Jun 3, 2017

Another Attack On People Suffering From Mental Illness

     From the Washington Post:
The food was nearly gone and the bills were going unpaid, but they still had their pills, and that was what they thought of as the sky brightened and they awoke, one by one. First came Kathy Strait, 55, who withdrew six pills from a miniature backpack and swallowed them. Then emerged her daughter, Franny Tidwell, 32, who rummaged through 29 bottles of medication atop the refrigerator and brought down her own: oxcarbazepine for bipolar disorder, fluoxetine for depression, an opiate for pain. She next reached for two green bottles of Tenex, a medication for hyperactivity, filled two glasses with water and said, “Come here, boys.”
The boys were identical twins William and Dale, 10. They were the fourth generation in this family to receive federal disability checks, and the first to be declared no longer disabled and have them taken away. In days that had grown increasingly tense, as debts mounted and desperation grew to prove that the twins should be on disability, this was always the worst time, before the medication kicked in, when the mobile home was filled with the sounds of children fighting, dogs barking, adults yelling, television volume turned up. ...
Talk of medications, of diagnoses, of monthly checks that never seem to cover every need — these are the constants in households like this one, composed of multiple generations of people living on disability. Little-studied and largely unreported, such families have become familiar in rural communities reshaped by a decades-long surge that swelled the nation’s disability rolls by millions before declining slightly in 2015 as older beneficiaries aged into retirement benefits, according to interviews with social workers, lawyers, school officials, academics and rural residents. ...
“I hesitate to use a term like ‘culture.’ It’s not a specific, measurable metric,” said Kathleen Romig, an analyst with the Center on Budget and Policy Priorities, who studies disability in the United States. “Certain things like toxic stress or nutrition or preterm births or parental depression or genetics” offer a more revealing context for understanding generational disability.
And yet others say it’s about money.
Ruth Horn, director of social services in Buchanan County, Va., which has one of the country’s highest rates of disability, has spent decades working with profoundly poor families. Some parents, she said, don’t encourage their children academically, and even actively discourage them from doing well, because they view disability as a “source of income,” and think failure will help the family receive a check. ...
     For the record, genetic influences account for 60-85% of the risk for bipolar disorder so it is hardly surprising to find several people with bipolar disorder in the same family. Many who are initially diagnosed with attention deficit disorder in childhood are eventually diagnosed with bipolar disorder.
     Bipolar disorder is a very serious mental disorder. Although many people with bipolar can be stabilized with medication to the point that they can work and live fairly normal lives, that is certainly not the case with all. The disability produced by bipolar disorder has nothing to do with where a person lives or what their source of income is. Cutting off the income of people with bipolar disorder doesn't effect any cure. It just causes stress which makes the condition worse.
     With one exception, I don't often see two members of the same family as clients either at the same time or at different times. The exception is families where there's a lot of bipolar disorder.
     By the way, I don't know if there have been any studies, but I think a fair number of people with bipolar disorder get involved in relationships with other people with bipolar disorder producing children who face a really high risk of bipolar disorder. Why would this happen? Well, I guess you could say "birds of a feather ..." or "misery loves company" or you could say there was a lack of alternatives. Sometimes people meet in a psychiatrist's waiting room or in a psychiatric hospital. For better or worse, love finds a way and that's not always a good thing.
     In presenting a family where there's a lot of bipolar disorder, the reporter presented a skewed picture. He would have found it very hard to find a family to illustrate the point he wanted to make, and he definitely had a point he wanted to make, where the genetics of bipolar disorder weren't a major part. Would the reporter have used a family where there was a lot of hemophilia present to make the same point? I think not since he would have known that genetics were the problem, not culture or poverty or living in a rural area. This reporter was almost certainly unaware of how big a role genetics play in bipolar disorder.

9 comments:

Anonymous said...

