Psychiatric Patients are NOT Mentally Ill Monsters

I will admit that I have spent the last three years rather displaced from current events, especially in regard to politics, as I have let medicine consume my life. However, when politicians begin broadcasting televised statements that have the potential to harm the patients I feel for most deeply, I have to pull my head out of the sand and pay attention. The stigma that surrounds mental health has been a constant barrier for patients who could benefit greatly from treatment. I can’t ignore the progress that has been made in recent years with the increased awareness and emphasis on the importance of mental health, but what I have seen in the news lately takes us many steps back.

Various online publications are citing studies and calling out the inaccuracies (Times, The Washington Post, The Hill) publicized by President Trump. I’ve read sources sharing the response from the American Psychiatric Association (APA), opposing the horrendous and flat out wrong remarks made by him in relation to mental illness. I’m glad that there is an attempt being made to set the record straight about the president’s audacious remarks, unfortunately the reach is not broad enough. Why does this man, with no medical background whatsoever, get to have the loudest voice on a topic so far removed from his area of “expertise”? Why aren’t psychiatrists and psychologists taking interviews on national television to share their views on the mass shooting epidemic? What station can people turn to, to see opinion from true experts? It seems to me that only those with the prior inclination to understand the falsities spewed by our nation’s president are likely to keep up with the sources that are doing their best to set the record straight.

Accessible and affordable mental healthcare needs to be a priority, but this cannot happen from a position of fear and hatred. Creating more barriers by promoting a stigma that discourages acceptance of mental illness is the polar opposite of what will help our patients. The sick need to feel safe and supported if they’re going to seek out treatment. Compassion and understanding are needed to facilitate the healing process. President Trump says that “we must reform our mental health laws”. In reality, we need to reform the management of, and accessibility to mental health care – yet this is a topic that should be kept separate and far away from the epidemic of violence our country has been experiencing for so long. Psychiatric care needs to be addressed in every conversation involving healthcare policy, however Trump’s uneducated opinion about mental illness is harmful to patients and society alike. As described in the Washington Post, one common motive for mass shootings is infamy. The toxicity coming from the president’s mouth, in regard to mental illness, is nothing but fuel to the flame. For all we know, he could be bolstering the next mass murder, creating the next real monster.

Yes, our country is in need of better access to mental health care, which means more psychiatrists. To have more psychiatrists, means creating more psychiatric residency programs. Increasing the number and availability of therapists is another essential part of improving care for mental health patients, and affordable therapy is vital. Many of the psychiatric patients I see in the acute hospital setting come from disadvantaged backgrounds and low socioeconomic status. This DOES NOT mean that they are more likely to be dangerous or kill people. This DOES mean that they need extra support in obtaining the care they need. Not only is calling psychiatric patients “monsters” wrong, it augments the stigma and is in stark contrast to the support they need. I would love to see the government do something to change the face of mental health care, but they need to be sure that they are doing the right things, and for the right reasons.

REFERENCES:

https://thehill.com/policy/healthcare/456226-psychological-association-warns-against-blaming-mass-shootings-on-mental

https://time.com/5644147/mass-shootings-mental-health/

https://www.washingtonpost.com/national/im-constantly-asking-why-when-mass-shootings-end-the-painful-wait-for-answers-begins/2018/03/15/6fb0347e-1d8a-11e8-b2d9-08e748f892c0_story.html

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Kailee Marin

Aloha! My name is Kailee Marin, I'm a DO student in California. I was 15 years old when I decided to go to medical school. I spent three years in Hawaii getting my bachelors, then I came straight to CA to pursue my dream. These three years have been a rollercoaster - the best and worst of my life. I've spent med school listening to, and participating in the complaining of my classmates. I've come to realized that it's all the same. It comes down to the common barriers that current and future doctors face - and it starts in medical school. Moral injury being disguised as burnout so that institutions can pretend they care... But moral injury can't be fixed by wellness Wednesdays, or fitness Fridays. I have realized, to heal moral injury, you have to treat the underlying cause. And there are so. many. causes. So I guess I have a lot to talk about! As an aspiring psychiatrist, I feel compelled to advocate for mental health. This includes the mental health of my colleagues, my future patients, and myself. 

  10 comments for “Psychiatric Patients are NOT Mentally Ill Monsters

  1. Phil Lavine
    August 14, 2019 at 5:02 pm

    Kudos Kailee writing an opinion piece while in med school! We all need to speak up and state the truth. Evil and hatred are the problems — neither is an illness!

  2. William E. “Win” Green III, MD, DFAPA, FASAM
    August 11, 2019 at 5:41 pm

    As a board certified psychiatrist, I agree with you 100%! The president (and other politicians, unfortunately) have periodically “lumped” ALL people with psychiatric disorders together, and labeled them “crazy”, “dangerous”, etc.

