There is a frail line between adulthood and childhood. Legally, at 22, I am an independent young adult. I can drink as much as I like, pay taxes once I earn a certain income, or even get married.
Yet I, a sane if nervous undergraduate live at home, under my mother’s watchful eye. I have never had to pay a bill or hold a full-time job; in fact, the opposite has been encouraged, with me continuing my graduate education. That said, I have the choice to leave but not the conscience, on account of having a special needs younger brother who needs lots of love and care. Two of my siblings have left the house quite permanently and return to assist on holidays.
My project is about parenthood when a parent has a mentally ill child, and it will remain thus. When I was researching laws for mental illness, however, I found that “parents” were not specified within legal language. That has enough disturbing implication if the government does not acknowledge a mentally ill patient as having a family, but for that reason I am using “conservatorship” within each work’s context since a conservator is the closest legal term to “parent”, and parents can become conservators. I am also referring to laws of “detention” in contrast to “conservatorship,” in the case that a schizophrenic or bipolar patient is locked up against her will.
This project will compare real laws for conservatorship and mental incompetence, comparing them to situations portrayed in the books that we have read for Mental Illness in Literature: 72 Hour Hold, The Center Cannot Hold, and Marbles, Mania, Depression, Michelangelo & Me. I wish to express my views and emotions through visual images, deciding if parents provide and receive ample support when their adult daughters are ill.
Keri’s California Catastrophe
During my research into mental health laws, I have not found ample material to describe “parents” in regards to mentally ill sons and daughters who have reached the happy age of 18 and adulthood. Instead, the definition of “conservatorship” is used to define incompetent individuals who require a “conservator” to manage the individual’s affairs; as the Special Needs Law Group writes online, “any adult can file for conservatorship”. Although conservatorship intends to protect the mentally ill or those with disabilities, the definition implies that a person with the ability to win over a judge will own another’s finances, or deem a sane person unable to care for herself. Swedish author Stieg Larsson explores that implication in his Millennium Trilogy books through Lisbeth Salander, for example, whose violence towards sadistic men and unwillingness to trust authority figures leads to others considering her “emotionally disturbed” and fit for mere menial work (158). She proves otherwise when an unscrupulous guardian seeks her finances and learns of Lisbeth’s extensive use of Tasers. We thus see the potential for power abuse and sadism towards the mentally ill or the system’s victims.
With that context, we sigh in relief that Keri in 72 Hour Hold thus seeks only temporary conservatorship for her daughter Trina. Trina, a bipolar patient and marijuana user, is not deemed mentally incompetent forever, just long enough to stabilize her routine and willingness to take medication. Keri holds more finances than her daughter and merely wants to save Trina from prison, where “she won’t get medication or therapy . .. she’ll just get sicker” (Campbell 273). In addition to the stigmas associated with jail time and mental illness, Trina and Keri are black, meaning that they have to face racism in the system as well as from their tight-mouthed LA community when confronting police and psychologists.
72 Hour Hold emphasizes that parents caring for sick children, even if the children are legal adults, need a support system. The government does not provide ample support for Keri, even with the wording of conservatorship and the titular hold that cannot keep Trina sane. California has the softest laws in regards to mental health; when I looked at the American Academy of Physician’s Assistants website regarding detention laws– detention being confined to a mental facility– and it reported that in California:
“The facility shall require an application in writing stating the circumstances under which the person’s condition was called to the attention of the officer, member of the attending staff, or professional person, and stating that the officer, member of the attending staff, or professional person has probable cause to believe that the person is, as a result of mental disorder, a danger to others, or to himself or herself, or gravely disabled” (“Summary of State Laws”).
In plain English, a Los Angeles mental facility can only confine an individual if they can write down the circumstances under which commitment is necessary, and for three days. During one of these hospitalizations, Trina loses her place in a support group and refuses to commit herself for a longer stay. Keri resorts to trying a health resort outside the law to keep her daughter on the path to recovery but eventually must seek temporary conservatorship and family support. She has to forgive her ex-husband Clyde for living in denial about Trina’s condition, allow her mother to come back into her life and provide help in the clothing store as well as at home, and allow her boyfriend Orlando to assist with Trina’s treatment.
