On Mental Health And Poverty

Perhaps as a continuation of Jen’s entry, I’d like to recognize that while navigating the health care system is already often difficult and frustrating the process can feel all but impossible for those struggling with mental illness. Usually the first to get cut and the last to receive advocacy, mental health services experience a neglect in funding that creates an even greater handicap for patients who are already at a disadvantage. Mental illness is receives tremendous negative stigma within society but affects one fifth of our population, according to the Mental Health Association. A very dear friend of mine falls into that sizable percentage, and has been open and kind enough to share his experience in the hopes of promoting education and awareness. My friend (whom I’ll refer to as Clark) suffers from bipolar disorder–also known as manic depression—which is a treatable illness characterized by extreme changes in mood, thought, energy and behavior.

In his case, treatment has been difficult and ineffective, requiring him to change medications and treatments fairly frequently. For Clark, bipolar disorder is disruptive to daily life, his prescription medications are often potent and debilitating, and because of this there are times when daily activities become overwhelming. Due to his illness, he has been unable to keep a job consistently and has been unemployed for the past few years. He has no insurance and receives medical services through Healthy San Francisco. Clark’s psychiatrist recently left his medical home; the clinic will not be refilling the position. Clark is currently in the process of finding a new provider—a tedious and arduous process compounded by the fact the Department of Health Care Services recently cut $92 million from Mental Health Managed Care making services sparse.

Mental illness, particularly in my friend’s case, can be incredibly disabling. His inability to maintain a steady job due to bipolar episodes led Clark to apply for government support. Clark’s initial application for Disability and SSI was in March of 2007, after having been truly disabled (that is, unable to show up and/or function at work) since August of 2006.  He is now awaiting the verdict on the most recent chapter of this claim from a hearing July 13th with hopes he will finally see results—Clark has suffered three YEARS of waiting for the help he needs as a result of this long and drawn out judicial process. If the judge qualifies him for disability, Clark will receive a stipend of $400 a month; a minimal subsidy as he continues to try and work part time to make ends meet. Without this funding Clark has been unable to live independently.

Witnessing Clark’s anxiety and heartache in recent months has been a constant reminder of the barriers those with mental illness face. Our city’s lack of financial support and medical care available is crippling for even the most ably equipped. Clark is one of the advantaged with a family to shelter him, a network of loving friends to support him, and no other physical ailments. This is not the case for many of our poor and homeless community. Just as with any physical ailment or disability, mental illness worsens if untreated—a fate many suffer who tragically cannot afford treatment.

At St. Anthony Free Medical Clinic we provide general counseling and support for individuals, families, and couples as well as general psychiatry to help patients determine if medication is appropriate and help them manage their medications. We offer weekly drop-in support groups and self care workshops aimed at relieving stress, anxiety, and depression and offer referrals to patients who need specialized treatment. Mental health care is an integral part of holistic health, mental illness being as valid and real as any more “tangible” physical ailment. We cannot devalue the importance of services necessary to at least 20% of our general population.