to tell someone why I was concerned, frightened, and behaving much like a mouse in a trap factory is a precious thing. Not just for me, but I think for many people with high intelligence but extremely low ability to bridge the gap that exists between us all.
The head doctor also said something that is very true, and has been getting a lot of press lately. Namely, we are more isolated than ever. Yes, the Internet has made it possible to talk with people from places we would otherwise know nothing about, but at the same time, it encourages us to sit at home and speak through proxies to these people. Only rarely do we get off our computers and actually meet the people we exchange so many words with, unless we are lucky enough to connect with people who live in our localities. And even then, getting such folk to turn up to gatherings can be a challenge.
Truthfully, I was frightened during the whole appointment. Although there are supposed to be rules and procedures in place to make certain that a doctor cannot simply snap their fingers and have a patient confined to a hospital, the truth is that the process is not very transparent. A health professional can simply have a conversation with a health service in one area, and the police can turn up to a “patient”‘s door in another area, all without the patient ever having even been spoken to. Not that I am complaining, at least not to the person who made the calls, but in case I did not already make this clear, frightening the patient is not a very productive thing to do.
Again, pets are always cuter when they are little.
I think I may have, at long last, solved the mystery of the mechanism by which institutionalisation works. You see, people do not become institutionalised by dependence upon the walls of the institution. Rather, the abuse and disenfranchisement people experience outside of the institution sends them wanting to go back. The expectation of abuse and disenfrachisement upon release also plays into the development of institutionalisation. Our hospitals designed for the mentally ill are, in fact, a good example of this. The majority of mentally ill individuals who do spend any time in them (a fifth of a fifth, as the statistics go) find a very different environment inside compared to outside.
This begs a question that norms often fail to understand. Or rather, it begs a pair of questions that norms often fail to understand. What does one find on the inside of a mental hospital? And how, exactly, does it differ from what is found in the confines of the outside world? Although we would need to ask tens of thousands of patients in order to arrive at a definitive answer, I will offer my version of the answer.
Now, you have to understand something. Visits to acute care facilities in mental hospitals progress in stages. There is the antagonistic stage, in which the patient has been yanked out of his normal day to day rhythm and is generally pissed off about the disruption to his affairs that has not only already happened, but he expects to continue for a while going forward. Then there is the negotiation stage, in which the patient tries to have a productive talk with the staff that make the decisions in terms of how long he will be staying or what will happen to him during that time. Next comes the compliance stage, in which the patient generally complies with the directives the treating doctor issues, at least as far as he can hold them to be well-intended. This stage is complicated, and deserves explanations of its own. Finally, there is the toxic stage, in which the patient begins to feel that the environment of the ward, members of its staff, or perhaps even other patients, are having a toxic effect.
Let me tell you a little something that should be readily obvious to intelligent people about being transported to a mental hospital. It is frightening. As I said, the patient often has their own life and affairs that they want to keep in some form of order. It might be focused on some trivial aspect such as the progress of one’s social group in World Of Warcraft or the state of the milk in the refrigerator. But when one feels anxiety and fear, combined with a powerful amplification of focus upon one’s everyday life, one is going to feel antagonistic towards the people who have brought them to the ward, or people who can be taken as representatives thereof.
Negotiating with the people who are in charge is a process in and of itself. And it is exactly that: negotiating. I have previously spoken of patients who are not merely antagonistic toward staff and other patients, but patients who have somehow done something to their own brains that make them less capable of negotiating with the rest of the world. If you have read the previous article I wrote of this matter, then you know the one I am talking about. Whilst I was incredibly angry and annoyed with him, I also cannot help but feel a certain pity. If I had to go through the rest of my life looking at the world through the kind of eyes he seemed to have, well, let me just say that I would rather be shot dead by the police.
All of this is a way of saying that one’s intelligence has a way of tilting the negotiation stage. I have no doubt whatsoever that when I originally sat down with Doctor Why and began to argue with her about what medications she wanted me to take and why, she spotted me for what I was. That is, someone clever enough to earn a degree, but having been set back by an almost unbroken string of hard luck. And that is part of the problem with having the doctor one gets assigned being a matter of pot luck. I am not sure exactly how the process of doctor allocation works. I am sure it has something to do with the caseload that the doctor has when patients come in.
Now, I know this is going to sound a little arrogant, but I have crossed paths with some patently stupid doctors in my lifetime. Ones who have only “earned” the PhD. necessary to be in their position through family wealth and power.
It probably comes as a surprise to some idealists, but the children of doctors and lawyers are the ones who are most likely to get through the intense schooling it takes to become a doctor or lawyer. I am unaware of what the requirements are to become a lawyer, but medicine entails the best part of a decade in tertiary education. Becoming a psychiatrist entails even more. Whilst there is less weighting of such professions toward the rich in Australia than is the case in America, it still exists. So when someone tells me that the holder of a PhD. has earned it through persistence and merit alone, it is as much as I can do to not mockingly laugh. Yes, it is possible to earn a PhD. when one is in desperate poverty, but the odds of accomplishing this are slim.
