Wednesday, 11 November 2009

Just because you believe something

does not make it right. I think I must be wrong a great deal of the time. Why? People keep arguing with me. They tell me I am wrong.
Take yesterday and that 'phone call. There were the dreaded words spoken with such enthusiasm, "Cat, we are going to have a meeting. You have to come." I do? I listen. After, almost thirty years there is still intense enthusiasm for "the cause".
"The cause" in this case is the deinstitutionalisation of the mentally ill. The voice at the other end of the 'phone fervently believes that no person with a mental illness should ever be institutionalised. "Care in the community" is her mantra. Nothing else will do.
I have to move carefully here. We are not on the same side of the fence. I believe there is a place for institutions. By that I do not mean there is a place for the old type of regimented institution which did not provide for individuality or personal space and did provide far too many opportunities for abuse. Unfortunately my caller believes that all institutions are like that and that no institution can ever replace "care in the community". She is right and I am wrong. I must be wrong. How could I possibly be right? She has invested thirty years of her life in this cause, ever since her twin sister committed suicide inside an institution.
I do understand 'where she is coming from'. Nothing else matters to her. Nothing is going to change her beliefs or her opinions. She is like the most fundamental religious fanatic. She is highly articulate.
Politicians listen to her. They listen because it is a mesage they want to hear. "Care in the community" is the cheap option. All too often the mentally ill are incapable of speaking for themselves. That means it is easy to keep services to a minimum. If they are mad but not bad then let them wander the streets. It is cheaper and, hey, we are doing what people want. We are keeping people out of institutions.
I want to tell my caller that I believe there are people who need to be institutionalised. They will feel safer and more secure in a place they can call their own, where someone else makes the decisions they find so frightening and encourages them to make decisions about the little things - like which t-shirt to wear today. They will feel they have achieved something if they produce a piece of artwork or plant a seedling or manage to actually voluntarily say something.
One of the local 'residences' which provides 'care in the community' sends the six residents out at eight in the morning and tells them to return at five in the afternoon. After that they are not supposed to go out until eight the following morning. It is their home but they cannot stay in the residence during the day.
Currently we are having a spell of very, very hot weather. One of the residents is incapable of buying as much as a drink. His mental illness is such that he will not go into a shop. The little money in his pocket means nothing to him. He does not understand what it is for. One of the other residents watches out for him after her own fashion. She will silently get two large bottles of soft drink in the supermarket, one for him and one for herself. They spend the rest of the day sitting in the same spot in the park. When one of the local businesses closes at five o'clock they know it is time to go 'home'. This is 'care in the community'. Now, I may be wrong, but I believe that an 'institution' with air-conditioning and activities is preferable.
Yesterday the girl was not there. The boy was on his own in the park. He did not have anything with him, not even water. "Time to get a drink" I told him. He looked blankly at me. "It is hot. You will need a drink." He followed me. I bought a bottle of the brand he seems to prefer. He understood enough to hand me some money. I gave him the bottle and the ten cents change and he went off without a backward look. I have no idea whether he understood or not. This morning I have just seen both of them walking off for another long day in the park.
It is not my responsibility - and yet it is.


Redleg said...

I concur, even from a world away. There are some mentally ill people who thrive in jail, even though jail is not where society should want them to be thriving. They might thrive in the military, too, if they were not mentally ill. Their illness might not be crippling if they had a little discipline to lift the pressure of everyday life. Certainly you don't want an institution where lobotomies are routine and electroshock is punishment, but do places like that even really exist anymore?

catdownunder said...

Not in this country but it seems we still do not care.

Rachel Fenton said...

Mental illness gives the (false) impression that this is just one thing which can or cannot be dealt with by an institution. Care in the community may cost money but not as much as giving each person an individually tailored health care plan which incoorporates the best living arrangements to suit each individual.