What Helps Mentally Ill People

RELATIONSHIPS ARE ESSENTIAL FOR RECOVERY

Copyright 2009 By Jack Kenneth Bragen

Jack Bragen

A common thread when you look at violent incidents involving a mentally ill person, specifically, shootings that receive a lot of publicity, is that the perpetrators were isolated from meaningful human contact. They did not have the necessary skills to create and maintain close relationships. They did not feel cared for in life, nor was there anyone in their life for whom they felt caring. This lack of care ultimately expanded to include the "self." Nearly by definition, people who commit mass murder for the sake of revenge are severely lacking of relationship skills. A recent example of this was the shooting that took place at Virginia Polytechnic Institute. The perpetrator, Mr. Cho, had a history of being bullied and did not relate well to his peers.
The vast majority of persons with mental illness are not violent. For a good outcome for all people with mental illness, and not just the ones who are potentially violent, close relationships are essential. I know of two brothers who both have a psychiatric disability but who have markedly different outcomes. One of them is isolated, has few, if any close friends, and spends his days smoking cigarettes and sometimes taking street drugs. Several of his teeth have fallen out, and he looks ten to fifteen years older than his chronological age. The other brother is willing to talk to people about the things that upset him, is able to make friends including female ones, has made numerous work attempts, has no dental problems, stays away from illicit drugs, and looks his age or younger. It seems that one brother has given up, while the other hasn't. While supportive relationships are not the whole formula, they are an important piece of the puzzle.
The absence of romance in someone's life is not necessarily what I am talking about. The difference between those mentally ill individuals who overcome the illness, and eventually "make it" in life, versus those with poor or even tragic outcomes, is having the ability to connect with another human being-by any means, and not just in the context of romantic partnerships.
I am not ignoring the biochemical factor of mental illnesses. Nor am I asserting that mentally ill persons can go without medication as soon as they have a social life. The neurological causes of mental illnesses as well as the usefulness of medication are foregone conclusions, and those who believe otherwise are uninformed.
Ultimately, relationships are the deciding factor in determining if these illnesses will be able to completely wreck the life of the patient. If the person with mental illness has relationship skills, the effect of the illness is demoted to a major but not deciding factor in that person's quality of life. If someone lacks the ability to connect with a fellow human being, no amount of medication will help him or her, and you will not get that person to voluntarily take that medication.
Sometimes a person with mental illness has impaired social functioning, but only to an extent. For example, shyness. For example, anger issues, but not combined with the absence of a conscience, or the absence of basic insight. In this case, the person may have a difficult path but has the chance to reeducate oneself and to eventually form these close relationships.
A major shortcoming in the predominant clinical approach to treating the mentally ill, one of many, is too much emphasis on employing the patient in a job performing unskilled work, and not nearly enough emphasis on helping that patient find and maintain close relationships. Many mental health agencies believe that the definition of success for someone with mental illness is entry-level employment. It isn't. Jobs will come and go, either for someone with mental illness, or for someone with no diagnosis. The thing of lasting value for a disturbed person is the ability to initiate and maintain relationships. It is the secret to getting well for a mentally ill person.
Other than relationship skills and being nonviolent, factors that contribute to the success of a mentally ill person include the ability to have basic insight, including about one's illness, being persistent in the approach to life's challenges, and finally, not using alcohol and illicit drugs. These are things medication won't do for you, no matter how much the drug companies try to make a better pill.