The reporter doesn't care what role genetics play because his job is to do the big smear on the system. I have watched this tactic in action for years in order to achieve worker's compensation reform in my state. The articles are to turn public opinion against the program to set up the big kill. I'm sure a huge purge of the rolls is coming that will make Ronnie Reagan smile in his crypt. They are setting up their cover by repeating the big lie. I fear Trump and the establishment are lined up together on this. We must present the counter stories or we will be in trouble. This is storytelling for the hearts and minds of the American public. Don't assume any good or innocent intentions on their part anymore than you would look for them in Joseph Goebbels.

Anonymous said...

I'm of two minds about this. First it is misguided to say a person who comes from a family where others are receiving disability is somehow less deserving of it. Many conditions are genetic, as Charles says. On the other hand, I occasionally meet claimants who suffered some childhood injury or mental illness and grew up being told by their parents to never try anything or exert themselves because it could flare up the condition. Then when they grow up and I try to help them get disability, it is apparent there are very few limitations except an ingrained belief they are incapable of anything because mama said so. I fear that's the path the twin boys in that article are headed down. I don't blame the disability program for that, because that would be happening anyway, but I certainly see parents who behave that way.

Anonymous said...

"Many who are initially diagnosed with attention deficit disorder in childhood are eventually diagnosed with bipolar disorder."

It looks like the linked article shows that in a community sample of around 100 children diagnosed with ADHD, just under 60% had some type of comorbid affective disorder. At the same time, it says that only 10% have comorbid ADHD and bipolar disorder. Are we supposed to extrapolate from these stats that the two kids mentioned in the article have disabling ADHD because bipolar disorder runs in the family?

Anonymous said...

nobody is suggesting anything about these particular boys. Being born prematurely and in poverty and with family facing a lot of struggles doesn't necessarily mean they are disabled--and SSA has found that they aren't.

But to see the Post's story as indicative as a need to reform the SSDI program is an error. Add more workplace safety initiatives since two adults featured were hurt on the job? Stop cutting workers' comp, which is displacing people into DI? Provide better mental health care and special education for kids?
Figure out ways to attract doctors--including needed specialists--to rural areas? Expand Medicaid so there's a better chance for prenatal care? Those seem to make a lot more sense.

Anonymous said...

"But to see the Post's story as indicative as a need to reform the SSDI program is an error."

I think we're talking about SSI here, not SSDI. And I know it's an unpopular subject in these circles, but judgments about lifestyle choices are not going to go away. You're going to have an extremely difficult time convincing the average non-disabled American that a family dependent on SSI needs to spend $460 per month on cell phones, cable TV, and life insurance. I think it's easier to bridge the liberal-conservative divide with arguments that society should make sure disabled folks have access to basic necessities. When the disability checks translate to smartphones, cable, video games, pets, fast food, cigarettes, alcohol, etc., that's when the reformists come out in full force.

We should expand all of the services you mentioned, but it's not an either/or situation. We can provide better work safety initiatives and health care while still acknowledging that there's room for SSI reform.

Anonymous said...

Cellphones are cheaper than landlines nowadays, they're not a luxury item and haven't been for 15 years.

Anonymous said...

Ruth Horn, director of social services in Buchanan County, Va., which has one of the country’s highest rates of disability, has spent decades working with profoundly poor families. Some parents, she said, don’t encourage their children academically, and even actively discourage them from doing well, because they view disability as a “source of income,” and think failure will help the family receive a check.'

And yes, lets have lots of babies while on disability because the taxpayer can just pick up the tab. Next time I want a brand new BMW I will ask the American taxpayer to pay my car payments and insurance.

Anonymous said...

You didn't read the article, did you? Their cellphone bill was $300 for the month. If you're right, I'd hate to see their landline bill.

Anonymous said...

@2:57 Let me get this straight. Ms. Horn is a social worker who does not have a medical degree and who is very likely not privy to all the confidential medical records of these people she is talking about. Despite this you believe that she KNOWS that the reason that those kids are approved for disability is because the parents are encouraging that result, instead of the fact that they have real medical or mental health problems? Is Ms. Horn the Wonder Woman of Buchanan County, with the amazing ability discern such truths without the specialized medical training and diligent study of facts that mere mortals require to make such determinations?