Why Doesn’t “Do No Harm” Apply to ‘Crazy’ People Too?

I think a lot about this subject almost daily. But talking it over again with a friend recently fueled up my rage again.

We as a society seriously do not talk about how so many mental issues/disorders are a NORMAL & understandable response to trauma(s). Why do you think marginalized populations suffer most in regards to mental health? ‘Hysteria’ was literally women reacting appropriately to the abuses they suffered in our sexist society. They stopped considering it a viable mental illness diagnosed but I honestly feel like they just changed the name. BPD (borderline personality disorder) & other PDs (personality disorders) share quite a lot of traits with ‘hysteria’. These MIs (mental illnesses) are also extremely stigmatized, misunderstood, and misdiagnosed all the time. The more I start to heal and put in the work in trauma therapy, the more I realize how important it is to have a decolonized approach when it comes to mental healthcare — and by that I mean all of mental healthcare, not just therapy.

So many of us are left traumatized then re-traumatized by our current mental healthcare system. Even when we have the resources to access care, that ‘care’ often does more damage than good. I mean how often is it discussed how messed up it is that psych facilities were modeled after prisons? What about the fact that little to nothing has been done about that? Like okay, the prison system is broken & bad. A lot of us can agree on that. But somehow the methods they use there are totally great for dealing with mentally ill people? That’s okay with y’all? I mean solitary confinement is definitely torture & absolutely heinous, right? But it’s totally okay when it comes to the crazies? How does that sit right with y’all? What about informed consent? Most people don’t realize how many laws are still in place to bypass the basic rights (that others are guaranteed to btw) of mentally ill people. This of course means that you don’t have to actually be mentally ill to be treated as such. As long as a healthcare provider claims you are, you are. Very little proof is needed — if at all.

I mean take a look at Britney Spears. She was subject to a myriad of violations. Everyone was outraged about but they were especially outraged at what happened to Britney because she wasn’t ‘actually crazy’. But what if she was? What if she did have a mental illness or two? What if she weren’t famous? What if she was Black? What if she was queer and/or trans? What if she was broke? Would the outrage really be the same?

Mentally ill people — especially the ones given the ‘crazy’ label (PDs, schizophrenic disorders, bipolar, etc.) — deserve to not have their basic rights thwarted at every corner. But what we deserve is not what we get. So many of us aren’t reacting all that differently to the current dystopian-vibe of the world because guess what? We’ve already been living dystopia since day one.

Do you realize how much of the homeless population are mentally ill? How many of that population are POC? Now, how many of them just happen to be Black? Racism and antiblackness, like all bigotry, are all encompassing. Medical racism is definitely a thing and it kills, go read about it. POC, and especially Black people, are much more likely to be labeled ‘aggressive’, ‘uncooperative’, and a ‘threat’. In psych facilities that means they’re much more prone to being misdiagnosed, stigmatized, and have their rights violated via involuntary holds, solitary confinement, and straight up abuse — I say ‘abuse’ because I’m referring to all types of abuse. Isn’t it funny how ‘Do no harm.’ only seems to apply to a certain portion of the population? Or how about the fact that that oath seems to just fly out the window when the patient is deemed ‘crazy’? Mentally ill people deserve to be treated with respect, dignity, and care. That should be the very least. They deserve not to be treated like outcasts and hostile demons. They deserve not to have the validity of every word &/or action of theirs to be called into question. And for fucks sake, they deserve safety! They deserve not to be threatened into submission. They deserve to be informed about the treatment they are receiving. They deserve not be subject to torture and other forms of abuse. The fact that they are such a vulnerable population means that they deserve to be treated with even more care and kindness not less.

