Let’s Talk 2013

My #letstalk tweets yesterday got a good reception. Here’s a less ephemeral version.

Slouching in my chair in my cheap red housecoat, tweeting from the netbook. It’s been a week of too-lucid nightmares and being unable to wake up before noon. I got cut off Ontario Works, so I’m paying out of pocket for meds, and Wellbutrin is too expensive. So I’m doing it the smart way and tapering off under my doctor’s supervision. It’s going fine except for the constant drowsiness and brain fog, which is tough when you’re on a deadline.

I shouldn’t have to bare my ugliest wounds to get people to be decent, to get them to take things seriously. I don’t really want to talk about suicide, or the sweaty nightmare of Effexor withdrawal, or the sludgey everyday feel of depression. I don’t want to talk about G-d or the absence thereof.

But today hath been decreed Let’s Talk About Mental Illness Day by Bell, who are going to donate 5¢ for every tweet hashtagged #BellLetsTalk. I don’t see why they can’t just donate a huge whack of money. Or hire a ton of lobbyists to pressure various levels of government to improve our existing mental healthcare system. Individuals speaking out are important, but it’s not complete without organizing for systemic change. Policy. Legislation. Stuff like that.

Let’s talk about the complete lack of mental health infrastructure here aside from the crudest emergency services, eh? They can’t do anything for you unless you’re actively suicidal, with a Plan and everything; you have to wait to get to that point. (I’ve been told this multiple times. I’m not the only one.)

The problems with mental healthcare parallel the problems with Ontario Works: you don’t qualify for help until you’ve lost everything…and you become ineligible again before you’ve gotten back on your feet. It creates a cycle of dependence.

We really don’t have to suffer this much. Why don’t we have pharmacare? Wouldn’t it be nice if you could book a free appointment with a therapist as easily as you can with a GP? Wouldn’t it be nice if no one ever had to quit venlafaxine (Effexor) because they couldn’t afford it any more? (For the n00bs, Effexor is real hard to quit. I did it once, cold turkey, and it was hell. I’m on it again now, for the long haul.)

Why can’t we have more places like the Gerstein Centre in this city? Respectful, dignified places to crash for a few days, to ease the transition between the ER or the institution and everyday life. You can come and go as you please, you just need to be back for dinner, and there are people on staff to talk to, and you can have guests if you want. I stayed there for a few days after one episode, during the G20 coincidentally. I licked my wounds and read Cryptonomicon and The Android’s Dream, left by some fellow traveller passing through. It was—gentle.

Depression has taught me to eschew the “man up”, “if you can’t handle the heat, get out of the kitchen” mentality. Toughness doesn’t mean learning to not care or not feel it. In fact the toughest people are the softest, the easily crushed, the sensitive ones. If you leave them (us) out—if you leave us behind—you’ll end up with a crowd full of, well, assholes. That’s the kind of macho culture endemic in a lot of industries, like politics and journalism. It’s terrible and I suspect many people would want something different, if they thought it was possible. But if you want things to change, you—you, personally—must stick your neck out for the “least of your brothers”.

An anecdote: at the end of the second all-night Executive Committee meeting, I think, after a night of deputations, they voted to Fuck the Poor™ anyway and I had a tiny mental breakdown. I felt like I had during my first suicidal crisis, which was brought on largely by poverty—being out of resources with nowhere to turn and no one to help me. Reporters and councillors were having media scrums, and everyone was milling around, and I kind of felt myself disassociating, completely losing touch with it all. To his great and everlasting credit, my city councillor actually listened to me try to explain my state of mind and said empathetic things. He seemed to take me seriously even though I was a complete wreck who had been driven to suicidal ideation by a committee meeting.

People like Cllr. Perks, and former alderman (councillor) David Reville (who I haven’t met yet), have convinced me that there is a place for me in politics. I think it is very important to create a political scene that people with mental health issues can participate in. We have to be decision-makers too, not just objects of policy, even at our messiest and maddest.

The most effective mental health treatment is supposed to be tripartite: medication, exercise, therapy. I would add a fourth: community organizing and political self-advocacy. Exercising your right to visibility and agency is not just personally empowering; it also makes things better for people who will come after you. It’s extraordinary if you think about it! We can’t change the physiological nature of mental illness. Meds can only do so much. But by changing our wider communities we can make mental illness easier to bear. I know this because the work of people like Pat Capponi, David Reville, and Reva Gerstein has improved my life in concrete ways. They didn’t just talk; they did. So can we.

A sombre What I’m Reading

Pat Capponi, Upstairs in the Crazy House (1992)

A memoir of the author’s post-institutionalized life in one of Parkdale’s infamous boarding houses, with flashbacks to her abusive childhood and the roots of her depression. She chronicles poverty, fleas, abandonment, addiction, and the determination to assert one’s humanity in the face of a system bent on denying it.