Keri has such a hard time facing the California laws which, while progressive compared to the laws of other states, provide obstacles for her goals to help Trina return to a functional state of mind. With these goals in mind, one wonders how Keri’s battle would differ if she had been in her home state Georgia, where the laws allow “mentally ill” patients to be detained for up to seven days instead of 72 hours as well as receive “involuntary treatment” if a “peace officer” wrote a certificate (“Summary of State Laws”). Unlike the California mandates for detention, Georgia law shows no concern for defining a mentally ill individual, or considering that peace officers may abuse their positions to write up misleading reports to commit sane innocents. Perhaps to avoid such a possibility, Bebe Moore Campbell set the story in the more liberal Los Angeles, where different stigmas and red tape block Keri’s path. We thus don’t see Keri pulled over for being black, or facing prejudice and poverty in Atlanta. In any case, the laws in either California or Georgia do not help her, except to grant her the ability to entrust her daughter to a locked, clean facility.
Fragile Ivy League
Dr. Elyn Saks,
in contrast to the fictional Trina, has to learn to avoid the mental health system because the laws completely work against her as well as her philosophy to be a go-getter and to pull herself up by her own bootstraps. At the same time, she has to make peace with taking medication while developing a support network with friends, loved ones, and psychoanalysts. She chronicles this lifelong development in her memoir The Center Cannot Hold
From a young age, Dr. Saks has learned not to trust her parents with every detail of her life, since they cannot handle the reality of an imperfect child. After smoking marijuana for a couple of days and hating the experience, for example, her parents put her in Miami drug rehab where she develops an addiction to cigarettes and incorporated tough love into every part of her life; she describes the experience as “breaking my spirit and rebuilding it to someone else’s specifications” (Saks 28). Rehab strips Dr. Saks of her freedom while instilling her with a broken spirit and the need to excel above personal flaws. Small wonder that when Dr. Saks is diagnosed with depression in Oxford, and schizophrenia later at Yale Law, she doesn’t want her mother and father to know about her failings for fear of running into that tough love again. They find out despite her effort to break the news gently, thanks to hospital policies.
To be honest, I find it difficult to reread Dr. Saks’s memoirs of being restrained at the Yale Psychiatric Institute as well as Yale-New Haven Hospital, where she’s nearly smothered forced to take ineffective psychiatric drugs. By falling into delusions after reaching memos, she runs afoul of Connecticut’s detention laws and medical institutions:
“Any person who a physician concludes has psychiatric disabilities and is dangerous to himself or others or gravely disabled, and is in need of immediate care and treatment in a hospital for psychiatric disabilities, may be confined in such a hospital, either public or private, under an emergency certificate as hereinafter provided for not more than fifteen days without order of any court, unless a written application for commitment of such person has been filed in a probate court prior to the expiration of the fifteen days, in which event such commitment is continued under the emergency certificate for an additional fifteen days or until the completion of probate proceedings, whichever occurs first.”
The law dooms Dr. Saks to spend two weeks at YPI and Yale-New Haven Hospital’s mercy, where her doctor write to “use restraints liberally” on her, withdraw her from Yale Law without her consent, and refuse to consider her opinion on treatment or psychoanalysis (159). They disregarded her family’s need to laugh about the situation, to cope with the mental illness’s reality. If she had been in California, with Keri’s 72 Hour Hold problem, she would’ve had less time in isolation and more choices given to her, and in her home state Florida –go Sunshine State, despite our disturbing, detailed laws– she could have likely received an involuntary examination and undergone indefinite confinement if diagnosed with schizophrenia. Small wonder that Dr. Saks makes it a point to never qualify for an ER visit again and works hard to stabilize her condition.