So when I say that I feel I could have gone into one psychiatrist’s office with “I am autistic” tattooed into my forehead and have them pay it no mind, understand my full meaning here. Whilst a lot of normies who want to believe the pile of shit they call “common sense” is somehow superior to extensive study and intelligence, they often prove themselves completely wrong in the conclusions they reach. A good example is the “common sense” belief that people receiving welfare payments in order to make ends meet are simply “too lazy” to work. Mention the words “corporate welfare” to them, or show them study after study that demonstrates many welfare recipients (especially in America) to already be working and amongst the poorest members of society, and their eyes glaze over. “Common sense! Waaaaah!”. Common sense once dictated the Earth was flat and the sun revolved around it, you morons.
Common sense also dictated that a small boy who would randomly burst out with bizarre outbursts in class was just disruptive and did not want to do the work. One of these statements has a shred of truth to it. But not the kind that the common sense moron thinks. In one draft or version of one essay about neurotypical privilege, we are told that the neurotypical (note that this is a different thing from what I call a “normie” in a voice that would impress Michael Ironside) has no fear of being forced to work on things that they are painfully bad at at the expense of things they are good at and enjoy doing.
I would pretend I hate breaking this to the knuckleheads who think television shows like Big Stereotype Theory represent the autistic in any manner (they do not), but here is a fun little fact. I hate mathematics. I never had any interest in it, and found it so difficult to learn that verifiable head-pain occurred during attempts to solve exercises. Even today, at my age, when confronted with long strings of numbers to add together (such as times for television series on BD), I not only need a calculator to add the columns together. I also frequently lose track of which number in each individual column I am up to. This also confounds people who depend on autism stereotypes in a big way. Why? Well, again, it is similar to a common stereotype about black people and how they interact with the world. Not every black individual cares to listen to whatever the commercialists call rap nowadays, nor do all of them find such things as The Cosby Show or whatever Will Smith is in this week edifying.
I am not going to pretend my hands are completely clean in terms of racist behaviour or speech. They are not. I doubt that any adult regardless of their race or nationality can do this without having lived their entire childhood and adolescence in a bubble. So it should not surprise anyone when I say that when I was originally being exposed to The Cosby Show as a little boy, I automatically assumed that black people in America, if not the world, were on board with this show that I began to feel increasingly awful about watching. I am sure you know how the rest of this statement goes.
Yet the so-called “geek culture” of today presumes, even outwardly states, that all autistic people are on board with them and the stereotypicality that they offer to the public at large. The thought that not every autistic adult collapses in a heap of orgasmic joy at the prospect of doing a mathematical or science test is one that never occurs to them. Or rather, if it does occur to them, they hide it for fear that it might invalidate their product.
A fact about racism, nuero-ism, or indeed many other -isms that people who campaign against them forget is that there is money tied up in them. As is said in Blade Runner, commerce is “our” goal. No, it is not the sole goal of the racist, neuro-ist, or other -ists, but the presence of commerce in what they do and how it influences them is something that bears a lot of thinking about. Autism Speaks sells merchandise not based on a desire to help the autistic, but rather on the basis of fear of the autistic. I am pretty sure that the Klan does similar based on fear amongst their diminishing audience of black individuals, too. That is why genuine education, not the mere perpetuation of stereotypes, is important in combating such purveyors of fear. Because nothing makes a person less (or in some cases more) frightening than knowing the relevant facts about them.
So having said all of that, it should come as no surprise to anyone that I believe simply protesting the actions of a group is not enough. As long as bad behaviour remains profitable in an immediate, short-term sense, all of the protests in the world will not change it.
I know not where the money comes from or goes where the Ku Klux Klan is concerned. At least one author I am in contact with suggests that there is police involvement with the Klan in America. To say that this infuriates but does not surprise me is an understatement. Whilst I am sure there are individual honest and integral police officers, the system as a whole can never be better than what the men paying them allow. And the people in the decision-making room today are some of the most evil, corrupt individuals to have been in this position.
What this all comes down to for the purposes of this article is that the mental health system is very severely shackled in terms of what it can or cannot do for patients. Especially patients with unusual or complex needs like myself. The extent of the corruption in our society in this matter is amazing to behold. As I have written previously, the governments in this country love to put up campaign posters everywhere proclaiming a bright, healthy, shiny attitude towards mental health issues. But when an individual finds themselves in need of the more intensive aspects of the mental health system, they discover a very unfortunate reality. Namely, that as long as Ma and Pa Kettle do not see what the situation is really like, the government could not give a shit about what happens to them.
