"Never events" is a term used in parts of the health care world to describe catastrophic events like death or the amputation of the wrong leg by a doctor in surgery. I was out of town when I got the news of yet another catastrophic, heart-wrenching event at a university. Northern Illinois University is about 60 miles from my office but only 20 miles from where I live, so the news was even more devastating, being so close to home. I thought about people I knew that might have been on the campus and, once assured they were safe, I began to focus my mind and heart on all the victims of this most recent tragedy.
There were so many victims of this shooting: the family/friends who lost a loved one (including, of course, the family and friends of the shooter) ... the students and faculty of NIU who lived through the event and now have one more trauma to deal with in their lives ... the faculty, students and parents of students at other schools across the country.
But in addition to these, we have yet another victim: those of us living with mental illnesses. Each tragedy like this builds stigmatizing opinions, reinforces fears and confirms stereotypes. Research shows that those of us with mental illness are more likely to be the victim of a crime-by a wide margin-than we are ever to be the perpetrator. And the fact is that these events, as horrible as they are, are still very rare. But they burn themselves into the national consciousness in a way that the millions of wonderful, outstanding things done by those of us living with mental illness never do. This stigma could also impact the funding and advancement of psychiatric research, especially considering recent, further cuts on the federal level to treatment-specific research dollars ... research dollars that would have offered at least the hope of better mental health treatments in the future.
I was recently at a very high-level think tank meeting where we were looking at the future of health care (I'll be posting about that in the next week or so). I was horrified to have to push back against a very determined leader who believed that the answer to all of our problems was long-lasting, injectable medication: "one shot and I'm good to go for the month" ... perhaps whether I/we want the medication or not.
Since I really don't like having to remember to take a medication (or six) every day, the idea of a catch-all shot once a month does have its appeal. But anyone who has been restrained in a hospital, either physically or by medication for days on end will tell you that you'll have a serious and understandable battle to fight by suggesting anything that takes the personal, daily choice out of their hands.
I understand the fear families have as they watch a loved one who grows unstable and then goes off their meds for no discernable reason at all. I understand the frustration of providers who see the same people back in the hospital, year after year, having gone off their meds because they didn't have enough money for medication. But I just have real fears—especially in the light of possible backlash against the consumer community after a "never event" like a school shooting—that use of a long-lasting injectable could too easily become forced treatment.
It's not simple. How do we avoid "never events" like NIU? How, as a community, do we encourage each other to avoid the temptation to go off meds that have awful side effects? How do we balance the needs of the community against so many people's desire to find a "simple" solution like forced treatment?
I look forward to your thoughts and comments.
Published On: February 27, 2008
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