Fortunately for Dr. Saks and for this easily upset reader, her parents do not seek to remove her rights as a legal adult via conservatorship. She is diagnosed in her early twenties and thus does not have to trust her social life and finances to a conservator whom the court may easily appoint. Her mom and dad do not understand that she’s sick but know that she cannot live through life with a label, whether to satisfy their expectations or to keep her motivated to work hard. The same “tough love” and “build yourself up” mentality that plagued her childhood keeps her from permanent hospital stays, for Dr. Saks uses psychoanalysis to pass law school and search for employment in California. She in time develops friends from support groups and law school to keep her going through delusional episodes.
Despite the legal decisions to maintain her independence, Dr. Saks’s parents cannot provide emotional support. They refuse to accept her schizophrenia diagnosis, her dad saying “This isn’t terminal cancer . . you can beat it with the right attitude” (Saks 183). That attitude allows her to return to Yale Law and pursue a career fighting for the mentally ill’s rights, but such a mindset does not allow for failure either. Ironically, her parents later refuse to show up when she is diagnosed with cancer several decades later, or for her wedding, because they cannot accept that she still has to take anti-psychotics and function with psychoanalysis. Independence comes at a price, with her moving across the country for her California position, and Dr. Saks has to compensate for her absent family by finding new loved ones. She does find them, including a wonderful best friend and a romantic husband, but at the books’ conclusion she acknowledges the possibility that her parents may have “deliberately chosen to be unavailable” as part of a defense mechanism (Saks 326). Support does not always come from the home, though it did come when she had her only ER experience, so Dr. Saks has found the balance between acknowledging that she has a brain disease and refusing to accept the stigmas that come with schizophrenia.
The Sane Artist
Personally, I believe that having a doctor for a parent makes the difference. Parents fret, and medical problems can be tremendous obstacles for well-intentioned mothers and fathers. Pediatricians know firsthand what mind-altering medications will do to children, and thus take steps towards prevention rather than treatment. That said, parents should do what they can to learn about the diagnoses, and not accept professionals’ words as final. I speak from experience, having a mother who is a retired pediatrician.
As an addendum, however, Ms. Forney does not represent every bipolar cartoonist or artist. No judge took away her status of mental competence, or assigned her to a conservator. She happens to be a successful one, and talented Eisner winner. As an added irony to the law-abiding Keri and Dr. Saks, Ms. Forney has done recreational drugs and never had to enter rehab.
Despite the government’s good intentions, parents and mentally ill children do not receive enough support from the laws or from the medical system. Parents are not even acknowledged in legal terminology, and thus as regarded as nonexistent. Senators and representatives lack awareness that the legal wording strips patients of their humanity, so that they appear burdensome and animals when compared to “sane” individuals. Yale-New Haven Hospital has not changed its policy regarding involuntary confinement, for example and California still has strict laws about the 72 Hour Hold and conservatorship. Law for other states allows for confinement based on a designated expert’s word, as well as for a week-long hospital stay without compromise. Patients and their parents have to fight for the ability to discuss treatment, while parents have to deal with the fact that their child suffers the mental illness label for life.
Parents and independent adults diagnosed with bipolar disorder or schizophrenia, need to find compromise between a psychiatrist’s label and the need to live an individual, liberated life. Ellen Forney and Dr. Elyn Saks found that balance by channeling their psychoses into creative and law-changing work, talking to licensed therapists who respected their choices, as well as finding family and friends who would support them through delusions and episodes. Parents want their children to succeed as artists, professionals, or as plain old human beings, and doctors labeling illnesses as “hopeless” does not respect those wishes.
We need to change the laws to identify parents rather than “conservators” and treatment rather than “detention”; unless a mentally ill person resorts to the rare case of violence, they need help as opposed to imprisonment. In addition, we need to recognize small communities coming together to help one beloved, valuable individual. A mentally ill child is still a child, and they need assistance with growing up. If the law won’t help with that necessary growth, then individuals need to step in and offer compassion. It takes a village to raise a child, and allow them to become actual adults.