Psychiatrists of my acquaintance tell me they've got a lot of work in the wake of the massacre at Virginia Tech. Parents who had buried their heads in the sandbox since Johnny or Chloe were young children behaving badly are dragging their late adolescent and young adult sons and daughters in for checkups and treatment. Many of them, says one psychiatrist, lapsing into the politically incorrect language the rest of sometimes use, are "lunatics."
We've whitewashed language about the mentally ill. Labels that once got immediate attention are obfuscated with evasion and euphemism so as not to offend. Psychiatric diagnoses are couched in frilly language to obscure so we don't "stigmatize" or "victimize." Calling an illness a "personality disorder" doesn't frighten with the urgency of "paranoid schizophrenic." Sometimes new diagnoses are tailored to persuade the green eyeshade men at the insurance companies. Sometimes the professionals don't want to lower the "self-esteem" of their patients, so they make them sound more normal than they really are. Trends in caring for the mentally ill run in several directions.
For eight years in the long ago I edited a mental health magazine for professionals, called "Innovations." We featured new treatments and attitudes toward those suffering from a wide range of mental illnesses. Some of the new approaches were promising; others were useless. They all were lumped together, entangled in public policy, abetted by a philosophy that one size fits all. That was a deadly formula for cost-cutting state legislatures.
Typical was a headline on one community program: "From the back ward to the front porch." A copy editor had put into neat perspective what we all wanted to believe, that new drugs could do what Freud never dreamed of. No soul searching or long sessions on the couch. Independent living in the community was the best way to treat mental disorder. States radically reduced their patient populations or closed mental hospitals, which cost more to run than luxury hotels (without the luxury). Patients moved into rooming houses or halfway houses with poor supervision. Neighbors protested. Hallucinating bag ladies and delusional men headed for warm climates to sleep on park benches and sidewalk vents. The golden age dawned.
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