Now, if the heinous suffering and deaths of fellow human beings isn’t enough to rile you up…let me remind you that as long as the system remains unchanged, you are also at risk. A lot of you may think that this couldn’t possibly happen to you. I mean come on! You’re not ~crazy~! Well guess what? You don’t have to be! Britney is a white cishet blonde woman and a mega-famous pop star. Her whole thing was (and still is) being a southern gal & faithful Christian! Even through her more ‘racy’ periods, she made it clear that she was faithful. Yet look what happened to her. She’s not the only one either. Like I said before, bigotry is all encompassing. This ableist system won’t spare you just because you’re not one of us. They don’t care. As long as they say that you are, you are — and with that all the same rules apply to you.

This kind of thing happens daily and all across the country. Yes, even in the most liberal cities and states. Of course, the conditions vary in how fucked up they are depending whether or not it’s a public or private facility — which often goes back to location. But honestly at the core, they are all the same. Need an example? I’ve been kept involuntary at both public and private facilities — as a minor & as an adult. The private facilities were a lot nicer on the outside & by that I mean in terms of accommodations (i.e. beds, ‘lounge’ areas, food, etc). So on the outside looking in, it doesn’t look so bad. In fact, if you were at these places voluntarily, you’d be treated very differently and even sometimes moved to a whole different area. These places often have names for different areas that are just codes for what the areas really are. For instance, they might label a ‘non-threatening’ patients area ~The Outlook~ and give them better accommodations with the constant threat of being sent to less fortunate sectors. They might also have a completely separate wing called ~The Haven~ where the often voluntary, VIP, top-billing patients are. So depending on your circumstances, it might not be so bad — especially if you’re ‘just’ an addict and a high-paying one. But if you’re not? If you’re involuntary and considered ‘crazy’? It’s still hell dressed in bougie shit. I mean I still don’t know how Medicaid paid for some of my stays (& programs) at these facilities but I assume it had to do with the fact that I’m in a more ‘liberal’ area. Still, as I said, it’s still a hellish nightmare zone. When I was 21 years old, I woke up from a brief coma after a near-fatal suicide attempt — 2nd in a month, 3rd overall) only to be mentally & emotionally broken down by the staff as they told me it was for my own good. The psych team (head psych attending & residents) told me they were doing it because I wasn’t crying and thus malfunctioning. They pointed out how I somehow got all the other patients in the ward to bond with each other, open up, and gasp! even smile in just one day as proof of my psychological malfunction. Yeah, that’s right. They started this after ONE DAY of me not crying — mind you it was not even a full day. I was in a different ward for adult women then suddenly moved to this bougier co-ed ward for ‘young adults’. I was trying to adjust and survive. But apparently, I should’ve of been sobbing and inconsolable because coping through social interaction during my THIRD involuntary stay at a psych facility after significant medical trauma + a lifetime of other traumas was malfunction. They claimed to be concerned about me but they weren’t. Plus I’m borderline (BPD) and you see, in medicine, that translates to manipulative & a liar. They didn’t ask me what led me to my attempt. They didn’t even bother asking about my past traumas or probing into any of that. Instead, they asked me how on earth I got the other patients to open up and bond with one another. Out of confusion & fear, I told them the truth. I didn’t know and didn’t even think that any of that was weird or cause for alarm. All I said was, “Hey, I’m Jazz. I’m 21yo and here because of a suicide attempt. It was my third and I’m told I should’ve been dead. What are you in for?” They were all just sitting in this lounge area, not speaking or interacting. So being a social person, I shared first and gasp! They shared too. I even reacted empathetically without judgement! Such a shock that a couple of scared kids in their early 20s would respond to that! The team didn’t buy what I said though. They told me how they tried for weeks to get some of them to open up and how apparently some of them never smiled once since they were admitted. What should of been a great thing was interpreted as a hoax by a manipulative liar and I was that liar. So they zeroed in on the trauma of my attempt. How close I came to escaping everything. They saw the shame, the guilt, and the intense pain. Instead of trying to console me and treating me with kindness, they kept poking at it. They forced me to face the trauma of it all, daily — all the time. Took me away from the group and didn’t let up until I broke down into tears. The head psych in charge literally smiled and said, “There don’t you feel better? I told you you would. We know what we’re doing here.” But I didn’t feel better. I felt immense fear. The same fear I felt a month earlier at the King’s County (public) hospital’s women’s psych ward. The message was clear: We’re in charge. Do what we say or you will suffer. The me back then was initially fooled by the bougie accommodations. I had only been in public psych facilities before. I saw the bougie accommodations and thought that I might be safe. I wasn’t even sure if they had solitary at first. But I was informed they did when they were trying to break me down & told me maybe I might do better if I had some time by myself in a separate area (after they had already restricted me to my room away from the group). Mind you this was after I told them about my past psych ward traumas of having solitary used as a threat. The month before, I saw a black woman screaming and thrashing — clearly out of fear, be tackled by several men. She was then drugged and dragged away. The attending psychiatrist dismissed the black box label reaction I had to Zoloft at 16 as just ‘teen hormones’. That reaction led to my first attempt and involuntary stay so I fought against it. But she informed me that nowadays if you have more than one suicide attempt, you’re labeled as having BPD. She told me that this label also meant that no one ever believe a word I said and that if I didn’t agree to take the Zoloft, she would extend my stay and that it would be incredibly unpleasant. She also mentioned how I was so young (21) and that she had medical training so I should trust her. I don’t know if it was the shock of the threat, fear, or desperation but I bought her schtick at the time. I agreed and took Zoloft. I had the same reaction and within a month I attempted again, leaving me in coma as ny organs started to fail.

