Some thoughts on Polarization, Power, and Compassion
by William Greer, MSSW, LCSW
What is the role of helping professionals in these times? I think it is to provide hope and understanding and to help people bridge the gaps that separate them. Never in recent history have our skills in these areas been more needed. Every day I have the privilege to work with people who strive to climb over the barriers that separate them from "mainstream" society whether they be class, race, culture, or disability. Their courage and persistence in the face of poverty, prejudice, illness and apathy is inspirational.
Early on in my career I encountered Mary (not her real name), a mentally ill woman who had gained a reputation as a "trouble maker" in the system. Mary had the annoying habit of disagreeing with what we professionals knew was best for her. She was bright, assertive and, at times, self-destructive. I usually encountered her in emergency rooms or police stations, and we were seldom happy to see each other because usually our purposes were antithetical. Over time, however, we developed a grudging respect for each other's persistence. Then one day Mary dropped out of sight. I did not see her again for almost three years. One night, out of the blue, she called the crisis line and asked to speak to me. She said she was passing through town and needed my assistance. It was unusual that Mary would ask for my intervention into her affairs. I agreed to meet her at our offices.
When she showed up, I was struck by the change in her appearance. Her hair was mostly gray and her face was lined with care. She said she had traveled East to be near family but found a community that was less hospitable than Madison to the mentally ill. Between stints in psychiatric facilities, she lived from hand to mouth. Her family was not supportive and the local community mental health resources for poor people were practically nonexistent. Mary read in a magazine about a commune in Northern Wisconsin that took in anybody who was willing to work and follow its rules. She saved enough money to make the trip by bus. She was on a layover in Madison and used her last money to call me. She wanted food and access to a telephone. I provided both. Apparently, Mary needed to know if what she had read in the magazine was true. It would be better to be disappointed by telephone than in person. I watched her dial the number and begin speaking. Then I gave her some privacy. When I returned, she was smiling through tears. When I asked her what the commune staff had told her, she said, "They said they'll be waiting for me." I never saw Mary again after that night, but I like to think that she found rest and peace at the end of her journey.
The poet, Robert Frost, described home as "the place where when you have to go there, they have to take you in." I believe our polarizing policies and values are creating a form of psychological homelessness for some in our country. Psychological homelessness results when a grieving mother is denied an audience with the Commander-In-Chief of the Army in which her son died, even though she has literally camped on his doorstep. It results when same sex couples are legally forbidden to marry. And it results when the 40 million men, women, and children who lack health insurance in our country are forced to choose between basic necessities (food, clothing, shelter) and treatment for persistent physical or mental health problems. These individuals have been denied a sense of place and worth in our society. They have been effectively "unhomed."
Martin Luther King Jr. was one of the unhomed. He allowed his displacement and that of his followers to be exacerbated through civil disobedience for the sake of justice. Forty-two years later, his words to his fellow clergy from the Birmingham jail still ring true. "I am cognizant of the interrelatedness of all communities and states. I cannot sit idly by in Atlanta and not be concerned about what happens in Birmingham. Injustice anywhere is a threat to justice everywhere. We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly."
I believe that the aforementioned polarization tears at the fabric of King's "garment of destiny" and diminishes our ability to sustain the values of justice and equality upon which this nation was founded. Am I my brother's keeper? Yes I am, if I want to live in a civilized society. Am I my sister's keeper? Yes I am, if I understand how tenuous is my own hold upon health, prosperity, and public approval. Am I my neighbor's keeper? Yes I am, if I am unable to sit in silence at the banquet that is America and watch as the powerful remove chair after chair from a table that is loaded to the point of embarrassment.
STIGMA
Life opportunities for some individuals in our community (such as those who have a mental illness) are undermined by stigmatizing attitudes and discriminating behaviors. Research suggests that people who are viewed to be personally responsible for their mental illness are likely to be viewed negatively and are unlikely to receive help from others. Conversely, we extend compassion and assistance when we view people as not responsible for their mental illness. For those we perceive as being "dangerous," and thus feared, we recommend community avoidance or segregation.*
Dr. David Satcher, past Surgeon General, wrote extensively about the effects of stigma in his 1999 report on Mental Illness.* "Even more than other areas of health and medicine, the mental health field is plagued by disparities in the availability of and access to its services. These disparities are viewed readily through the lenses of racial and cultural diversity, age, and gender. A key disparity often hinges on a person's financial status."
He also speaks to the "subtle" and "overt" forms of stigma. "It appears as prejudice and discrimination, fear, distrust, and stereotyping. It prompts many people to avoid working, socializing, and living with people who have a mental disorder. It reduces access to resources and opportunities, e.g. housing, jobs and leads to low self-esteem, isolation, and hopelessness. It deters the public from seeking, and wanting to pay for care. It gives insurers in the public sector as well as the private sector permission to restrict coverage for mental health services in ways that would not be tolerated for other illnesses."
In his report to the country, the Surgeon General came to the following conclusion -- "Stigma results in outright discrimination and abuse. More tragically, it deprives people of their dignity and interferes with their full participation in society." While Dr. Satcher was focusing on the stigma that challenges those who experience mental illness, his sobering statements can be extended to others in our community; particularly those who are dependent on alcohol/drugs, live in poverty, have experienced trauma, are homeless or undocumented.
The fact remains that these individuals/families are our neighbors, relatives, co-workers, and friends. Investing in ALL of our citizens strengthens us as a community.
CALL TO ACTION
I urge everyone who reads this to get involved personally, politically, and spiritually in supporting the vulnerable and disenfranchised among us. Non-profit organizations in Dane County are facing another year of zero percent increases in the face of overwhelming demands for service.
What can the average citizen do to help besides paying taxes? Consider offering your time or money to the charity of your choice or educating yourself about the human service programs in your community and the populations they serve, so you can be an informed voter and advocate.
As citizens of Dane County we can also begin to recognize the destructive impact of stigma and the barriers our attitudes and perceptions can create, both to the individual and the community as a whole.
There are too many people in our community and in our country for whom hope is a scarce commodity. It is nurtured by our empathy, our neighborliness, and our steadfastness in the face of crisis. What you have to give as a volunteer, worker, donor or advocate and what you will receive in return is ultimately what makes us a vital community.
POSTSCRIPT
Since I wrote the article above, Hurricane Katrina has come and gone leaving in its wake devastation, misery, and outrage. This unprecedented natural disaster has expanded the ranks of the homeless and jobless in our country by tens of thousands. It compels us to answer the question, "Am I my brother's keeper?" at governmental, corporate, and interpersonal levels. Hopefully, the emerging answer will help define public policy and private behavior for the foreseeable future.
William Greer, MSSW, LCSW, is Executive Director, Mental Health Center of Dane County, Inc.
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* Chicago Consortium for Stigma Research [http://www.stigmaresearch.org/]
* Mental Health: A Report From the Surgeon General; [http://www.surgeongeneral.gov/]
