Help! I’m at the bottom of a rabbit hole, and I can’t see daylight!
Last week, I started on research for the concluding section of the book I’m working on about family members who advocate for a loved one diagnosed with a mental illness. I interviewed 12 family members in four categories: parent, child, sibling, or partner to get a broad perspective on how mental illness in their family affects them. Patients with mental illness cannot—should not—be treated in isolation.
My premise is that family members provide essential support systems to persons who struggle with mental illness, and they should be included in treatment decisions. Many times, family are expected to ensure a patient adheres to whatever plan they’re prescribed, because a patient’s perceptions or reasoning may be affected by their illness. They may not adhere on their own.
The most prominent complaint I heard from family members, regardless of relationship, was that when a diagnosed individual refuses to allow them access to mental health professionals or medical records, they are shut out. HIPAA law protects an individual’s records and the right to make their own health decisions, but when the patient doesn’t allow access, those who may be the most helpful to them cannot help.
Every one of the persons I interviewed acknowledged the rights of patients with mental illness to make their own decisions and to control access to records. However, when their family member was diagnosed with a serious mental illness (SMI), making informed decisions was often impossible. This is particularly true with schizophrenia and bipolar disorders.
I think of myself as a competent researcher, having taken a couple of awesome courses in grad school that helped me build some pretty useful skills. One maxim I remember was this one: dig until your sources begin repeating themselves. Only then can you be sure you’ve found the definitive word on a topic. The problem is that on the way to researching a topic thoroughly, the more sources I turn up the more relevant topics I uncover. I’m lost in the proverbial rabbit hole and still thumping around in here.
While exploring mental health statistics for Texas, where I live, I came across a news item about bills proposed for the 2025 legislative session that ends on June 2. I was pleased to discover that Senate Bill 646 proposes repaying student loan debt for certain mental health professionals who set up practice in Texas. My state senator voted for it. Yay for him! Something good for a change!
Wonderful! I thought. What a creative way to encourage mental health professionals to locate here, where it’s been reported that 170 of 254 Texas counties have no certified psychiatrist and not enough mental health professionals in general. I’m already aware that rural communities in Texas are considered healthcare deserts because of their lack of hospitals or physicians. Don’t get me started about the shortage of gynecological care and the reasons for it. (For more, see my Maternal Deaths post from December.)
Another Substacker, Michele H. Davis, who writes Lone Star Left, reported last week on some insane theatrical shenanigans during debate of this bill. Her piece is called “They Don’t Care About Texas. They Love the Sound of Their Own Voices,” which pretty much sums up her analysis.
I haven’t read the full text of the bill, but I don’t need to know more than what Davis presented to agree with her assessment. A video clip she posted of an exchange between one of the bill’s sponsors and a state representative during a reading in the house tells you where the minds of Texas Republican legislators are hyper focused this session: sexual identity. That this has nothing to do with repaying student loans for psychiatrists, psychologists, nurses, and other mental health providers matters not a whit.
The legislator presenting the bill for debate could hardly get a sentence out, because she was constantly interrupted by her colleague’s gibberish. She kept repeating that the bill was designed to increase the number of school counselors because of the mental health crisis in our state, most notably apparent in the Uvalde school shooting of 2023, in which 19 children and 2 adults were murdered by someone having a mental health episode.
Her colleague’s interruptions were a garbled mix of fears about school counselors advising students with gender identity concerns. He asked if she was aware that most national professional psychiatric or mental health organizations require training in counseling of individuals with gender dysphoria. He objected to the possibility that the state would pay for such an individual to corrupt schoolchildren by hearing their concerns.
Suicide is the second leading cause of death among youth ages 10-24. For youth ages 10 -19, there were 7.38 suicide deaths in Texas in 2022, which is higher than the national average. The rate is 12.2% among 15-19 year-olds. God forbid we should provide them some mental health support! Best to leave their depression and suicidal thoughts surrounding gender identity unaddressed, right?
Senate Bill 646 is due to be read in the Texas House again this morning, right about now, as a matter of fact. It has been delayed several times already, but I’m hopeful there will be no partisan theatrics and grandstanding. I hope that people in rural Texas might soon have their mental health needs served. Fingers crossed.
Now, let me get back to my rabbit hole. I’m off to California for a few days later in the week and hope to dig myself out before I go.
Janice Airhart 