Public or private, it doesn’t matter.

These facilities and this system of ours isn’t meant to treat. It’s meant to keep us silent, to keep us hidden away so that the rest of society doesn’t have to feel any discomfort about the reality of things. I mean sacrificing the lives of millions is totally worth it if even one privileged person doesn’t have to feel guilt, right?

Now mind you, the memories I’ve shared aren’t even the worst in terms of the entirety of medical trauma I’ve accrued over the years. Furthermore, in terms of the entirety of heinous fucked up shit that happens under this system, I’m one of the lucky ones. I know that despite those traumas, I have been extremely fortunate compared to others. I was able to escape being put in solitary. I was able to escape being tackled and sedated. I was able to escape physical and sexual abuse (in mental healthcare). I got the privilege of staying at private psych facilities. I got out. I can get the meds/treatments I need. I’m alive and I’m getting mental healthcare that is actually healing not harming. It took 15 years and a shitton of trauma but I now have a mental health treatment team that I can count on. Providers I can actually trust and feel safe with. Providers that actively include me, as a participant, in my treatment by asking me for my thoughts on the matter. Providers that aren’t bigots who try to use my identity — a queerean (bi queerean), disabled woman with some more stigmatized MIs — against me. Providers who will actually fight for my care and believe in me. These are all privileges that majority of the mentally ill population does not have. You cannot say that there isn’t deeply wrong with everything if these basic resources & himan decency are considered privileges. These things should be a given, the standard not a treasure that so few are privy to.

I’m not just upset for myself and my community for all the stuff I mentioned either. The fact that so many of them are driven to death and suffer till the very end is enraging. But I’m also upset because more often than not, their stories, their identities, their lives — everything is erased. It’s like their very existence is gone, like they never were here in the first place. They say the opposite of love is not hate but indifference. Society has shown, and continues to show, just how indifferent they are to us ‘crazies’. Especially if they’re Black, LGBTQIA, broke, &/or disabled.

The message has been clear from day 1: “You do not matter. Never have and never will.”

That needs to change, now.

And stop expecting the ones who are most marginalized, and thus vulnerable, to do the heavy lifting. Stop expecting perfection from them either. People don’t need to be savants, heroes, or anything to deserve the very basics. Their lives matter and their existence in this world is very much real & valid — they need to start being treated as such. If you’re uncomfortable fighting for change because of just how much discomfort you’re feeling, you’re part of the problem. It means you’re the one that needs to change not them.