Thursday, February 12, 2009

Update from the frontlines of mental health...


Oh no! No medicaid! Drink yourself to stability!!!!!!!!!!
Well, so ends another day as a cog in the great machine of mental health servicing. I admit this is one of the most frustrating jobs that I have ever seen. I would almost rather push a boulder up a hill endlessly because at least there nothing is truly at stake.
I get the chance to see fascinating (depressing) phenomena manifest themselves everyday. An example if you please maestro! Have you ever had the chance to watch a child from the moment they take their medication up to and past the point where it takes hold? It is like watching the life drain out of someone! I am not kidding! The percentage of kids I see who are medicated is an amazingly round one (100% hooray). I admit I begin to wonder if taking add medications for study purposes (I of course do not actually KNOW anyone who does this) is simply a pyscho-somatic attempt to force oneself not be lazy! While most of the kids I know who take ADD meds do actually achieve more school work there is less of exhilarated sense of urgency as that of resignation. A light goes out in their eyes. I see the wisdome of thinkers (from Dewey on) who do not characterize the discharges of physical action in children as evil as just simply natural. The natural response to a boring/boorish situation. I am now surprised a the fact I do not defecate on my trig teacher for lack of something more interesting to do.
I am also begining to truly see the harm that notions that see the mind as distinct from the body has on the population at large. To fight over this fact with philosophers and neuroscientists is a moot point. It is like trying to argue FOR Lamarkian evolution these days. No one actually buys it but when you try to explain it to your average Joe on the Clapham Omnibus it makes perfect sense. And it is here, with this population that that people need to be disabused of the idea. I am reading a lot work about psychological trauma that expands our notions of how the traumatic experience and its manifestations in life are understood. One of the main contentions of this work is that not only do we still come up against stigmas of mental illness but the very way we conceptualize the symptoms of it are woefully inadequate. That we tend to ignore way in which this pain manifests itself in the corporeal body. That we tend to view natural discharges of emotion as signs of weakness, unintellible, not worth studying or even worse the product of an overactive imagination. The way we treat children stifles the ability to properly express our feelings this creating "cultural cages" which produce, promote, and sustain cognitive dissociation in a way that is ONLY found in captive animals. We assume that a lot of things we are do are in no way connected with our "mental state" because (unlike the weak Cartesian attempts to prove causality between the mental and physical) that the mental and the physical are simply discrete domains that are mutually exclusive. A problem in the mind is just that. Alas....
Then there is the part of this where the government gets involved. The amount of hoops, snares, paperwork, phonecalls, faxs, signatures, time, bullshit, redtape and hairpulling mental drainage required to get menial and necessary mental health services provided is one of the darker spectres of the "Welfare State." I have spent the last three weeks trying to get one kids medicaid turned back on (it expired because a simple form was turned in late) so that he can receive necessary therapy and medication (despite my moaning above some medication truly does contribute to an improvement in a great many people's quality of life). Of course, after days I did in fact get it back on line today but there are two kinds of medicaid for children in this state. If you are dirt poor you get type A: no copay. If you are not quite that poor you get B: a $10copay that would still bankrupt a lot of people when you consider that a school based therapist/para-professional will see a kid 5 days a week if such services are necessary. Of course my kid whose type was originally A got it turned back on and it is now B. The childs parent has of course lost his job due to having to leave so often to come up to school and see get his kid because he was out of control because he wasnt taking his meds because his medicaid had expired because a simple form was not turned in in a timely manner. This will of course result in the need for a "change form" which even if it was filled out and turned in tomorrow by hand (to avoid the lag time of mailing it) it woul still take a "minimum of 10 days maybe longer depending on the backlog" (quoteth the civil servant on the phone) to get fixed.
I of course believe in treatment with a guaranteed track record of therapuetic efficacy: Beer for me tonite!

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