{"id":20212,"date":"2020-04-06T15:03:16","date_gmt":"2020-04-06T22:03:16","guid":{"rendered":"https:\/\/www.pbs.org\/independentlens\/?post_type=blog&p=20212"},"modified":"2023-09-06T15:54:26","modified_gmt":"2023-09-06T22:54:26","slug":"peer-support-complexity-of-mental-health","status":"publish","type":"blog","link":"https:\/\/dipsy.pbs.org\/independentlens\/blog\/peer-support-complexity-of-mental-health\/","title":{"rendered":"Peer Support and the Complexity of Mental Health"},"content":{"rendered":"

By Lennlee Keep<\/strong><\/p>\n

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The film <\/span>Bedlam<\/i><\/b><\/a> explores mental illness from the perspectives of physicians, politicians, parents, and patients themselves. The power of documentary film is that it generates conversations about more than what is on the screen. After I watched <\/span>Bedlam <\/span><\/i>the first time, I wanted to watch it again with my friend “Pete.” [We changed his name for privacy protection.] He’s a filmmaker and writer, and has been diagnosed with a mental illness.<\/span><\/p>\n

There is a very thin line between the personal and the political when you are talking about mental health. And I learned quickly that some words and phrases that are commonly used to describe mental health issues are not only incorrect but in some situations even weaponized. <\/span><\/p>\n

“The idea of mental illness has been highly politicized,” Pete told me. “For example, it was used against dissidents during the birth of communism in Soviet Russia. Soviets made up the diagnoses of \u2018slow schizophrenia\u2019, which meant that a person was schizophrenic but just hadn\u2019t shown all of the symptoms yet.\u00a0 Communists would use this \u2018mental illness\u2019 to put dissidents into asylums, The prevailing theory was that anyone who wasn\u2019t on board with Communism must have a mental problem. I mean, you\u2019d have to be crazy to not want to be a Communist, right?”<\/span><\/p>\n

\u201cSo calling someone \u2018mentally ill\u2019 wasn\u2019t just a way to describe them or their behavior, it was a weapon. That is a stark example, but overall, the idea of \u2018mental illness\u2019 is erroneous and not innocuous.”<\/span><\/p>\n

In addition to Pete\u2019s other work, he is also a <\/span>Peer Support Specialist<\/b>.\u00a0<\/span><\/p>\n

To be a peer support specialist, you have to have diagnosed mental health issues. Then you receive training to learn how to use your experience to assist others. As a result, Pete works with people to help define what their goals are, and build skills that will help them live the life they want, rather than focusing on changing behaviors.\u00a0<\/span><\/p>\n

Whatever their goal, he helps them create a plan which can include anything from medication to therapy to nutrition or meditation; it all depends on what they want. This model focuses more on quality of life, and also reinforces the very basic and human idea that people, regardless of their diagnosis have agency and control of their own lives.<\/span><\/p>\n

Early in <\/span>Bedlam, <\/span><\/i>we meet Johanna, a girl in her 20’s. She’s handcuffed to a chair in a psychiatric ward. She’s talking very quickly, and she’s not making a lot of sense to the people around her. She seems agitated and upset, or that\u2019s how I view it. Pete views this scene differently because he has been in Johanna’s shoes.\u00a0<\/span><\/p>\n

“I don’t know if this is what she’s experiencing, but I have had that feeling before, an intense speed of thought,” Pete told me. “In and of itself, it\u2019s not really a bad thing. It only becomes an issue when other people can\u2019t effectively communicate with you. That\u2019s when you end up where Johanna is.\u201d<\/span><\/p>\n

We then see that the doctors are going to give Johanna medication. Pete says, “Here is one thing that can really help both patients” — he doesn’t like that word either, but we have agreed to use it here for lack of a better one — “and the people who care about them. Personally, I have an advanced directive for my mental health care. When you are in an ER for psychiatric reasons, doctors and nurses are going to take action and the first is usually medication and then it might be restraint or isolation or any other number of things.” “I encourage the people I work with to have an advance directive.\u201d<\/pullquote><\/span><\/p>\n

“So when I am having speed of thought,” he continues, “I might be unable to articulate or remember that maybe a certain medication causes me to react badly, or that being restrained will cause me intense panic and make the situation worse. I encourage the people I work with to have an advance directive.”<\/span>
\n<\/span><\/p>\n

“There is a more thorough plan called a <\/span>WRAP<\/b> or the <\/span>Wellness Recovery Action Plan<\/b>, a personalized wellness and recovery system born out of and rooted in the principle of self-determination.\u00a0 WRAP\u00ae is a wellness and recovery approach that helps people realize their own patterns and articulate what they would want in case of a mental health emergency. They can share this plan with friends and loved ones before.\u00a0\u00a0<\/span><\/p>\n

“For example, I have a friend that if he suddenly starts sleeping only a few hours a night, he knows that might be a sign that something is up. Now it could be that he\u2019s bothered by something at work, or it might also be that his medication needs adjusting. But because of his plan, his wife knows that it\u2019s worth mentioning. It doesn’t mean she rushes him to the doctor or calls 911; it just means that something might be up, and it’s worth talking about to possibly avoid a larger problem.”\u00a0\u00a0<\/span><\/p>\n

So what is Pete’s diagnosis?\u00a0<\/span><\/p>\n

“Labels are really just fishing in the dark,” Pete says. “I know from my own experience that when doctors spend time trying to assign names to and treat behaviors it complicates everything and it sometimes pathologizes behaviors that may just be who the person is. But mental health is complicated. Most psychiatrists I know are really good people, they really want to help. They are in this for all the right reasons. I use medication, and, for the most part, it does make my life a little bit better.\u00a0<\/span><\/p>\n

“But in general, following only a medication model will not only fail many people, but the wrong medications can also make a person’s life much much worse.\u201d\u00a0<\/span>\u00a0<\/span><\/p>\n

NOTE: <\/b>**Pete and I have spent many hours digging deeper into other terminology that isn’t entirely correct. Ultimately, we agreed that, for the purposes of this article, I would use the term mental health. We only settled on phrasing because we lack the language to come up with a more suitable term. He spends a lot of time learning about and thinking about these issues, and I could spend years writing a thesis on it. We realized that I couldn’t fit all of his knowledge about this into this piece, but if you want to know more, he said to “start with reading <\/span>Foucault<\/b>.”\u00a0<\/span><\/p>\n

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BONUS:<\/strong><\/p>\n

Extra scene from Bedlam in which Richard Friedman, MD, director of psychopharmacology, Weill Cornell Medical Center, talks about the failings of drug treatment in our society, including how most studies are funded by pharmaceutical companies.<\/p>\n