Mental Illness as an Issue of Diversity
By Maureen Murdock
Published in San Francisco Medicine, May/June 2006
Each culture has its own customs and language. We identify them by their dress, music, food, and rituals. The homeless mentally ill are no exception. They wear a variety of costumes— multiple coats, ragged jeans, shoes run down at the heel, funny hats. They tote a series of bags or push shopping carts. Some mutter, some yell expletives, some discourse endlessly on physics. But we don't usually take the time to look closely or listen to them because we don't want to know this particular diverse group.
I sit in my car as I wait for my son who is temporarily staying at a youth hostel at 6th and Minna Streets. He is officially homeless, having been evicted from his last apartment four months ago. He was diagnosed with bipolar illness eighteen years ago and struggles to find housing.
While I wait outside the building, I watch an assortment of homeless people, crack addicts, and prostitutes make their way down the street. A white man dressed in khaki Bermuda shorts and a sleeveless undershirt pushes his shopping cart with what I assume to be his worldly belongings across 6th street with great gusto. He averts his eyes from those who linger on the corner, looking aimless and lost. An African-American woman in a torn flowered housedress walks back and forth in front of my parked car muttering to herself. She tries to engage a Hispanic man sitting dejectedly in a doorway smoking his cigarette. She screams at him as he waves her away.
Estimates range widely as to what percentage of homeless people in the United States suffer from mental disorders but they are part of a diverse group we don't think of when we think of diversity. We include ethnicity, race, class, sexual orientation, age physical illness, and gender when we discuss diversity, but we don't usually take into account those who think differently, those who live in the terror that misfiring neurons inflict. We stigmatize them because they don't fit the expectations of our success-oriented society. Our society is bipolar: you either fit in it or you are on the street. And if you don't fit, it is your fault.
A person with a mental illness did not choose to have a brain disease. It is a biochemical disorder. There is so much fear and ignorance about mental illness that we think that the person who is mumbling in the middle of the street or sleeping in the doorway wants to live life that way. Or is too lazy to get a job; or did something so awful he deserves to suffer; or is "just an addict." In many cultures, a family member who suffers from mental illness is shunned or stigmatized. In my own family, my son's step-mother, who is Taiwanese, "does not believe in mental illness" and will not allow my son in her home. She does not want her own young son to be exposed to his erratic behavior.
Those who suffer from mental illness used to be hospitalized. Now they can only be legally held for "treatment" for 72 hours unless they are determined to be a "danger to themselves or to others." It doesn't matter that they may have no place to go when they are discharged, no one to monitor their medication, or that they are still unstable and confused. Our quest for individual rights in the 1980s resulted in the closing of our institutions that treated the mentally ill. At that time, advocates for the mentally ill considered these institutions to be warehouses, and many were, but at least patients were not subjected to the violence and drug use on the street. When asylum doors were unlocked, the patients were released to community-based treatment centers, which ultimately were not adequately funded to care for them. Since then, the severely mentally ill have been placed in nursing homes, abandoned to the streets, or criminalized and incarcerated in our prisons and jails. We do not have the interest in or funding to rehabilitate them.
Mental illness is a diversity issue. We have stigmatized, shunned, and excluded those who suffer from mental disorders just as we have done to other groups we considered to be "different," such as non-white racial groups and homosexuals. Mental illness is the last frontier to be explored and normalized. It is time to find ways to include those who suffer from a brain disorder in our society. Compassion and human dignity demands it.
Maureen Murdock, M.A., MFT is a depth psychotherapist in private practice in Santa Barbara. She was Chair and Core Faculty of the MA Counseling Psychology Program at Pacifica Graduate Institute in Santa Barbara and currently teaches in the Depth Psychology Program at Sonoma State University. She is the author of the best-selling book, The Heroine's Journey, as well as the newly revised Fathers' Daughters: Breaking the Ties that Bind; Unreliable Truth: On Memoir and Memory; Spinning Inward: Using Guided Imagery with Children; and The Heroine's Journey Workbook.