The Avian Approach To Salvation (#poem)

FB_IMG_1559921327758.jpgWriters often wax poetic over birds
Soaring, gliding, touching the sun,
Portending trouble, and eating their weight daily.

I’m more interested, though,
In the birds that appear to suddenly fall
From the sky without plan or purpose.
On a few occasions, I have thought a bird
Died suddenly in flight and came crashing
To earth only to see it open its wings at the last
Moment and land safely next to a worm or morsel of bread.

I’m relieved to see them touch down without so much as
A ruffled feather, and I begin to think that I may
Be just as lucky and find wind beneath my wings
At the last possible second.

Perhaps what feels like a free fall at the moment
Is my own weight carrying me to my destiny
Or some small nourishment.

(Dis)Associates

Straddling me, you shake your hair, grin, and gaze down.

“What do you really want me to do?” you say.

I really want you to become a fortress.IMG_6604

I want you to be the wall against the hordes.

I want you to be an opaque integument and block the light.

I want you to envelop me, surround me, and smother me.

I want you to take me away or bring me home.

I want you to numb the pain or make me feel.

I want you to make it all go away.

 

“Where are you, right now?” you say.

As your voice quivers, I float back into place.

I settle down in my skin again.

I can hear you and eventually my eyes

Focus on your face and your lips.

I explain everything to you in detail,

But you can’t hear me, despite the screams.

You can’t hear me from the other side.

I will have to cross over—meet you half way.

 

I whisper, “Please don’t leave me.”

You promise to stay forever as I slip

Into orbit again watching this dance.

I see you lean over to kiss the tears

And brush my cheek. To my surprise,

My face seems to respond in gratitude.

It would seem my body remembers

What to do, and you understand it as well.

In the end, the two of you sustain me.

 

You shouldn’t have to go to jail for mental health treatment

Last week I tweeted a link to a Texas Observer article by Emily DePrang about sexual assaults in Harris County jails. DePrang had written about two Bureau of Justice Statistics studies that showed the Harris County Jail on Baker Street had sexual assaults that are higher than national averages.

One survey reported rates of sexual victimization as reported by inmates, and found that inmates reported higher than average rates of victimization from other inmates. The other survey was based on official reports of sexual violence in jails and also reported higher than average rates for the Baker Street jail. DePrang did not discuss, in her short post, all the statistical and methodological limitations of the studies in question.

To my surprise, Alan Bernstein, the director for public affairs at the sheriff’s office tweeted me, saying he hoped someone would fact-check DePrang’s article as it had many mistakes, so I asked him what the mistakes were, and he sent me a list of items he felt were misleading. Later, the Texas Observer agreed to publish his response to the article (his published response was slightly different from what he sent me).

For the most part, his response pointed out the limitations of the study. Also, he noted that only one of four jails in Harris County had a higher incidence of sexual assault, and he also noted that jail had a high percentage of inmates who are under treatment for mental illness. In his note to me, Bernstein asked, “Is touching a clothed inmate’s thigh sexual violence? Maybe so. But this is one of the actions considered sexual victimization in the study.” I will just say that I consider any unwanted touching of my upper thigh over or under clothing to be sexual assault, even if the “violence” seems minor.

In trying to separate the signal from noise, though, what interested me most was not the definition of sexual violence or even the limitations of the study but the fact that the jail had so many inmates on medications. The Houston Chronicle quoted Sheriff Adrian Garcia saying, “The Harris County Jail has been referred to as the largest psychiatric facility in the state of Texas” and “More than 2,000 inmates … are on psychotropic medications on a daily basis.” And in Bernstein’s response, posted on the Texas Observer site, he said:

That building houses the jail system’s inmates with acute mental illness. In fact the statistician who worked on the 2011 study tells us that two-thirds of the surveyed inmates in the so-called “high” rate building had “psychological stress disorders.” We don’t know how that was determined, and we would never allege that people with mental illness fabricate allegations more often than anyone else.

