25 – Who’s in Charge?

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Mr. J: “Hello, this is Mr. Johnson calling. Is this the director of the Crabcake County Mental Health agency?” 

Director: “Yes, sir. How can I help you?” 

Mr. J: “Well, it’s my daughter. She’s acting very erratically and doing all sorts of strange things. Ever since she stopped taking her psychiatric medication, she’s been really struggling.” 

Director: “Ah, I see. However, I regret to inform you that your daughter recently rescinded her permission for us to speak with her family. Since she’s 30 years old and a legal adult, that is her right. So, I can’t comment specifically about your daughter’s case. Sorry.” 

Mr. J: “So, my mentally ill daughter is in charge? You can’t work with her family to help her? Her mother is a physician and her brother is a psychologist. She’s a diagnosed schizophrenic. She had been doing great for over 10 years on her medication, but now, at 30 years old, she’s suddenly decided to completely stop her meds. She’s been off them for almost a year now, and’s been hospitalized four times for threatening other people, psychotic delusions, hearing voices, threatening suicide, breaking the law, you name it! On top of that, she thinks she’s perfectly fine, even though she’s sleeping in her car because she’s convinced there’s poison gas being pumped into her apartment due to some kind of secret government plot!” 

Director: “Yes, well, I understand your concern. However, unless she’s at imminent risk of harm to herself or others, we can’t hospitalize her again. Besides, the prior hospitalizations don’t seem to have been very effective.”

Mr. J: “Well, that’s because she stops taking her medication the minute she gets out, and there’s no enforced treatment plan to encourage her to continue! She’s fallen so far in such a short time! We’re talking about a college student with just a few more courses needed to graduate. When she was taking her meds, my daughter was a straight-A student, working part-time, and had a nice boyfriend. Now, she’s dropped out of college, lost her boyfriend, and can’t hold a job! She’s living in her car! She’s also taken to abusing alcohol, which she’s never done before, and’s been ‘date-raped’ by several men, which she refuses to report because she thinks the police are part of some secret government plot against her. What kind of a world do we live in where people with serious mental illness are allowed to live like wild animals in the street, and be taken advantage of by strangers?”

Director: “I am sorry, Mr. Johnson, but that’s just the way things are. There are thousands of people living in the streets, taking drugs, abusing alcohol, begging for money, and refusing any help from society. Many of them suffer from mental health challenges like your daughter. If they choose to live that way, then that’s their right as free human beings. We’re not here to judge. We can only help if we see imminent risk of harm accompanied by a mental health crisis. That’s just how the system works.” 

Mr. J: “Works? You mean how the system doesn’t work! So, you can’t help my daughter to help herself because the whole world is crazy?” 

Director: “Not without her permission, unless she’s at risk of imminent harm to herself or others.”

Mr. J: “But she’s not thinking properly! And by the time you decide she’s at ‘imminent risk’, she could either be dead or in jail!

Director: “Mr. Johnson, if we locked up everybody who’s not thinking properly, there wouldn’t be many of us left. There are millions of people who believe all sorts of strange things: secret government conspiracies, alien visitations, ghosts haunting their homes, strangers secretly plotting against them, the list goes on. We can only do so much. If they’re not at risk of imminent harm, then we must respect their freedom.” 

Mr. J: “Is living in a psychotic fantasy world really being free? Are you suggesting that most of humanity lives this way? In complete ignorance of reality? Stuck in a LaLaLand fantasy world?” 

Director: Mr. Johnson, I’m truly sorry. You seem quite agitated. Perhaps we could offer you a few psychotherapy sessions to help you deal with your frustration?

Mr. J: “Huh? Now I’m the patient?”

(awkward silence) 

Mr. J: “Hello. Are you still there?” 

Director: “Yes, sir, but I really must be going now. Have a nice day.”

(click) (sound of phone disconnecting) 

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