    The reality is the vast majority of individuals with a mental illness are NOT more likely to commit violent acts, when compared to the general population. Common sense gun regulations such as universal background checks, “red flag” laws where police can remove weapons from persons temporarily for safety, etc., MIGHT help. But stigmatizing anyone with a psychiatric illness (depression, anxiety disorders, etc.) will just drive people back into the shadows and worsen the situation.

  3. Steve O'
    August 11, 2019 at 5:09 pm

    1)I find that veterans with PTSD are mortally afraid of being branded “monsters” and being adjudged unfit to own firearms. I will look whether people with PTSD are more likely to engage in firearm violence. Nevertheless, we cannot deny or incarcerate people based on the risk of acting out, unless the risk is clear, present and individual.
    2) I have always been concerned when I hear Mr. Trump speak that his manner of speaking contains elements of expression which I associate with thought disorder. I am not seeking out mental illness in Mr. Trump; rather, in his public expression, he offers these particular elements publicly. Note that I am making no inference as to his own state of psychiatric being. I am not a psychiatrist, nor can I diagnose a patient without meeting the patient in a professional encounter.
    I find that his speeches manifest a discontinuity of thought, where a spoken thought process continues silently, and the next statement seems to jump ahead disconnectedly. This is not evocative of any sort of mental disorder, but makes for some confusion for the listener. I am not referring to any peculiarities in assertion of fact and opinion. Rather, I am referring to disruptions thought flow which are quite familiar, such as circumlocution, tangentality, verbigeration and clang associations which completely obscure any meaningful process of expression and call into question the process of thinking itself.
    I am not diagnosing the President with a thought disorder, but I find it uncomfortable that the discussion of mental illness and violence is proposed by someone who himself speaks in a dialect of thought disorder.
    Thought can be disorderly without being bereft of content. That is not the issue. On occasion, I find Trump’s speech to be so convoluted that I cannot glean any understanding of the underlying ideas. But, for instance:

    “We’re going into the war with some socialist. It looks like the only non, sort of, heavy socialist is being taken care of pretty well by the socialists, they got to him, our former vice president. I was going to call him, I don’t know him well, I was going to say ‘Welcome to the world Joe, you having a good time?’”

    This flow of speech, in a clinical setting, calls my attention to whether there might be underlying thought problems. To hear them in a public speech by anyone is unsettling.

    • Pat
      August 11, 2019 at 5:50 pm

      Nah, I find it entertaining as all hell 😂

  4. Randy
    August 11, 2019 at 2:24 pm

    I would say your question asking why someone with no medical background at all is making major medicine-related decisions and pronouncements would apply to all politicians.

    But there is a conversation here that really isn’t happening. i think most of us agree that ideally;

    People with a mental illness that put them at a high risk of gun violence shouldn’t have guns.
    People with mental illness that are not at a high risk of gun violence should have the same rights as everybody else.
    People who need treatment for mental health should get it without it carrying a stigma or risk.

    Again, that’s in an ideal world which is not the one we’re in. So there is a thoughtful conversation to be made here but I don’t see many in power trying to have it.

  5. arthur gindin MD
    August 11, 2019 at 1:39 pm

    Rather than another rant on the president, your point should be devoted to medical matters e.g. how to select people who might benefit from some sort of screening procedure BEFORE they commit crimes.

    • Tdray
      August 12, 2019 at 5:19 pm

      Great idea! Sounds like you have an article to write yourself.

  6. Pat
    August 11, 2019 at 10:43 am

    1) I’ve no respect for pronouncements from the American Psychiatric Association, which has a record of bending their positions and pronouncements to fit the prevailing fashions of social hysterics.

    2) Problems such as these are another wonderful demonstration as to why we should opportunity we federal government involvement in health care policy and resources distribution. Inviting politicians to comment on health care leads to hilarities such as:

    https://www.foxnews.com/world/brazil-president-poop-every-other-day

    • Pat
      August 11, 2019 at 11:05 am

      I have no idea how @#&$ auto-correct did that 🙄

      “…as to why we should avoid any opportunity for federal involvement, etc…”

      *&@#$ auto-correct

  7. robert p duprey jr
    August 11, 2019 at 9:58 am

    Well written. I’d also like to see the discussion of mental illness separate from the gun violence. These criminals are not mentally ill. It stigmatizes the mentally ill. I agree where you wrote “we need to reform the management of, and accessibility to mental health care” – how many times are hospital days limited for the mentally ill while they are not for medical conditions. Lastly, as a recent new MD applying for psychiatry residency this fall, I can only hope for more residency positions. Thank you for your thoughts.

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