An overwhelmingly vast majority of mental illness is organic in etiology. This means that most cases of mental illness have a basis in biology. The development of powerful anti-psychotic drugs virtually emptied the state-run mental hospitals where the "crazy" had been warehoused, locked away from society for decades. The 70's and 80's saw patients mainstreamed into society and moved from state hospitals to assisted living centers.
The people at risk due to mental illness are at risk of relapse and rehospitalization. And an unmentioned problem is that patients who have been controlled and on maintenance doses of medications for years - I am thinking specifically of schizophrenics and bi-polar patients here - are at risk of never regaining the ground they will certainly lose if they are without their medications for even a short period of time.
Mental illness is especially cruel. The victims are not readily discernible from the rest of us. They suffer from chemical and physiological differences in their brains. Depressives are easily treated by Selective Serotonin Reuptake Inhibitors (SSRI's) and schizophrenics are generally treatable with anti-psychotics. It was a huge stride toward mainstreaming when patients were able to return to homes and families, and when patients without that support network were able to move into assisted living facilities and group homes.
(My actual Bachelors Degree is in Neuro-Sciences. At the time I started my
course of study, it was still called Biological Psychology. When I was a
Junior, it became Physiological Psychology. By the time I graduated, it
was Neuro-Psychology. My vintage 1980-something degree is one of the first
to specify "Bachelor of Science in Neuro-Psychology." The next
year, the degree became a Bachelors of Science in Neuro-Physiology.
Eventually, about five years and three name-changes later, the degree became
Neuro-Sciences. )
I make my living in a hospital lab, but that is not where my passion lies. My passion lies in the physical structure of the human brain, and the electro-chemical interactions of the neural synapses. My passion does not rest in the "How does that make you feel?" branch of psychology. Frankly, I couldn't care less. I want to know what physically happens in your brain that makes you experience that feeling. I want to be able to repair damaged brain tissue. The mechanics and chemistry are more interesting to me than the expression of the disorders of affect. So I work, I volunteer with a community-based mental health program, and I go to school, chipping away toward the answers to the persistent questions that have dogged me for 20 years. (Why do some autistic children get lucid and communicative when they spike a temp? Why do some ADHD kids experience greater relief of sypmtoms using L-Tryptophan than Stratera or Ritalin? These are the kinds of questions that keep me awake when I am supposed to be sleeping.)
My goal in life is to offer these patients real, physiological-based treatments that will not require powerful, mind-numbing psychoactive drugs. But that is years away, and for now, psychoactive drugs are their best bet.
But boy, howdy, are these people easy to dismiss and overlook. They don't vote, they don't contribute to lobbyists, they don't work so they don't pay taxes, they don't attend fundraising dinners at three grand a plate. They exist. Out of sight and out of mind for most people.
Prior to "Part-D" these patients received Medicare and Medicaid. When Part-D kicked in on 01 January, their Medicaid coverage terminated. Many have been denied medication because they lack the ability to cover co-pays. Psychoactives have some nasty side effects that require more drugs to palliate. When a patient receives a cash allowance of $54.00 per month to cover all their hygiene and personal needs, and must pay a $3.00 co-pay on eight or nine different formulary medications, that doesn't leave much for personal expenses. Some drugs, such as Depakote and Abilify and Effexor are costing co-pays in excess of fifty dollars.
I did do the one thing that I had the ability to do, besides volunteeer at a free clinic. First I went to the "Check Cashing Place" and bought a $250.00 pre-paid Visa card. I then went to the Walgreens across the street and spoke to the pharmacy manager. I gave her the pre-paid Visa and told her to not turn anyone away without their psychotropics because they could not pay, make sure that everyone got a 10-day supply while the kinks were ironed out. And as for school, I am taking the spring semester off so I can volunteer more in the mental health clinic. The university will still be there in May, but there are patients with real and pressing needs that I can help now. And Spock said it best: The needs of the many outweight the needs of the one.
