The Year 2016 and Some Implications for the Mental Health Field

What a history-making year 2016 turned out to be. Just turn on the television, open up an online news portal or pick up a newspaper during the past year and you saw change happening all around us. The mental health field was not spared in this year of change. Changes seem to be coming to the healthcare arena whether we are prepared for them or not.

Many news stories focused on cannabis and the legalization debate across the country, with some states adopting legalization. Even some national and international pharmaceutical companies are now getting involved in the manufacturing of cannabis drugs. There’s debate about whether legalization is good from a public health perspective, with experts in addiction on both sides of the argument. Regardless of how you feel about the issue, there’s a need for acceptance that change is occurring and, for those who work in the addiction field, a need to adjust our perspectives. This may require a more liberal perspective on drug usage, or a perspective that includes the concept of harm reduction, which recognizes tapering usage as a necessary step towards recovery.

It was almost impossible to ignore the news stories about the growing “opioid crisis” in suburban and rural communities across the country. The face of addiction has changed since the days of President Reagan’s “war on drugs.” Prescription drugs in medicine cabinets are becoming the place where addictions start. Some statistics indicate that 75 percent of ER admissions are due to physical pain that gets treated in the ER with prescription opiates, thus setting the stage.

The story of Jessica Grubb comes to mind when thinking about opiate addiction because of all the attention her story got from the outgoing President Obama and the White House. Jessica Grubb was a young lady who died from crushing and injecting Percocets (oxycodone), the drug prescribed to her for pain following surgery in March of 2016. Before the surgery, she was recovering from a heroin addiction she had battled since being raped in college. Jessica’s story came to the attention of the national media when her parents spoke about their daughter’s addiction and recovery process at a televised town hall meeting in West Virginia with President Obama. That night, they received a sympathetic ear from the president. Several months later, their daughter was dead from an accidental overdose.

Also during 2016, there were many news stories about people with mental illness and the less-than-desirable — often violent — treatment they received from public safety officials when they were in crisis or suffering. Statistics reveal that about half the people killed by public safety officers have a disability.

The case of Deborah Danner of New York City comes to mind. Deborah Danner was an elderly African American woman suffering from symptoms of schizophrenia. Her neighbors called the police when they were alarmed by loud noises coming from her apartment. A NYPD officer entered her apartment, perceived her as a threat — later claiming she had a baseball bat – and used lethal force that killed her. Danner wrote, years before her death, about the police being ill-equipped to handle persons with mental illness and criticized their use of lethal force.

So what does all this change mean for those of us who work in the addiction and mental health field — and the consumers who use our services? The short answer is that, as a government bureaucracy, the healthcare system will likely not make adequate adjustments to policies as quickly as change needs to occur in providing direct mental health and addiction services to consumers. For example, the federal government (DEA) still proclaims cannabis as a Schedule I (criminalized) substance. This is interesting if you reside in a state that has legalized recreational cannabis.

As clinicians, we must learn how these changes in our current political climate will affect our own social interactions and those of our clients.   We also have to become advocates and activists for advancing appropriate responses to people with mental illnesses by civilians and those whose job is to serve and protect the community.

The truth is that most psychiatric emergencies are handled by public safety officers because they are the first responders. In my own work with Ellenhorn, I have had to use public safety officers as back-up when dealing with clients in crisis. It usually goes much more smoothly for the client and for the public safety officers when a clinician is present who has a relationship with the client and understands their behavior. I had very satisfying experiences with public safety officers when I engaged with them in those situations. However, very few towns and cities have clinicians on the force to respond to such emergencies, so there is an urgent need for much greater inclusion of clinicians in first response cases.

We understand that people with mental illnesses face micro-aggressions and misattunements from others on a daily basis. This increases greatly if the person is a person of color. It appears that in the current socio-political climate, many people face an environment that is increasingly inhospitable to inclusion, personal differences and acceptance of others. As clinicians, we need to understand the current social context and work towards helping clients deal with it.

At Ellenhorn, we pay close attention to the social experience of the client. We believe that the nature of a client’s social experience is often more indicative of whether that person will have a chance at full recovery or not. One of the great realizations clinicians gain when working in the field of mental health is that regardless of a person’s station in life, having mental illness profoundly affects a person and their social experiences. We also believe that, in addition to the impact of traumatic childhood experiences, painful social experiences one has as an adult can move a person towards addiction and self-harm.

Today more than ever, it is important for mental health providers to pay attention to each client’s social experiences as well as to their biology. We have an important role in making sure that in 2017 and the years to come, more people are properly educated about the mental health barriers faced by some members of our family and community. We can help set the standard for compassionate care.