Capponi has since become a prominent mental health and housing advocate here in Toronto, making the city a little more humane. Once, after a spell of suicidality, I was able to stay in the Gerstein Centre which she had a hand in establishing. It helped restore the dignity that the P. E. S. U. strips away from you; I’ll always be grateful.

Stevie Cameron, On the Farm (2010)

The book on the Pickton case. Seriously, there’s nothing I’ve read about in the news from the ongoing inquiry that isn’t in On the Farm.

Cameron focuses on the lives and personalities of the missing women throughout, an emphatic unspoken assertion that they were not “disposable”, they were not worthless, they were talented and vivacious and loving and loved women—their relatives fought for years to get the Vancouver police to take the disappearances seriously. In some cases the VPD flat-out lied to the families to get them to go away; and upper brass refused to let top profiler Kim Rossmo help investigate. To the VPD, women who were poor and addicted and prostitutes and (it’s impossible to deny this had an influence) Native weren’t worth finding.

(Slutwalk is happening right now; stayed in and wrote this up instead. Is SW relevant to impoverished mentally ill women? To addicted Native women in sex work? I suspect not but I’d love to be proven wrong.)

In the News: Social Assistance and Affordable Housing

A few interesting articles in the papers recently:

Globe and Mail: “To end poverty, guarantee everyone $20,000 a year. But are you willing to trust the poor?

This week, a House of Commons committee on poverty released a report proposing a guaranteed basic income for Canadians with disabilities, on the model already available to seniors. The Senate released a similar report this spring calling for a study of how it would work for all low-income Canadians.

In Quebec, a government task force went further, recommending a minimum guaranteed income starting at $12,000 for everyone in the province.

The article covers several promising case studies from all over the world. As a pessimist, I expect the moralistic middle class to react by shooting itself in the foot. Bootstraps!!1!!1, etc.

Globe and Mail: “Health of 400,000 ‘nearly homeless’ as dire as those on streets: study”

So far, [the researchers have] concluded that the biggest gulf in health outcomes is not between the homeless and the housed. Rather, it’s between those who have adequate housing and those who don’t.

Their lifespans are about seven to 10 years shorter than the general Canadian population, the study points out, citing previous research done in 2009.

Men in vulnerable housing situations have the same chance of living to age 75 as an average man in 1921 – before antibiotics were around. They’re more than twice as likely as the average Canadian to commit suicide.

Women in similar situations are as likely to survive to the age of 75 as an average woman living in Guatemala. They’re six times more likely to commit suicide than the average Canadian.

Toronto Star: Porter: “Linda Chamberlain’s job was making her broke”

As I mentioned on Twitter, even a part-time minimum wage job pays substantially more than social assistance. The “welfare trap” comes into play when someone’s on social assistance and working: half your pay is subtracted from your social assistance payments. And if you’re in subsidized housing, your rent is geared to your income—your gross income. Such is the case of Linda Chamberlain.

After three decades of battling schizophrenia and homelessness and poverty, Chamberlain finally got a job. She worked 2 ½ days a week as a peer support worker on the very floor where she once lived at the Centre for Mental Health and Addiction. It’d be hard to find a better success story.

Except, under the antediluvian web of provincial rules, she lost half of her paycheque to the government, while her rent-geared-to-income skyrocketed by 471 per cent.

The article notes that, when a panel of welfare experts recommended—among many other things—that rent-geared-to-income be calculated from net and not gross income, the Community and Social Services Minister shot it down. Because we’re in a recession. And we have to cut expenses—inevitably at the cost of the poorest, most vulnerable, and most marginalized.

Old Habits Die Hard


Originally posted in November 2009


It seems that, even among people who should know better, it is very easy to fall into the trap of thinking of oneself as a mind encased in a body. That is, thinking that there are two very different kinds of stuff in the world: mental stuff (thoughts, emotions, memories), and physical stuff (organs, bacteria, tables). This way of thinking, which expresses itself in platitudes like “mind over matter”, is called dualism, and it has been deeply unfashionable among philosophers for the past two hundred years or so. The cool kids have long ago moved on to monism, which is the idea that there’s only one kind of stuff in the world (nowadays, matter—i. e., atoms and molecules—but more on this later) and everything is made of it. Of course, the rest of the world generally takes longer to catch up with philosophy, so you still see people unashamedly espousing dualist metaphysics, unaware that it is the philosophical equivalent of wearing white after Labour Day.

This way of thinking is especially pernicious when it comes to matters of health. In some cases, the mind is thought to be “really you”, and your body is a thing that can conspire against you. “That’s the depression talking.” It leads to a kind of “love the sinner, hate the sin” mentality with regards to disability or chronic illness…but having been well acquainted with that mindset I assure you it’s just a long-winded way of saying “hate the sinner”. However, in other cases, “mental” things are considered less real than “physical” things. “It’s all in your head” (as if your head weren’t a part of you, or what goes on in your head isn’t “real”). Or the artificial distinction between mental and physical disabilities.

It’s all the same stuff, people.