I’m not sure what “acute” means in this context, but I suspect anyone on medication is assumed to have an acute mental illness. Given the number of prescriptions written for antidepressants and anti-anxiety medications these days, I suspect a fairly high percentage of the general population is acutely mentally ill, according to these assumptions. Even someone being treated for mild depression, though, will experience unpleasant side-effects if doses are missed, as they are likely to be missed inside a jail. We should be concerned both about lack of treatment for mental health and the over-prescription of  drugs for depression and anxiety. Withdrawal sometimes leads to aggressive behavior and could account for some problems. On the other hand, mental illness is also stigmatized, and those receiving treatment may become targets for abuse at the hands of other inmates.

Fortunately, I found more information on treatment of the mentally ill in Harris Country jails in excellent article by DePrang titled “Barred Care.” According to the article, the jail “treats more psychiatric patients than all 10 of Texas’ state-run public mental hospitals combined.” And why is that? Because no one else is treating those patients. Again from the article: “Harris County has one of the most underfunded public mental health systems in a state that consistently ranks last, or almost last, in per capita mental health spending.” Some people get so desperate for relief, that they break the law just so they can go to jail and get treatment.

The program in the jail is commendable. The funding priorities of our state government are not. In 2003, the Texas legislature slashed funding for mental health services in Texas. According to DePrang’s article, “In Harris County, the number of law enforcement calls about people in psychiatric crisis jumped from fewer than 11,000 in 2003 to more than 27,000 in 2012.” So, the Harris County jail has a high number of mentally ill as a result of deliberate action of our state’s lawmakers. This should make us all angry. Cutting funding for mental health services only to force the mentally ill into jails is cruel and expensive. No matter what sends people to jail, many will never really recover from the stigma and the trauma of the experience.

What should be done? We should lobby our lawmakers to restore funding for mental health services in Texas. We should stop blaming the mentally ill for their problems. We should resist the temptation to treat even minor difficulties with powerful and addicting drugs. We should insist that Texas expand Medicaid as part of the Affordable Care Act (this would cost the state nothing) so that people can receive basic medical care and avoid crisis.

In short, we should learn to heal each other. The person with a mental health crisis tomorrow could be you.

The Ethics of Caring and Seasonal Depression

I don’t know if it is the changes in the weather, the length of the days, or what, but we

The suicide
The suicide (Photo credit: Wikipedia)

sometimes find the world slipping away from us. As we reach, objects, people, and activities seem to continuously recede into the distance just beyond our grasp. We forget how to be engaged with even the most basic tasks. Seasonal changes can leave us feeling depressed and melancholy. As the poet Phillip Larken put it:

The trees are coming into leaf
Like something almost being said;
The recent buds relax and spread,
Their greenness is a kind of grief.

For reasons that aren’t completely understood, spring seems to bring a surge of depression and suicides, but winter gets all the attention for warnings about seasonal depression. Some researchers have noticed that suicide spikes coincide with increased pollen production.  Apparently, allergies release cytokines, which affect appetite, activity, sex drive, and social engagement. There may be a philosophical question in there as to the difference between having “depression” and having a response to allergies that looks a heck of a lot like depression. Sufferers of either will probably not worry the distinction too much.

Some theorists suggest that suicide peaks in spring because of a “broken promise effect.” When spring doesn’t bring the joy and energy it generally promises, the depressed are moved to suicide. Others have suggested that springtime brings more energy and agitation (and a corresponding drop in melatonin), especially to people with bipolar disorder, that moves them to act against their own lives.  Still others speculate that springtime increases in serotonin give people the energy to kill themselves.

I don’t want us to turn away from people who are depressed during the holidays. Rather, I just hope we can remember that some of us occasionally feel depressed and hopeless throughout the year. The extra effort we make through the holidays may be worth making year round.

Still, I know it is true that many of us mourn with greater intensity during the holidays as we count all those who are no longer with us and grieve for our losses, so maybe we should be a little extra careful during December. A little care can go a long way to avoiding a holiday crisis. But we should remember to keep caring and reaching out during the new year, into spring, and for the rest of the year. When we help each other, we are all stronger.