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Connecticut Shooting

Can't believe the tragedy in Connecticut, yet at the same time it feels like this known tragedy that keeps repeating itself in different iterations. It makes me sick. It makes me sad. It makes me think a lot about mental health, and how that often plays into these events. I mean, gun control, yes please. Right now.

But also, as I went to sleep last night I thought about all the people I've worked with who have known homicidal ideation, and how when people are receiving mental health services, it's generally really clear who those people are, because the nature of their illness and the terror of these thoughts daylights them. Not always, but often. And it's not that social workers and the mental health system have a perfect way of keeping these people from taking that kind of action, especially since the level of mental health funding in this country is shockingly low, but they do receive extra attention and services, when they are known. Frex, I worked with one guy who all I had to do was make one phone call and the cops would show up and have him indefinitely institutionalized. I worked with another person who talked with me weekly about her voice that told her to hurt people, and we made weekly contracts that she would contact our agency if these desires grew more intense. Both times we did the tricky tight-wire act of granting people their maximum freedom while also looking out for society at large. In general, people who had violent and homicidal ideation felt terrible about it, and with help were able to actively work on not expressing. Our agency had a high success rate of taking in violent offenders and stopping their violence.

The problem is, one of a thousand problems, is that it can be really difficult to get someone mental health services up until the moment they have some kind of catastrophe in their life, because unless they are a danger to themselves, or others, or are gravely disabled, they will only receive services if they go along with it willingly. Imagine anyone paranoid and hearing voices. Guess who generally does not want psych drugs and social workers poking around in their lives? Add to that the stigma of mental illness, and everyone doing their best to not be labeled crazy, and a lot of families wait around for a tragedy to get services, and hope that it is contained and not too bad.

The other looming elephant in the room is a lack of funding, so parents and family are often expected to take care of their troubled family members when the level of care needed is much higher.

I don't know if the shooter was mentally ill. There are reports that he was known to be "deeply troubled" in his community. Who knows what this means, exactly. His actions sound like that of someone hearing command hallucinations or someone deeply psychotic and delusional, in that his victims, excepting his mother, weren't personal. That's just a guess.

Today I'm wondering what if his access to quality mental health had been a lot easier than his access to guns? There's nothing that could stop this kind of thing all the time, but what if our country started seriously working on systems that would reduce these horrific tragedies?

The Gamification of Me

I'm trying to stretch in all kinds of ways these days, and what I'm focusing on right now, particularly as I'm in a new city without a lot of friends, is to face the ever lame shyness that could really go away and I wouldn't miss it one bit. For those of you who aren't hip on the self-change research: it's really helpful to try to focus on one thing at a time, rather than everything that needs changing, at least when you are doing behavior modification. It's interesting to try to do it on myself, since as a mental health counselor I've used these tools lots with people who've been seeking change. Turns out, it's always more fun to be the one helping from the sidelines than actually doing the work. Shocking, I know.

So, anyway, my current strategy is borrowed from my friend Jeremy (who is a lover of video games). When he was last in a depressive rut, he created the game of Jeremy to play where he got points for doing healthy good things for himself.

The game of Katie, which has yet to be licensed or franchised, and which I suspect has an extremely limited audience, awards points for stepping out of her shell, frex going to scifi events and readings, commenting on people's blogs, talking to people in the park, and remembering to be friendly rather than withdrawn. I'm not sure if there are penalty points, or what rewards I get when I have enough accrued points. Something frozen and chocolate is a good guess. We'll see how it goes. There's a couple TED talks about the gamification of life which is sort of interesting to me and sort of infuriating, which is how I feel about most TED talks.

And, a note on shyness, which could also be called social anxiety: mine is strange, in that if I have a friend with me, someone who really knows me, I'm not shy at all. And I tend to like people and find them interesting and do okay in the thick of things, but have a hurdle ahead of time. Like stage fright, a bit. It's very historical and comes from some sad places, so that makes it interesting to try to change, I guess.

Jul. 21st, 2009

I'm going to a big BBQ today with lots of mentally ill people from all the different facilities at the company I work for. Santa Cruz county has events year round for MI people to hang out all together, and it creates some really nice community of people knowing and being able to see each other fairly regularly. Everyone who goes to these things works with people or has mental health issues.

In Seattle, where I last worked, we'd never do something like this. There were various events we'd all go to, but they were more likely to be town hall meetings for advocacy or integrated events with lots of mental health supporters from all walks of life.

My impulse is that the second way is less isolative and assumes that MI people have a place in society that isn't segregated from everyone else. But I also guess that when I'm at the picnic today most people will feel relaxed and happy, and not pressured in any way to prove their normalcy.

In some ways it shadows political discussion around integration vs separatism, and all the goods and bads both things bring, except none of the MI people involved here are choosing: folks above my pay-grade decide and plan these events, and people's choices are to go or not go, rather than about what they'd like to participate in.


I've been watching Mental, a new TV show that I'm fairly certain had the elevator pitch, "Like House, but in a psych ward." It is like House, except the shrink in charge has charm and whimsy, rather than anti-social traits and pain med addictions. Plus, he's super-fine.

It actually does the mentally ill characters fairly well. There are some major blunders: it seems to think that most mentally ill peeps, including aqua-phobics, have visual hallucinations, which are hella rare in reality. (Hella? Why yes, I have moved to California, why do you ask, dude?) But I can grant them creative license on that since they have to show it in television.

And generally, they treat the patients like they are people with an illness, rather than being swallowed up by the disease. They work hard, I think, at showing people's humanity -- even a schizophrenic guy in the first epi who seems so out there and violent to begin with.

The one place that's pure fantasy is the amount of time, leisure, and depth the docs have to work one on one with patients and investigate their psychiatric histories. And again, I don't mind that too much, because I would love to live in a world where that was true.

However, as someone who's worked in mental health for twelve years, and as someone who's mom was a psych RN for thirty years, it's really not a fair picture of what happens to people when they go to the hospital for psych reasons. Most people don't generally have a bunch of eager doctors who are trying to unravel the route of their illness. Most people's interactions with their psychiatrists are brief and end up with them being given large doses of meds--often injectables--that will hopefully quickly stabilize them because hospital beds are expensive. These interactions often feel alienating and scary to people. And it's not the fault of the psychiatrists, (some of whom are awesome and work way too hard, some of whom suck, like all people everywhere) but the whole structure of our crumbly crummy health care system.

Okay, end of rant. Mental is on Hulu. I'd recommend it. Have a good Sunday.


Katherine Sparrow

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