Mad Pride

He asked to talk to me on the phone. I’m not sure why. He’s a former nursing home resident, known for his sexual innuendos, talking to himself, and refusing treatment for his schizophrenia for fear of impotence. He left against medical advice almost a year ago, and is back at the psychiatric hospital, needing a long term situation.

As an employee at a nursing home, we often have to consider the issue of “competence.” At what point does a person lose his or her right to make decisions because they are no longer mentally capable of making them? Who makes the determination? How can nursing home residents lose their rights to choose treatment due to incompetence when they are lots of “incompetent” people living in our community who do not make decisions that serve their own best interests.

Ray Sandford of St. Paul, Minnesota, is fighting for his right to forego his monthly electroconvulsive therapy (ECT) treatments. A lot of people don’t know that some mental health professionals still use electroshock therapy. No one is even sure how it works, but by inducing seizures, ECT seems to reset the brain, and put a halt to severely psychotic or depressive behavior.

Mr. Sandford has a history of psychotic behavior including violence and acting on delusions. He has been declared legally incompetent, but he and a group of other people diagnosed with mental disorders want to be able to pick and choose their treatments. They want their diagnoses respected, rather than treated like a problem. They celebrate mad pride.

We have had residents at the nursing home throw chairs through windows, bite, punch, kick, and try to run away. Some have had a diagnosed mental illness; others have had a form of dementia. Without some kind of treatment, they are likely to hurt themselves or other people.

The question arises, again, as to where the line is drawn, and when someone becomes incapacitated to the point that he or she forfeits the right to say “no.” Realistically, everyone has a bit of mental illness lurking in the corners of their consciousness. Most people have enough common sense and social grace to overcome their shadows. Then every once in awhile, you hear about someone that cracks, and loses it.

So, maybe we should all join the mad pride cause. Instead of the fist high in the air, I think the gesture should be the finger encircling the ear, also known as the “cuckoo” sign. When you see me on the street and flash me the sign, I’ll know that you, too, are crazy, and proud of it.

Source: “Patient wants right to refuse electroshocks.” http://www.msnbc.msn.com/id/30670631/