by Jack Bragen
As a disclaimer, I’d like to emphasize that this piece does not offer proven facts, but merely opinions based on my own experience. And in that respect, it’s not unlike most of my other work.
I collect my information and draw conclusions through seeing the details in Contra Costa County, where I live. It seems that social service systems, administered by counties, are not designed to make poor people into highly successful people. And at best guess, other counties in California are essentially the same.
The aims of the social services systems are to sustain people, to keep the peace, to keep costs down, and to prevent disruptions in the lives of the good working taxpayers.
The social services systems do provide help. But they’re not here to make you into a stellar achiever. They will provide varied levels of assistance, and in return for that you must give them information, and you must submit to various types of controls.
The first things the county wants are your personal information and history. When they have all of your data, they can fit you into one of their categories of people with varying needs. For example, there is the category of people in and out of jail, involved with drugs, violence and other crime. There is the category of disabled people unable to take care of themselves, who need many services. There is the category of the working poor. And there are several other categories. I don’t know them all. But it seems to me that the counties definitely want to put people in categories.
What we sort of have is like a caste system, one in which you’re at a certain level or in a certain category, and it can be very hard to climb any higher than that. In some instances, I have been on the verge of success, and at that point, services are withdrawn under the premise I don’t need the help anymore. At that point it becomes very hard not to backslide.
The treatment system for mentally ill people seems to have ways of pulling me back in. I might be successful up to a point, and then something happens to me, and it screws everything up, and I become desperate for more help. This results in more services but also more restrictions and becoming more encumbered by the help I’m getting.
My mental health condition is enough to keep me coming back. I periodically get flare ups of my mental health symptoms, and I need more help during those times. The services I’m getting are a big help with these periodic flare ups.
My housing and income are mostly subsidized by the government. In return for this, I need to stay out of trouble, document my earnings, and continue my mental health treatment, which includes medication and counseling. I’m not being substantially helped to improve my life circumstances. But so far, I haven’t been kicked out onto the street either. I hope it remains that way. I would like something better. But the systems don’t provide that.
It amounts to this: The system can only do so much, and if I want things to be better, it is up to me.
People experiencing poverty and living with a disability frequently jump through hoops to obtain income and housing. Periodically we must prove our need by completing paperwork and examinations.
That’s not to say that the county government is staffed by horrible people: Many are here to help. Some might get too complacent, concerned mostly about collecting their paychecks while not working too hard.
Nineteenth century politician Robert G. Ingersoll once wrote of Abraham Lincoln—to whom many mistakenly credit the quote—”Nearly all men can stand the test of adversity, but if you really want to test a man’s character, give him power.” Aside from the misattribution and highly gendered language, that point should be well taken.
I have seen police officers abuse their power. In the distant past I’ve seen people in the helping professions abuse their positions. Currently I’m working with a mental health agency staffed with very dedicated and good people.
Here’s what scares me: If I were to have a relapse of acute symptoms of psychosis, it could damage my life circumstances and thereby could ruin my life. It isn’t safe to get sick. Once I’m not at the helm and not handling my personal responsibilities in a substantial manner, I fear that everything would turn around and I’d be in a hole that I couldn’t dig my way out of.
I find that it’s no longer safe to relapse. If you have a mental health condition and are not independently wealthy, you had better keep on top of that condition. When the staff of government agencies or nonprofits learn about someone’s relapse, they might “move in for the kill”—figuratively. This is where social workers can too easily disrupt and ruin other people’s lives, if only through pure error and carelessness!
A well-meaning caregiver came within a hair’s breadth of signing me up for the wrong service, and it could have ended up changing my category for the worse. Social service system workers might sometimes operate solely on the limited information available to them, and might not question an action that would inadvertently and improperly recategorize their clients.
From what I’ve seen, the mental health treatment system has not improved in the past thirty years. It looks like a depletion of voluntary services. I have also seen the disappearance of the mental health self-help movement in Contra Costa County. What happened?
The mental health survivor self-help movement hasn’t disappeared entirely. It seems to exist within the context of the written word such as the magazine called “Mad In America.” Also, yours truly writes about mental health.
And yet I don’t know any activists who are defiant against the mental health treatment systems. There might be valid reasons for this.
The modern “second generation antipsychotics,” according to one doctor, do more to block brain function than the older, “first generation antipsychotics.” If you are taking heavy doses of these newer drugs, it is likely you could be much more shut down, mentally, than with the earlier drugs.
The mental health treatment system has agendas other than your success in life; treatment systems don’t offer anything better for voluntary patients than they did thirty years ago; surviving as a disabled person is tough, and you periodically must prove you merit the benefits you get from the government; the consumer self-help movement is not what it was.
None of the above should make us happy. We might have to find alternative methods of getting the help that many of us are entitled to in pursuit of any life success.
Jack Bragen lives and writes in Martinez, California, and is author of “Instructions for Dealing with Schizophrenia: A Self-Help Manual,” as well as three fiction/science fiction collections.
