Inclusion | Montana's Peer Network

Human Rights When It Comes to Mental Health

Beth Ayers — Tue, 19 Dec 2023 18:35:09 +0000

by Beth Ayers, Family Peer Support Lead

December 19, 2023

When I began this article, I was going to write about involuntary commitment, in particular for young adult children by their parents. But after spending hours writing and talking to others, I was more confused than when I started. I was left with more questions than answers. And maybe that’s how it should be. Maybe we should wrestle with it. Maybe there is no right or wrong stance but many answers that depend on numerous variables.

As I was looking up human rights and mental health, involuntary commitment was listed as a human rights violation by the World Health Organization (WHO). But more of the article by WHO, titled Mental Health: Promoting & Protecting Human Rights, was about a person’s right to “available, accessible, acceptable, and good quality care; and the right to liberty, independence, and inclusion in the community.” The article also stated that “lack of community-based services means the main setting for mental health care is long-stay psychiatric hospitals or institutions.” And it got me thinking that instead of writing about this complex, complicated, and emotional topic of involuntary commitment maybe I should focus upstream on prevention so that maybe fewer situations for involuntary commitment arise.

An online article by Mental Health America (MHA), titled Mental Health Rights, expanded on these rights of liberty and autonomy, community inclusion, and access to services. It states that persons with mental health and substance use conditions “have the right to make decisions about their lives, including their treatment.” This tells me that my adult child with a mental health condition has a right to see a counselor or not; take medication or not; want recovery or not. As a parent that is sometimes a hard pill to swallow. I want the best for my child, but maybe what I think is best for them actually isn’t. I believe everyone deserves the dignity and respect to make their own choices. I wouldn’t be the person I am today without the struggles and lessons learned by my consequences and successes. But then I think about if my child was in psychosis and mentally unwell to the point that they had lost the ability to make decisions. Well, who determines what well or unwell is? Who determines if my child should be involuntarily committed? And do I trust this person? See, I told you I had more questions than answers. However, a preventative measure a person with a mental health and substance use condition can take is having an Advanced Psychiatric Directive. MHA, in the same article, explains that with an Advanced Psychiatric Directive the person can “designate in writing, while competent, what treatments they should receive should their decisional capacity be impaired at a later date.”

Community inclusion. MHA writes, “People living with mental health conditions have the right to live and fully participate in their communities of choice.” As a parent of a child with a mental health condition, I have firsthand experience with stigma and exclusion. I have had to fight for my child’s condition to be looked at for what it is, a physical condition and not laziness or their choice or bad parenting. As a Family Peer Supporter, I have worked with many families whose children have been kicked out of daycares and schools because of their mental health conditions and the behaviors that can come with it. The article takes this further saying, “Community inclusion means not only addressing discriminatory practices that exist but also providing necessary supports that allow people to live and find meaningful roles in their communities.” One way to combat community exclusion is through education. When people know better, they do better. Understanding mental illness breaks down the stigma and helps the community feel comfortable interacting with people with mental health conditions. We can also tell our stories. Putting a human face to mental illness breaks down walls and helps communities find their common humanity. Peer support is another great way to empower other peers and advocate for inclusion.

Access to services. The above-mentioned article address this by saying, “People living with mental health conditions have the right to receive the services they want, how and where they want them.” While I agree with this statement wholeheartedly, I also realize the many challenges that make this hard, if not impossible. Lack of community-based services, rural landscapes, insurance, systems, and a lack of providers all limit access to services. The increased use of telehealth has helped providers see and treat patients from hundreds of miles away, increasing access to care for rural communities. I have experienced the frustration of trying to get services for my child. The behavioral health system, in my experience, uses a reactive approach to treatment rather than a proactive one. I remember trying to get my child into a partial hospitalization program. Due to insurance approvals and the way access to treatment worked, my child had to go into crisis, be admitted to the in-patient psychiatric center, and then they could be accepted into the partial hospitalization program. I was told that we needed to prove that my child “really needed” the service. As an advocate, I can contact legislators, get in front of people who make the decisions, and sit on advisory councils to change these systems. Even as I do all of this, I have found the most effective method for change has been partnering with service providers and organizations in my community and connecting families to these services. I am fortunate that as a Family Peer Supporter, I have the opportunity daily to connect with families. Data has shown us that when a parent feels heard and validated, their perception of care positively increases as does their confidence in taking care of their child and advocating for their needs. Using our lived experiences brings light to these challenges and moves people towards change.

