There's a patron at the Starbucks I frequently write at who is schizophrenic. Judging purely from the state of his clothes I would guess that he's homeless (although it's certainly possible I'm wrong). Almost every day he comes in, buys himself a cup of coffee with his change and then sits at a table by himself and carries on an animated conversation (with himself). I don't know what the "voices in his head" are saying but apparently they are very entertaining. He never raises his voice but if you're at a nearby table it's easy to hear that his conversations always make him laugh and smile and at times I'm almost jealous of him. If I want to hang out with a friend I have to pick up the telephone and arrange a meeting. He on the other hand apparently carries his friends with him everywhere he goes. If he had access to Microsoft Word he could probably turn those voices into endearing characters who we could all enjoy.
I told this to a woman I met at a party who had just told me that she worked at a different Starbucks. She nodded and then said, "The Starbucks I work at has security so people like that never get in."
Note that I never said that this man harassed the other customers. I never said he hassled the staff. In fact what I did say was that he was a paying customer and that he was in good spirits. I also said he was schizophrenic and homeless and in this woman's mind as well as the minds of the vast majority of people all over the world (whether they admit it or not) that is enough of a reason to forbid him access to establishments where "civilized" people like to hang out.
The other day while I was at my standard Starbucks the man fell out of his chair. He just sort of tipped over and landed with a thud. He lay there stunned for a moment and then pulled himself together, righted his chair and sat down again. I was on the other side of the cafe but I noticed that no one near him asked if he was okay. No one said anything. They just stared at him and then returned to their coffee.
If I had fallen someone would have asked if I was okay.
It got me thinking of the time, several years ago now, that I took someone close to me to a psychiatric ward after he became suicidal. His suicidal impulses were brought on partially by extreme circumstances but mostly because of a psychiatric condition he had not fully gotten a handle on or been able to fully accept. When you take someone to the hospital so they can commit themselves (and he was going willingly) you don't go immediately to the psych ward. You go to registration. I went up to the woman at the desk and explained why we were there. The woman, who was extraordinarily solicitous and kind...to me, directed me to a seat and gave me some forms. She did not direct the man I had taken with me to a seat. She did not say hello to him. She offered me a glass of water and a huge comforting smile. But the guy who was to actually become a patient...well it was like she was willing him into invisibility.
The man I had brought to the hospital was suicidal but he wasn't stupid nor was he incoherent. In fact he's fairly brilliant and he was, at that moment, very calm. "She doesn't think I can fill the forms out for myself," he said under his breath as he took a seat next to me. "She's not even treating me with the respect you would show a five year old."
If this is how people with psychological conditions are treated at the hospital why would anyone reach out for help? Why would they accept a diagnosis that would ostracize them from the rest of the world? Those who clearly have a psychological disorder, like my buddy at Starbucks, are treated like lepers. Those who have psychological disorders that manifest themselves in more subtle ways are treated like high-maintenece freaks who always get what's coming to them. If someone comes out and admits to having heart disease or AIDS we don't roll our eyes and tell them to pull themselves up by their own bootstraps. When someone tells us they have cancer we don't get angry at them when the symptoms of their illness overwhelms them and affects their behavior. That's not to say that we should shrug our shoulders and smile when a loved one fighting diabetes binges on chocolate cake and tosses their medication out the window. In fact if we saw someone we cared about behaving that way we would probably get angry and demand that they put the fork down and get their butt to a pharmacy and/or doctor. But with the mentally ill we rarely demand that they get help. We're much more likely to tell them to just pull themselves together, get angry when they don't and eventually become ambivalent and...well, will them into invisibility.
I have seen both friends and family members self destruct. Once I've tried and failed several times to get them on the path of recovery I have walked away. It is, of course, important to know the difference between being tenacious and beating your head against a brick wall. Plus truly self-destructive people are like suicide bombers. They blow themselves up and everybody around them gets hit with the shrapnel. I'm compassionate but I'm no martyr and I won't be an enabler. Still, before I walk away I TRY. I try to help them get over the shame they feel for having demons or an illness. I try to get them to accept their situation so they can deal with it. But I am one voice trying to be heard over the collective screams of a society who would have these individuals believe that their demons are their own personal failings. That any admission of a psychiatric condition will be used by others to define them as human beings.
I think that more people WOULD get help if we all bothered to ask the homeless man if he's okay after he falls down. I think more people would choose an option other than self-destruction if the receptionist at the hospital didn't treat those with psychiatric conditions like lepers. I think if we didn't immediately back away and avert our eyes when someone confesses to having a psychological disorder more people would seek treatment and if they did more resources would be assigned to finding newer and better treatments. That's just supply and demand. But we live in a world that is trying to squash that demand to the peril of a huge portion of our population. I know there has been some improvements in our understanding and acceptance of psychological disorders, but we have such a long way to go.
We have to change our thinking about this. We can't withhold our compassion from those who need it most.
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