In church this morning we read the story of the rich man and Lazarus (Luke 16:19-31), a poor, sick man who lay at the rich man’s door. The rich man did nothing to help Lazarus—perhaps he hardly noticed him—and when the men died, the rich man suffered. Of course, the moral of the story is that we must treat other people—no matter how poor, how sick, how wretched—as our brothers, and help them when we can.

I will admit that when it comes to mental illness, I have not always been great at this. Growing up, I’d seen many a homeless person sleeping on top of a subway grate in the winter—an incomprehensible action if I’d ever seen one. Canadian winters can clock in at five, ten, fifteen degrees below zero. Why wouldn’t you go to a shelter? Why would you leave home in the first place? Why wouldn’t you impose to stay with friends?

Tempting death and frostbite by sleeping outside didn’t seem desperate to me, it seemed foolish. Who in their right mind would do such a thing?

And so, until John’s breakdown, I’d always skirted by bums and beggars on the other side of the street; their dirtiness and lack of pride scared me, plus I figured I’d be better off donating my money to charities, where I could be certain it wouldn’t be spent on booze. You see, as someone who’d sought a solution to her own addiction, perhaps I was a little intolerant of those who had not done the same. Homeless? Must be because you’re an alcoholic: Get thee to A.A.!

During John’s hospitalization, I began to see the homeless a little differently. It was indeed quite possible that some of them—many of them, even—were alcoholics, or even scam artists, taking the tax-free bounty from their begging home to their five-star condos every night, but it was equally possible that mental illness had come on like thunder and earthquake and fire, and that nobody had been there to convince these people to enter the hospital; nobody had been there to persuade them that something was wrong.

Or, if there had been people there who loved them enough—and were competent enough—to help them seek treatment, maybe there was no health insurance. Maybe there was no money to cover the expenses involved in seeking care for mental health. (John’s first, seven-day stint in the hospital cost upwards of $11,000, not counting the doctors’ fees, which ran an additional $3,000 or so.)

And all of this coming like a thief in the night—no warning signs, no time to get prepared. What if the psychosis had come upon John while he was still single? What if he’d been alone, fairly new to the city, with no family or close friends or ties beyond his job? Work would have probably managed to get him into the hospital, but then what? Would he have been able to pay his bills, put a stop on his automatic investments, and apply for disability checks? Would he have recognized the need to switch doctors or go back into the hospital? Would he have stayed there long enough to recover if he had?

Before John got sick, I knew very little about psychosis beyond that it seemed frightening and shameful—the province of bums and the criminally insane. The people who suffered from it were different from me somehow, even though I qualified as a person with a mental disease. (Eating disorders, or so the stereotype goes, tend only to strike privileged little rich girls. They’re bourgeois—acceptable, even. For what you do with your food behind closed doors isn’t visible to the public, which isn’t the case for the rantings and ravings of the psychotic mind. You can’t keep untreated psychosis private. You can’t hide it or pretend it’s fine.)

But mental illness—psychotic illness—happens to the most stable people in the most loving homes. Those lucky enough to get proper treatment keep the illness a secret because they don’t want to incur the stigma associated with a psychotic breakdown. They don’t want their associates to feel they can’t trust them, or to look at them as though they’re crazy for the rest of their lives.

Those who aren’t lucky enough to get proper treatment, even with all the love, money, and competence in the world…? Well, many of them probably end up like the people we walk by every day, begging for spare change. Paranoid, they flee from the people who could help them. Delusional, they do not believe that anything is wrong.

Now, when I see beggars, I do try to give them a buck or two. But really, that kind of haphazard charity isn’t good enough to help the people who suffer from mental illnesses. If John was out on the street, I wouldn’t want passers-by to give him enough money to stay on the streets and remain ill, I’d want some kind of systematic response from society that would help him get treatment.

So I’m trying to get more involved with NAMI, because I know that it supports legislation that will bring about real change for the mentally ill. I’m also trying to raise awareness by writing this blog. If you have other suggestions for things I can do to help other people see mental illness in a new light, please let me know.


2 Responses to Lazarus

  1. Sometimes the alcoholic homeless are also mentally ill – they are self-medicating with alcohol, though they may not be conscious of it.

    Heather, I am SO glad for you that your husband is aware and accepting treatment. *Not* the case for many people with mental illness – they may also have a condition called ANOSOGNOSIA, which is a problem with the brain updating its self-awareness. Here’s some good books on the subject:

    If you don’t think anything is wrong with you, why on earth would you want to see a doctor or take pills? Trying to argue to PROVE to people they are sick generally doesn’t work. These books suggest other ways you can work with someone who is NOT self-aware about his/her mental disorder, to get positive results anyway.

    • I think my mother-in-law, who died of alcoholism last year, was actually someone who drank to deal with undiagnosed bipolar. I always thought her behavior was due to the alcohol, but when John was in the hospital, he was doing A LOT of the same things, which was pretty bizarre. It’s really sad that so many people with mental illnesses end up on the streets instead of in treatment.

      And thanks for the link to the books! I’d heard that I AM NOT SICK, I DON’T NEED HELP! is really good, but I haven’t gotten around to reading it yet, so I’m glad to have the reminder.

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