The Consequences of Pretending Severe Mental Illness Doesn't Exist

Can we admit Thomas Szasz was wrong?

I know a thing or two about mental illness. I struggled with anxiety and depression for decades before getting free of it. I have a BA in Psychology, and I lived with a seriously mentally ill person for almost ten years. Before I was born, and based on the work of Thomas Szasz, mental hospitals started closing. Szasz maintained that there was no such thing as mental illness and that the abuses [there were real abuses] didn’t justify incarcerating and treating people against their will.

I used to agree with him.

In 2002, I married a man with a couple of kids. I hadn’t had any of my own, and he was snipped not long after his youngest was born. I thought - I hoped - that his kids could become my kids and that it would be enough. Both kids lived with their mom, who lived with her parents. My husband thought she might send his son to us at some point. He’s in his 30s now and as sweet-tempered a person as one might hope for. The younger girl was a different matter. I’ll call her Veruca. [Yes, from Willy Wonka, and not the revised version.]

When Veruca started acting out [worse than she had been], things started to get ugly. She’d always been strong-willed, and her mother wasn’t [I can relate.] Her mother had been administering consequences with a wooden spoon. One day Veruca pulled it out of her hand and threatened her with it. Veruca was a big girl. At 11, she was 5’4” and close to 160 lbs. The next year she keyed her mother’s car. Why? Because she’d back-talked her mother and her mother took away her Gameboy.

Veruca was never shy about upping the anti.

My husband spent quite a bit of time on the phone with his ex while she bemoaned Veruca’s behavior. From my end of the conversation, I was banging my head [figuratively] against a wall. I hadn’t raised kids of my own, but I had trained horses and my dog, and I had an alcoholic parent. I knew poor boundaries when I saw them. My husband and I talked about this, and about taking her for the summer.

We also recognized that it might be permanent.

I took the bull by the horns and found out about the local school and what they might have to offer a troubled girl. The services were about as good as they could have been. Connecticut is a wealthy state and we were in one of the best districts.

Veruca was… difficult. She loomed when she entered a room. She was usually scowling and radiating anger. [If I hadn’t trained in martial arts I couldn’t have managed her. I only ever had to apply it once, our interactions were more about my confidence that she would do what I said than about open aggression.] She was passive-aggressive. She broke things and denied doing it. She cut a piece from one of the bath towels and claimed it was a tear. Things disappeared: jewelry, money from my husband’s wallet, kitchen knives, and random stuff like combs.

We put a lock on the bedroom door.

One day I came home to my cat bleeding. His ear had been nicked. I lied to myself [the alternative was me running screaming into the night] and decided his buddy had accidentally clawed him during play. [Veruca confessed years later that it was her.] I treated it and we moved on. She was far smarter than her parents and I was the only one who ever figured out how to get her to do anything she didn’t want to. This is only a tiny sample of our living situation.

But eventually, things started to look up. She joined the marching band, and her school won the regionals. They marched in Obama’s inaugural parade, and she went on trips with them. She once marched right out of her shoe on a muddy field and kept going, earning the team extra points. She started going to the local aquaculture school in Bridgeport, and eventually got into SUNY Maritime.

The night before she left for induction [SUNY’s version of boot camp] She read to me while I drew her marching band insignia on her sea trunk. We were hopeful, and for the next two years, things got better. She failed her math assessment [raw overconfidence] but sucked it up, took the remedial course, and tutored other students. She talked about how much time she’d wasted on video games and how good it made her feel to help people.

Then things started to get weird. Again.

She ‘lost’ the knife I’d given her [this is a required item for maritime students] and we found out later that she’d threatened another student with it. She started failing classes or just getting by. Eventually, she ended up back home for what was supposed to be her last summer. She broke things. I came home one day to shards of glass all over the back room. Then she did it it again, and left a threatening note about my cat.

At that point, I left. I ran up to Maine in the middle of the night with all three cats. I only came back when she left for her last cruise [Maritime students go on training cruises during the summer] and left again when she came back. Now there was not just drama with her but with my husband as well.

My sister-in-law rescued us by allowing Veruca to live in an efficiency on an investment property she’d just purchased. But Veruca’s behavior continued to deteriorate, even as she continued to attend classes in the Bronx. She believed someone was following her. She asked my sister-in-law for security cameras because she was sure someone was breaking into the basement.

Her mother figured out she had schizophrenia and got her into an early treatment program at Yale. She started on medication and things improved. I let her move back in, hoping this would turn her around at last. While she did finally graduate, things didn’t turn around. She immediately announced she wouldn’t be working in her field.

I share this not to depress anyone, but to give a few of the realities of living with someone who is seriously mentally ill.

Freddie deBoer writes about their plight and how we got here. We Closed the Institutions That Housed The Severely Mentally Ill.

Veruca will not stay on medication voluntarily. She spent six weeks in jail where the jail infirmary made her take medication. She’s been in and out of the hospital multiple times. In the most recent, she had a hearing to force her to take meds because she broke a nurse’s glasses. She stabilized. When she was released, she had to be taken straight to court to deal with an assault charge. The charge was pled down by her state-appointed lawyer. Until she does something that would send her back to jail again, she is refusing her medication. Her former housemate described her as ‘the most vindictive person I ever met.’ The woman was traumatized after living with Veruca for 18 months.

I know the feeling.

Soon, Veruca will be evicted from her state-subsidized apartment because she won’t behave in a civilized manner. The legal process started months ago.

I know her brain state isn’t her fault. That in no way means I want her anywhere near me. This is one of the few places where I think there is a genuine need for state intervention. I’m not sure if she really can’t take care of herself, or if she just refuses to do so. Either way, Veruca is a danger to herself and others. But the state ignores that in the name of care, kindness, and personal autonomy.

Doesn’t feel very caring to me.

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Selina Rifkin, M.S. [Nutrition], LMT, has been to Hades in a handbasket. More than once. This has given her some opinions. Like most of her generation [X] she’s okay with snark. Most days she tries for good writing. But the snark, and side comments creep in. She lives with her husband, and is Mother of Cats; four boyz and one cranky gurl. Selina has written The Young Woman’s Goodlife Guide: Things I Wish I’d Known When I Was 20. Or… Learn From My Pain, and How to Train Your Cat: Using a Clicker and Leash to Keep Your Indoor Cat Happy and Healthy, and the Goodlife Guide to Nutrition.