Do I know what the solution to the problem is? Well, in general terms, yes. Probably more importantly than anything else, governments all over the world have to stop excusing the rich from paying their bills. Even having to say that flabbergasts me. It is not as if people who are wealthy and deserve to be through playing the breaks in the right ways cannot afford to pay their bills. And if there is a rich person who genuinely cannot afford to pay for the armed services, roads, and health services that they make use of, then they have no business being rich in the first place. So the first order of business should be cracking down and making the rich pay for what they use at minimum. The amount of welfare paid to rich folk and their corporations in a year could easily fund the building of new mental health care facilities and the renovation of existing ones.
In terms of smaller, more direct steps, however, I have not a clue. As the population continues to expand whilst the relative number of clinicians stays static or even declines, obviously something needs to be done to address that. We need less of the kinds of doctor I am used to seeing, and more like the one I refer to as Doctor Why. And I do not merely say that because I felt high after almost every conference with her. The big difference is that she listened to my descriptions of what the problem was and did something to help solve what part of them she could. Pretty much every patient in the modern system finds that a dream come true.
But most especially, and this is a problem across the board, we need our services to recognise that social problems like mental health and autistic spectrum disorders do not just magically evaporate when the individual reaches adulthood. We need people like our health ministers to understand that not only do these problems not go away when ignored for long enough, they have shown a remarkable tendency to get worse.
But then again, I guess pets are always cuter when they are little. Right?
Not much to say on the actual content as I am in a very bad place myself at the moment, in danger of ending up in a mental health ward myself and cannot think straight. Only reason I am not in one already is because of the disruption it would cause my daughter. Currently have home treatment team visiting every day. Would quite like to be put down.
I had a lot of reasons that I did not wish to go to hospital, myself. None are as compelling as the disruption you cite for your daughter. But perhaps it is worth considering whether the disruption will be worth it. Although certain information has come to light that irks me a little, I still think that the combination of Fluoxetine and Quetiapine has made most things a lot easier for me to deal with. But then, as I believe I have indicated, I also got very, very lucky.
Seems like I’m going to get to stay out of hospital. Home Treatment are going to be keeping an eye on me at the weekend which is when I am most at risk of harming myself (as my daughter will not be here). I suppose, too, that they only have limited resources and can only take in the most at risk patients and as I have managed to control my self destructive urges – but the are still there, gods are they still there – since my trip to A&E, I am not one of the most at risk.
I am glad the medication is helping you. I am on a similar combination – Venlafaxine and Quetiapine. The Venlafaxine, I am not sure if it helps. I have been on various anti-depressants pretty much my entire adult life so it is really hard to know if they are having an affect. The Quetiapine definitely helps though, and I suspect my dosage will be put up next week.
Sometimes, staying out of the hospital is a good thing. As I have said indirectly, hospitals can be very toxic places for people who are not really in need of them or have things in real life to attend to. Truthfully, I am a bit amazed that they have not thrown you in an acute-care ward already. Perhaps the resource shortage is even worse there than it is here (which would not surprise me, given the relative populations of the countries we live in). Exactly how do they assess the level of risk?
I must admit, I have never heard of Venlafaxine. Sounds like a new one. *looks it up* Ah, okay. Yeah, I know that one more by its brand name. Truthfully, I do not know if any of them really help much. I find that writing is a lot more difficult when on the combination of Fluoxetine and Quetiapine. It is as if some sense of where to put what word in what place on what page goes away when I am taking them. Perhaps I should look into another hobby.
I just ran across your blog frm a link on another post. As someone who has battled depression on and off for about 40 years, your description of the mental health system in Australia, (I am assuming that is where you are based on some of what I read.) sure reminds me of my own experiences here in USA.
I do not have autism, but as a result of a head injury 3 years ago, it is a constant battle to get anything done on the outside world’s schedule. I have trouble with planning steps and most of all motivation. Most of the time, I would rather stay home, browse the internet and pet my dog.
I wish for you the best you can be. Your obvious intelligence shines through your writing like a beacon. I found myself identifying with your description of the different kinds of practitioners.
There are differences between here and the USA. Probably the most profound of which is that the USA has a user-pays system that seems to have been designed with the goal of driving people into poverty. There are other differences both big and small, but that is the one that causes me the most surprise when I read that the USA’s disabled populace has less poverty amongst it than Australia’s.
I do not have autism, either. I am autistic. There is a big distinction. That said, I truly believe that motivation in the present and expectation of reward generated by the past are joined at the hip. If people reward a person for going out and seeking the help they are told they need with stonewalling, abuse, and emotional let-down, getting them to go out and seek the help they are told they need in future will be that much harder.
Hmmm well, flattery will get you everywhere. No, all kidding aside, hopefully in another five hundred years when archaeologists dig this part of now up, they will know whether to laugh or cry. Lately, I certainly do not.