Voluntary Madness by Norah Vincent

I went into Voluntary Madness with really high expectations. I had heard that this book was a critique on the mental health system, specifically, the inpatient mental health system, from the point of view of an immersion journalist. My expectations were met for the most part, and surpassed in many parts. I have some problems with Norah Vincent's overall conclusions, but I'm really so glad I read this book and think it's one that everyone in the mental health profession should take the time to read.

Norah Vincent wrote a book prior to this one called Self Made Man, where she lived as a man for 18 months and reported on what men do and how they behave when women are away, and then wrote about it from the point of view of a woman. I haven't read this one yet, but you can bet that I already have my hands on it! After doing her form of journalism (immersion journalism) for that book, she had a breakdown and ended up in a psychiatric hospital. She starts the book by saying she left that hospital worse off than how she went in and faked being better just to get out. She never wanted to see the inside of a psychiatric hospital again, but knew in her heart that's where her next book would be.

Vincent says from page one that she has a history of depression, has been on numerous medications, and seen many therapists throughout the years, all of which helped her sadly with this book....aka, made it easy to get into hospitals. This alone got me thinking. Working at a psychiatric hospital, I know we admit pretty much anyone who says they need to be in. I don't know what percentage of those people ACTUALLY would benefit from our treatment, but I imagine it's a small percentage unfortunately. As Vincent concludes at the end of her book, there has to be a want to get better from the person before any treatment can work and many times, our hospital is just a holding cell for people who are at their wits end or who need to dry out for a few days. More on this in a second.

What Vincent does for her research is checks herself in to three different hospitals...a public/state funded hospital, a private hospital (similar to the one I work at), and an "alternative treatment center", the type of facility that focuses more on therapy, meditation, mind and body connection and less on medication. The short of it is that treatment gets progressively better as you move up with the state hospital actually making her worse.

She legitimately goes through her own crises throughout this book. She's not making this up just to get a book out of it and that's what I appreciated the most. The honesty behind this. She lets the reader in in her own journey through healing or trying to find healing and I think she does in the end find some sort of healing.

She has similar complaints as I do about the mental health system. Complaints about the hospital that I work at even. They are basically holding cells for people who are either placed on commitments or don't feel safe on their own, or have an addiction that has become physical and they need to sober up (whether that be for financial reasons, reason being pressured by others, or because they legitimately want to sober up). Mental health inpatient hospitalization has become a medication farm these days. They throw different medicines at every patient, expect them to be alert and oriented enough to go to therapy daily, and when they seem to not want to kill themselves for a day or two or are no longer talking to the wall, they let them go. Sadly that's what we do too.

Part of me says it's awful that we do that and part of me resigns myself to that's the best that there is to offer right now. And at least we're keeping people safe in the middle of a current crisis. But there's no true healing going on there except for maybe a very small percentage that WANT the true healing AND are connected with the right therapist. The stars have to be aligned. For some people, working at the hospital is just a job, and that's obvious. But I know for a fact that there are people at our hospital who genuinely care about the patients they work with and want to see them get better.

We do offer a few programs, a program that specializes in the treatment of people who have been through trauma, and a program that specializes in treating eating disorders that I believe make a real difference in people's lives. They're nationally recognized programs and people come because they want to be there and the treatment is much different from an acute unit. It's much more like what Vincent describes at the last treatment center she goes to, the one she finds the most help with.

Her final thoughts are that these programs really can't help people. That only the person themselves can help themselves. And I agree with that to an extent. A person has to want help to get help. I DO agree with that. But maybe I'm doe eyed, but I'd like to think that sometimes even if a person is committed, SOMETHING might get through to someone every now and then that will make them see things in a different light. I know it's a small percentage..probably a very small percentage of people who are helped when they don't want to be there, but I do think some people end up being helped.

I've ranted for long enough now, but this book really just hit home for me. As someone who's had my own share of depression AND who works in the mental health field, it was really enlightening to read this book that looks at things from both sides of the desk. And I honestly learned a lot from this book that I will carry with me. Woke up a lot more in me than I had initially expected! Highly recommended.

This post is cross posted from my other blog Plenty of Penguins.