||Volume 22, Number 7, May/June 2010
Acknowledging serious mental illnesses
By Susan Inman
One night last week, I received a desperate phone call from another teacher whom I’ve known for over 20 years. She was frantic. An ambulance and two police officers were on their way to her house to take her very psychotic teenage son to Vancouver General Hospital’s emergency unit. His psychiatrist, from a community mental health team, hadn’t been able to persuade him to go back on to his antipsychotic medication; he has very little insight into the serious mental illness that he’s living with and this involuntary hospitalization was the next necessary step. My friend has been learning a lot about these illnesses, but the imminent arrival of the police was understandably frightening to her and she was very worried about her son’s response. Fortunately, the likely scenario I painted for her did play itself out; the police and ambulance attendants were very sensitive and skilful, and my friend’s son is now safe in the psychiatric assessment unit and responding well to treatment.
Both of us were the kind of mothers who assumed we knew a lot about child development. We were both in the position to give our children just the kind of careful nurturing we believed would lead to fairly predictable results. Our children’s genetic codes and a complex mixture of environmental factors had a different and a more cruel fate in store for them. Even though we’ve now both educated ourselves to understand the research into environmental factors like flu during pregnancy, birth complications, age of fathers, and other newly researched issues, we knew very little when we were tossed into these chaotic circumstances.
When I was in grad school at UCLA in the 1980s and later took courses in UBCs Counselling Psychology Program, I trained in theories based on the assumption that nurture, not nature, determined a child’s destiny. It was a comforting belief system but, even when I was sitting in those courses, the bigger world of neuroscience had already begun transforming psychiatry. Rather than continuing to base interventions in dealing with schizophrenia and bipolar disorder on the unscientific, non-evidence based theories of Freud, psychiatry had begun to take its rightful place in medicine.
Families today still have to confront the legacies of parent blaming as they try to get help for their ill children. The shifting of paradigms doesn’t happen quickly. Most of us who are teachers have had very little opportunity in our training to learn about new ways of understanding serious mental illnesses. This lack of training, unfortunately, often makes it difficult for us to interpret behaviour in our own classrooms; this is a problem because one in 100 people have bipolar disorder and one in 100 have schizophrenia, and these disorders often begin to manifest themselves in adolescence. At the secondary school where I teach, the counsellors have connected to Vancouver’s Early Psychosis Intervention Program; this helps ensure that ill students can receive the timely treatment that can lead to better outcomes. This program not only offers necessary medical treatment but helps the students and their parents learn to adjust to these disorders. I have no idea what people in many other parts of the province can do.
My daughter had one of the most severe schizo-affective disorders that psychiatrists in Vancouver had seen and after a two-year psychotic episode had a grim prognosis; some psychiatrists predicted she would have to be institutionalized for life. My ability to take unpaid leaves of absences and to teach part time enabled me to assume responsibility for her recovery. Eventually, a new medication strategy freed my daughter from her hellish psychosis. I could not find the stories of other parents when I was the most overwhelmed during these ordeals and in my memoir, After Her Brain Broke, Helping My Daughter Recover Her Sanity, I share the complicated story of helping my daughter get her life back. In the introduction to the book, Senator Michael Kirby, chair of the Mental Health Commission of Canada, talks about “…the work we still have to do to ensure that people with mental illness and their families get the same treatment... that individuals with physical illness receive.” The work to be done is immense.
As teachers, my friend and I both know that educational institutions need to do more if we want our students to receive the kind of care that offers the best opportunities for recovery. The Counselling Psychology program, where I took classes, still doesn’t offer any course on serious mental illnesses and none of the student teachers I’ve asked have received any training at all in understanding these disorders. This training would not only assist us in spotting potential crises and later help us reintegrate students back into our classes, but would improve our understanding of our many students who grow up in households impacted by these disorders. The institutions that train us have a responsibility to help us understand these issues that they have ignored for too long.
Susan Inman teaches at Windermere Secondary School, Vancouver.