As a Family Peer Supporter and mental health advocate, I can help protect the rights of people with a mental health condition through my voice, actions, and compassionate support. And I will continue to wrestle with the tougher questions surrounding mental health and human rights, dialogue and listen to people’s point of view and life experiences, and connect to our shared humanity.

Embracing Resilience: LGBTQ+ A Journey of Struggle and Triumph

Mandy Waite — Wed, 11 Oct 2023 17:37:14 +0000

by Mandy Nunes, Assistant Director

October 11, 2023

In the tapestry of human history, the LGBTQ+ community has woven a thread of resilience, creativity, and love that stretches back centuries. Despite monumental progress in recent decades, LGBTQ+ individuals continue to face discrimination, adversity, and stigmatization. This blog aims to explore the intersection of LGBTQ+ history, mental health, addiction, and recovery, shedding light on the unique challenges faced by this community. As a lesbian woman in long-term recovery, who came out at the age of 37, I've witnessed firsthand the transformative power of acceptance, support, and inclusivity from many within recovery communities. Yet, like countless members of the LGBTQ+ community who have come before me, my journey has also been marked by moments of fear, judgment, and significant adversity. Embracing my authentic self has meant navigating a world that, at best, strongly favors heteronormativity, and at worst, as history has shown, can be hostile to individuals like me.

The LGBTQ+ community has a dark but rich history that spans millennia, showcasing immense resilience.

Sappho and Plato (circa 630 BCE - 347 BCE): Ancient Greece saw the flourishing of same-sex relationships, with figures like Sappho and the philosophical musings of Plato touching on love and desire between individuals of the same gender.
1610: Virginia's Sodomy Laws: The Virginia Colony passed the first sodomy laws, imposing the death penalty for offenders. This marked a dark chapter in LGBTQ+ history, as legal persecution took a brutal turn.
1641: Massachusetts Broadens Laws to Include Women: Massachusetts expanded on the Virginia legislation, now targeting both male and female same-sex relationships in its penal code.
Victorian Era (1837-1901): The 19th century was marked by the stifling mores of the Victorian era, imposing strict gender roles and stigmatizing any deviation from the heterosexual norm.
Section 377 in India (1861): In 1861, India passed Section 377 of the Indian Penal Code, criminalizing same-sex relationships. This draconian law persisted for over a century, until it was finally struck down in 2018.
Havelock Ellis's Pioneering Research (1897): Havelock Ellis challenged prevailing notions with his groundbreaking research on human sexuality. His work laid the foundation for more nuanced understandings of sexual orientation.
Evelyn Hooker's Trailblazing Study (1957): Evelyn Hooker's paper, "The Adjustment of the Male Overt Homosexual," revolutionized perceptions of homosexuality by demonstrating that homosexual individuals were just as mentally healthy as their heterosexual counterparts.
Alfred Kinsey's Revolutionary Research (1948-1953): Building on Ellis's work, Alfred Kinsey's studies on human sexuality, notably the Kinsey Scale, revealed that homosexuality was far more common than previously assumed. Kinsey argued that the rigidity of institutions like religion, marriage, and social norms were often more damaging than the sexual behavior itself. He advocated for the change of laws to end bans on specific sexual acts, including homosexuality.
Frank Kameny's Pioneering Activism (1925-2011): Frank Kameny, an astronomer employed by the US Army Map Service, faced discrimination based on his sexual orientation. When he refused to answer questions about his sexuality, he was terminated. Undeterred, Kameny took his case all the way to the Supreme Court, although he did not succeed. This experience transformed Kameny into a tireless activist. In 1965, he led the picket line at the White House. He collaborated with groups like the Mattachine Society and the Daughters of Bilitis, organizing pickets at various government institutions. Kameny also played a pivotal role in the campaign to overturn DC's sodomy laws in 1963. The bill he drafted eventually passed two decades later. His advocacy extended to the removal of the classification of homosexuality as a mental disorder from the DSM.
Stonewall Riots (1969): The Stonewall riots were a watershed moment in LGBTQ+ history. On June 28, 1969, a police raid at the Stonewall Inn, a popular gay bar in New York City, sparked resistance from patrons and activists. The ensuing days of protests, led by transgender women of color like Marsha P. Johnson and Sylvia Rivera, marked a turning point. The LGBTQ+ community's defiant stand against police harassment galvanized a broader movement for LGBTQ+ rights, leading to the establishment of Pride parades and a renewed spirit of activism.
DSM Removal of Homosexuality (1973): A monumental step forward occurred in 1973 when the American Psychiatric Association removed homosexuality from the Diagnostic and Statistical Manual of Mental Disorders, affirming that being LGBTQ+ is not a mental illness.

