Helping or Hindering Mental Health Education?

Do you help or hinder educating people about mental illness when you title a column “undefinable madness,” then proceed to define it poorly?

Elissa Ely provides the fodder in today’s The Boston Globe through an op-ed on schizophrenia. I wanted to like this column, but I was immediately put off by her self-assured misrepresentation of our understanding of this serious mental disorder.

Schizophrenia is a biological illness caused by excessive stimulation in one part of the brain, dismally balanced by deficits in another. It is not due to angry mothering. A virus may or may not be involved. Being born in certain months of the year seems to increase the risk. It is genetic and ruinous.

To say schizophrenia is simply a “biological” illness really begs the question… If it’s just another biological illness like the flu, or kidney disease, or diabetes, how come we don’t have a simple blood or other lab test for it after decades of research? How come one schizophrenia medication works for some people but not for others??

To say something is “caused” by “excessive stimulation in one part of the brain” is just ridiculous. Our understanding of the causes of schizophrenia is still very much in the dark ages. Let’s not simplify these things just to try and reduce their stigma, okay?

“A virus may or may not be involved.” True. But there may also be environmental and social factors that “may or may not be involved” (which she indirectly notes in the very next sentence about the time of the year you’re born). There’s a lot of theories on the causes of schizophrenia and if you just want to cherry pick the ones you agree with, then you a disservice in educating others about this disorder.

And while schizophrenia is indeed “ruinous” for most people who get it, it is neither a purely biological illness, nor a purely genetic illness. Our genes only increase our likelihood of getting schizophrenia, but they in no way predict whether we will or not.

Two other things about this op-ed concerned me, too. One was the fact that at least one, and possibly two, of the patients described in the stories she told about people with schizophrenia may be identifiable through the details she disclosed. Is it right that people’s personal lives become the subject of stories told to millions in a newspaper column without their consent?

Second was the poor manner in which the ‘teaching psychiatrist’ treated the person with schizophrenia called “Father Christmas.” Why would any professional with any experience and knowledge of schizophrenia try to “gently point out the absurdity” of their delusions? I didn’t understand that. I also didn’t understand a professional who then used “humor” to ask the person with schizophrenia, “Is that crazy?” What kind of stupid question is that to ask someone who’s come to you for help and treatment? What kind of answer would the professional like to such a question??

All in all, I find such editorials as these doing a disservice to people who struggle with mental illness. While providing a tiny bit of insight into the world of people with schizophrenia, I believe the misinformation the author provides about this disorder completely undermines such experiences she shares. It also felt like the people’s experience she shared she did more so as “case studies” rather than sharing real people’s personal stories — with their real consent.