My first experience as a mental health client was at age 24 when I moved into a residential treatment house in Davis for mental health clients. I had dropped out of UC Davis at age 23 and had been treated for depression since age 21. I didn't know it at the time but I had grown up in an alcoholic/dysfunctional family and inherited depression from that environment.
I lived in the treatment house for a year. There were six beds and while I was there maybe 12-15 clients lived there. The staff was composed mostly of undergraduate psychology students at UC Davis led by a 30 year old program director. Most of the clients had been in the mental health system for years and were one step away from living on their own. During my year there I got on SSI. Overall, my experience there was so-so. When I moved in I perhaps had a naive notion that I could be "cured" there, but after a year there was little change in my depression.
During that year I applied to the California Department of Rehabilitation for help in seeking employment. DR helps people with disabilities. I was referred to a mental health client job program in Davis working on a gardening crew for minimum wage. It didn't interest me at all and I lasted maybe four months.
After I moved out of the treatment house I started going to Adult Children of Alcoholics 12-Step meetings where I learned I'd grown up in a dysfunctional family with an alcoholic father. This was crucial information because before this I had basically assumed that I was solely responsible for my depression and was inherently "defective". Learning the truth that my depression was the result of growing up in a dysfunctional family allowed me to give myself at least enough of a break that prevented most likely an eventual suicide attempt, because if I'd continued under the lie that my depression was "all my fault", surely I would have preferred being dead.
Looking back it's interesting and disturbing that weekly therapy with a psychiatrist and later a psychologist for over three years before ACA gave me no insight into the truth of being a victim of a dysfunctional family, and certainly being a mental health client would never expose me to that truth because mental health clients are not encouraged to question why they are "sick" but merely to see themselves as identified patients both on a family and societal level.
I left Davis at age 26 for Marin County to live with my parents which predictably did not work out well. After nine months I struck my mother and was hauled off on a 5150 for a two week stay on a psychiatric unit. After staying in a homeless shelter for two weeks I stayed in a "hotel" for mental health clients in downtown San Rafael and then moved into a "training" house for an assisted living program for mental health clients. That lasted about two months as I couldn't stand a housemate who was both schizophrenic and an alcoholic and who was a man in his late 20's who had the mentality of a six year old.
I should say that most mental health clients are diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder. I think in all my years of being a mental health client I only met one other person with a depression diagnosis. A large percentage of clients also have a substance abuse issue.
I eventually got established living in an apartment living off my parents and SSI. My next mental health client experience was attending a mental health day treatment program in San Anselmo where the clients would go for several hours a day attending groups and classes. That lasted maybe two months before I had a problem with the psychiatrist who ran a group therapy there who was basically the top dog of the staff of the program. I basically thought he was disrespectful toward me and the counselor assigned to me as I remember said I was a "disruption". Basically she took the psychiatrist's side which was not surprising since the counselor with her career aspirations didn't want to challenge the top dog psychiatrist on my behalf.
In my early 30's I went back to the day treatment program. I told the new staff that I'd had a problem with the psychiatrist (who was still there) when I was there before. They said I could skip his group if I had a problem with him again. This time at the day treatment program it went pretty well with groups and classes like art therapy and drama therapy amongst clients who were part of the mental health system in Marin, most living in houses for clients run by the Buckelew program (a non-profit mental health agency in Marin). Most all of them were on SSI.
After graduating from the day treatment program, I started Buckelew's employment program for mental health clients, working a part time job during the Christmas season at a clothing store before working with a job "developer" to find a job in the community. Eventually with his help I got a job at a nursery as a laborer, working for a little over minimum wage. Other than having two female college student job coaches spending some time with me at the job site for the first two weeks, it was a normal job situation. I got along well with the two nursery managers, and the job went pretty well although as a nursery laborer at a hardware store/lumber yard/nursery where the nursery was third in importance in the overall business operation, I was clearly at the bottom of the employee hierarchy. After seven months working there, during the winter season when there wasn't as much to do in the nursery as the warm season, and also because I grew tired of the man who ran the company, I quit.
To get this job I'd gone back to the Department of Rehabilitation and had been assigned a counselor there who seemed to have barely disguised contempt for me because she was barely civil to me. During one appointment with me when she was entering my information into her computer, she looked at my college history (I went to three colleges before dropping out) and said "So you didn't accomplish anything in college, huh?"
