Cultural Survival Skills

Into The Darkness

She had walked about three miles in the dark and was lost for a time before she found my office. It was cold and sprinkling rain as she walked through the “wrong side of town” to seek my help. Her journey took her through tough streets where rapes, robberies and gang shootings happen all too often.

She was a very slight waif of a young woman and she hid in an over-sized hooded sweat shirt, her head and face were well recessed into the protection of that dark hood. She had withdrawn from the world around her.

I expressed my concern that she had walked at night through a dangerous area of our city. She said that she wasn’t afraid because when she “walks at night no one can see her”. She sat in my room with her head bent down and the hood making it impossible for me to see her face, unless I bent low from my chair to look into its recesses. There I saw an expressionless mask with wide eyes that gazed at the floor.

With my hearing aids on their highest setting, I strained to hear her voice. At times she made sense, but often she did not. She said that she wanted to get better and to be normal. She said that she used to cut herself and that she had tried suicide many times. She said that she had been in mental hospitals frequently and that she was afraid of those places.  She said that she is always nervous and can not come out of her house during the day and that she gets confused and scared and wants to feel better. At times she was whispering. I asked if she was hearing voices: She said “yes, but there are many voices talking at the same time and I can’t make out what they are saying”.

My heart sunk and I felt a little sick as I told the lady that she appeared to be suffering from schizophrenia. I said that I could not help her through counseling until she was on anti-psychotic medication. Her voice became louder and very firm as she stated that she was not crazy and did not need any medication: “I just needed someone to talk to”.

I tried to explain that it would be unethical for me to provide-long term counseling to her for a condition that required medication before counseling would be any benefit. I told her I could not participate in prolonging her illness that was harming her. She began to mumble about cutting herself and she fumbled in her purse for something: I was fearful she was looking for a knife.

It was a tattered intake form that she had meticulously filled out and brought to give to our receptionist. She continued to slouch within her hooded sweat shirt as she shuffled slowly from my office. She lingered near the reception desk for a time and finally walked out the front door into the dark, cold, and rainy night.

I normally do not loose sleep over my client’s problems. However, I did not sleep well that night and I cannot get visions of this poor and pathetic young woman of my mind.

Both the poor lady and I were caught in the results of a terrible mistake that America made following the discovery of anti-psychotic medications in the 1950’s. At that time close to six hundred thousand patients were confined in public mental institutions. The new anti-psychotic medications frequently ( but not always) helped to control the active symptoms of many forms of psychosis. However, the medications did not cure the conditions, which were prone to return when the patients encountered stressful conditions, and  with near certainty if they had stopped taking their medications.

During the 1960’s, in the name of “humane treatment of mental patients”, the U.S and other nations began the process of letting these patients out of hospitals. This process has been called deinstitutionalization. By the year 2001 there were less than 60,000 patients confined to mental hospitals on any one day. Also, strict patient’s rights laws were past by our federal government forbidding the hospitalization of mental patients against their will, unless they were a clear a danger to themselves or others. This led to the insane practice of letting severely mentally ill citizens being given the choice to be hospitalized or not.  In other words, people who were not in contact with reality were (and are) being asked if they think they need to be hospitalized: tragically their answer is very often: No!

This has led to the increase in the social horrors which we all plainly see, such as mass murders in our schools, or killings and attempted killings of high profile entertainers and even U.S. presidents and others, by people who are very severely mentally ill.

Just as painful to see,  are the severely mentally ill who are cold and starving in the streets, who seek shelter under bridges and train trestles, or in boxes and other make-shift shelters all over America.

I will never forget a documentary I watched showing mental health workers putting sandwiches on a bench in a city park hoping that a starving psychotic man, who thought people were trying to poison him, would finally eat. As often is the case, the man ran away from them and would not talk to them. No one had the power take him to a safe environment where he could have been medicated, and cared for. My perception was of a cultural practice, which is as psychotic as the starving man who though it was t“trying to poison” him.

One final thought. The psychotic woman who I could not help and who walked out into the darkness from my office, had told me she had two children.

Think about this: schizophrenia is a biogentically-based mental disease that is heritable. After deinstitutionalization in America, the reproductive rate of schizophrenics came to approximate that of the rest of the population. Therefore, we should realize that serious mental illness has been growing in proportion within our population. This sector of our population has exponentially increased America’s homelessness problem. Furthermore, the children of schizophrenics are at greater risk of that and other psychological disorders.  

The truth is that there is nothing humane about the way we treat hour severely mentally ill citizens–and/or their children. I see our treatment of these suffering people as being negligent and abusive and I see the true motive for this abuse as being financial in nature. Deinstitutionalization saves money in the short-term, pure and simple.

This is another example of America’s short-term avoidance of short-term expenses and trouble, at the expense of long-term self-abusive and destructive outcomes.

V. Thomas Mawhinney, 10/30/09, now 3/6/20

P.S. I am republishing this writing now, in 2020, as countless hundreds of thousands of people are living in boxes and make-shift tents on the streets of America’s formerly great and beautiful cities, now bastions of grotesquely liberal-leftist administrations.

It is estimated that there are approximately 500,000 thousand of people in America homeless each night. How many are actually living on the our streets is very hard to estimate.