Friday, May 24, 2013

Amanda Bynes & The Mental Illness Conundrum

She's crazy.
She's a trainwreck.
She's a stoner.

She pierced her cheeks, crashed her car - twice - while driving drunk, wears awful blond wigs, Tweets bizarre statements, and retires-un-retires-retires from acting on a regular basis. Her neighbors complain about the pot smoke and smell constantly eminating from her apartment, and finally called the police when they found her rambling and stumbling in the hallway, stoned off her butt.

Why don't her parents do something? Why doesn't someone do something?

There is no law against being mentally ill - but there is a law that prevents someone to lock up or restrain or forceably commit another person to a mental health facility unless they are a danger to themselves or others. When she was arrested most recently, she was given a psych evaluation before being booked at the police station - so they thought she may be having a mental health crisis, but once it was determined she was not going to harm herself, they had to release her.

There are very good reasons for this - there was a not-too-distant past time when it was all too easy to commit a mentally ill person to a mental health facility - an "asylum" in antiquated terms - when they were not deemed to be fit to live in civil society. Those so-called asylums were anything but - they were often no more than warehouses for the mentally ill and those with profound physical or emotional disabilities, or mental retardation.

Many people with mental illness do not know they are mentally ill. It slowly creeps up on them, and builds up in such a way that it's not evident to them they are ill. There are no red splotches on their foreheads that let a family member or friend say "Uh oh, Amanda, you seem to be coming down with a case of szchizophrenia or bi-polar...". I can only imagine it's worse with celebrities, who are already often eccentric by nature, or made that way by the bubble they live in.

When they feel out of control, they may  try to self-medicate.
How would you self-medicate? Alcohol and drugs....
Pot quiets the disturbing thoughts and the voices in their heads.

As someone close to several people dealing with a variety of mental illnesses, it saddens me that she will eventually be diagnosed and get help, and will have to look back at the social media trail of destruction in her wake, look around and ask herself the same thing the general public is asking every time she posts a strange selfie, or is caught rambling non-sensically on a streetcorner...

"Why didn't someone do something?"

The answer is complicated. It has to do with free will, government non-interference in our private lives, and the challenge of convincing someone with a problem that they in fact have a problem they don't think they have. It has nothing to do with how much her parents love her, or how badly she needs help.

We don't want the government dictating how we live our lives or keeping track of our medical history, but we see someone in crisis like she is, or like Britney Spears was, and our hearts want someone to do something. I feel that way too. 

The question is: Who gets to decide where the line gets drawn?

California disability rights activists in the 1960's, from what I can find, appear to be the source of the modern legislation attempting to ensure humane treatment of the mentally ill. The Conservatorship law that governs Britney Spears life was conceived and passed by California state assemblymen, and is described here: http://www.calhospital.org/overview/lanterman-petris-short-lps-act.

It seems this is also where the rumor circulating since I was a child that Reagan 'kicked people out of the mental hospitals in the 80's' comes from... He was Governor of California and passed the legislation reforming the mental health system in the 60's - not as president in the 80's. And that was bi-partisan legislation, by the way. Another example of a good idea executed poorly, to disasterous results.

It was a perfect storm. The ACLU provided the lawyers for the original cases that were the genesis of many changes and legislation - advocated that the definition of someone being able to take care of themselves should mean able to bathe, dress, and feed ones self, versus the more traditional definition of being able to obtain food and shelter and financial livlihood. But the half-way homes and community support services that were supposed to simutaneously arise to support the people who were not ill enough to be institutionalized, but were not well enough to live indepdendently, never materialized. Most of those people ended up as homeless on the streets as a result.

So Amanda Bynes bizarre behavior is very likely due to the onset of mental illness in her early 20's - the most common time for the emergence of several common mental illnesses, by the way. And the good intentions of both the Left and the Right in the 1960's to change the way mentally ill citizens interact with the healthcare system have created an impossibility to help those closest to her to help her.

In the end, it's a draw....
Should we provide support to those in crisis? Yes.
Should we protect the rights of individuals? Yes.

Meanwhile, people like Bynes are trapped in the midst of this philosophical tug of war.
I don't have an answer, but we have to keep asking the question.



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