At age 39 I again went back to the Department of Rehabilitation and was referred again to Buckelew Employment, this time to work on a janitorial crew composed of mental health clients. My other choices were some kind of office work and a landscaping crew. I hated the work and didn't like, or really I should say, didn't find interesting most all of the clients I worked with. I even worked with one man who didn't talk. On the rare occasion when he actually did want to express himself he would make Caveman-like noises.
After doing the janitorial crew for seven months I quit and was assigned another job "developer" with the task of finding me a job with minuscule work experience on my resume. One day he had a colleague of his playing the role of potential employer in a job interview with me. She asked me a question about previous bosses and I said that I'd had problems with two of my most recent bosses at which point the job "developer" stopped the mock interview and in what I can only describe as agitated anger said I couldn't admit to an interviewer that I'd had a problem with bosses. He didn't tell me to lie but he clearly didn't want me to tell the truth. On an emotional level I interpreted his reaction as "You're a lowly mental health client looking for entry level work. You have to portray yourself as docile", or "You don't have the right to have a problem with bosses."
I felt and still feel that it is natural to have a problem with bosses; there's such a thing as corrupt authority figures in life. I wasn't going to lie about the matter so I dropped the job "developer" and again was finished with Buckelew Employment.
Years later in my late 40's I again went back to the Department of Rehabilitation and Buckelew Employment. This time there was the option of training as a barista in a cafe consisting of mental health client employees and run by a mental health professional. This was more appealing than the previous options.
Mental health clients are generally damaged people but the boss at this cafe didn't treat me any differently than normal employees. She pointed out everything I did wrong like touching my face or hair or telling me to wash my hands or disgustedly ordering me to force a smile on my face, but she never pointed out anything I did right. Just like my alcoholic father. This stint at the cafe lasted five months, and in the last two months I didn't show up for several shifts because I couldn't stand working for the boss. I failed to learn how to make all the coffee/espresso drinks, which I'd say was part my fault and part the boss' fault, so looking for a barista job in the community was not possible. Again I got a job "developer" and we worked on a resume and started looking for entry level jobs in the community and began practicing interviews. I was quite unenthusiastic about the menial, minimum wage jobs I was looking for, and during one practice interview I asked the job "developer": "So, how long do I have to fake being enthusiastic? Just for the interview or for the first day on the job or through the first week? Because I can't fake it indefinitely." I told Buckelew Employment I was interested in going back to college and discontinued my "case."
I think there's an underlying black-and-white belief in mental health employment agencies that is espoused that any employment is better than no employment. The reality for me is that menial, minimum wage jobs are not going to do anything positive for my self-esteem or hold my interest. That reality along with my minimal desire to finish college (a whole other loaded issue for me originating with my socially elitist father and social class of my upbringing) puts me in a pickle.
I'm currently doing volunteer work, not so much as a prelude to employment but simply as something constructive and hopefully meaningful to do to break my longstanding pattern of social isolation and disengagement from society. The thought of returning yet again to the Department of Rehabilitation and Buckelew Employment is repugnant and also reminds me of the definition of insanity I've heard many times in 12-Step groups: doing the same thing over and over again and expecting a different result. This avenue hasn't worked for me four times previously, so why would it be any different a fifth time?
My overall experience of being a mental health client in employment, residential, and treatment programs has had little impact on making me a productive member of society. This is because it continues to do on a societal level what happened in my family: make me an identified patient. This merely creates large amounts of anger and resentment in me. For instance, most people go to work and they're merely an employee. But as a mental health client in an employment program one goes to work as an employee AND a mental health client. This just adds to the sense of being "defective" I learned in my dysfunctional family.
My opinion is that the vast majority of mental health clients and mentally ill people were abused physically, sexually, or emotionally in childhood. It seems most of them aren't aware of this. Mental health clients provide job and career opportunities for mental health professionals of all kinds, not to mention psychiatrists, as well as massive profits for pharmaceutical companies. Psychiatric medication is a whole other loaded issue I chose not to cover in this article.
(Mr. Bramstedt is 50 and lives in San Anselmo.)