The classification of homosexuality as a "pathological behavior" in the Diagnostic and Statistical Manual of Mental Disorders had far-reaching consequences. It provided a basis for:

Justification of Criminal Laws (e.g., 1948 Miller Act): Laws such as the 1948 Miller Act authorized penalties of up to 20 years in prison for individuals engaged in same-sex relationships.
Explanations for Anti-Gay Laws: The classification was used to rationalize laws against congregating in public places and to support discrimination in public spaces and housing against "known homosexuals."
Medical "Interventions": This misguided classification led to a range of harmful medical interventions aimed at "treating" same-sex attraction, including lobotomies, sterilization, and hormone injections.

Mental Health Disparities in the LGBTQ+ Community

The discrimination and prejudice that LGBTQ+ individuals face contribute significantly to their higher rates of mental health challenges. According to the National Alliance on Mental Illness (NAMI), LGBTQ+ individuals are more likely to experience mental health conditions like depression, anxiety, and substance abuse disorders due to the cumulative effect of societal stigma, discrimination, and isolation.

Statistics reveal that:

Depression and Anxiety: LGBTQ+ youth are four times more likely to experience symptoms of depression and anxiety compared to their heterosexual peers.
Suicide Rates: LGBTQ+ individuals, especially transgender and gender non-conforming individuals, face significantly higher rates of suicide. Studies have shown that transgender individuals are nearly twelve times more likely to attempt suicide.
Substance Abuse: The LGBTQ+ community faces higher rates of substance abuse disorders compared to the general population. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that 39.1% of LGBTQ+ individuals use illicit substances, compared to 17.1% of heterosexual individuals.

The interplay of addiction with mental health struggles is often profound within the LGBTQ+ community. Substance abuse can frequently serve as a coping mechanism for the discrimination and rejection they face, exacerbating the cycle of addiction and mental health challenges.

Looking back, it’s no surprise that I didn’t come out as a lesbian until I was 37, and until after five years in recovery. The journey was fraught with uncertainty and fear, as societal norms and internalized stigma collided with my newfound sense of self. In many ways, my recovery journey paralleled my journey towards self-acceptance. Both required vulnerability, resilience, and a supportive community.

This history underlines the significant progress made in understanding and advocating for the rights and acceptance of LGBTQ+ individuals. However, it also emphasizes the vital work that remains in creating inclusive and equitable communities. Together, we can continue to create safe spaces where members of the LGBTQ+ community can embrace their authentic selves without fear and be welcomed into communities, including behavioral health and recovery communities, with open arms.