By MAEL ANNE DINNELL Santa Cruz Sentinel April 18, 2004

I belong to a community, a social class and a subculture that, by necessity, requires that I regularly be categorized for the purpose of treatment and concrete assistance.

This is a community whose members are familiar with constant challenges and frequent anguish. People die frequently in this community, from suicide, drug overdose and physiological complications, which are the side effects of very powerful medications — side effects like tumors, heart problems, kidney failure, poor liver function, toxicity, etc.

But for all these high prices, we in this community suffer most profoundly from stigmatization, derision, misunderstanding and discrimination that no other minority would allow to pass unchallenged. Paradoxically, the way we are included in society is by segregation, which we wearily (and necessarily) allow. We are the "mentally ill," the consumers in a system of a particular kind of care.

I feel urgency, in the light of attempts by the governor of California to minimize and even cap our services, to address the larger society about what life is like for us. Severe mental illness is a tiring challenge, every waking moment of every waking day. Do not dismiss this essay at this point out of an ignorant conviction that we are lazy, crazy or unsalvageable. You stand to learn something about your fellow human beings.

Segregating us allows for specific kinds of treatment the average citizen does not require, but it also engenders our dismissal. We are accused often of being dependent on the mental-health services that provide us with medication, living assistance, payees, programs, therapy and group support. But you would not judge a diabetic for being dependent on insulin, or the dependence of someone with kidney failure on dialysis. These things are matters of life and death to us, not only health and comfort. At some point we have been judged inappropriate enough often enough by society to warrant our assignment as members to this system, but at some point our functioning in it becomes relevant to the length and quality of our lives. There are many people in this society with fixed delusions or idiosyncrasies of thought and behavior that never get diverted into this system, and whose lives are not affected in terms of length or quality. The quality of our subjective experience (of ourselves and of the world) then becomes the most important aspect of being assigned to this system.

The typical image of a mental-health client is one of a client in crisis. That is when the public notices us, and that is when we come to the attention of the police. These acute episodes are the subject of ignorant jokes and the reason for unquestioned prejudices. In actuality, most of the time we are not visibly distinguishable from you. But jokes and stereotypes at our expense occur regularly even in ultra-liberal Santa Cruz, and even in the alternative publications. Derisive references one would never dare to make toward blacks, for instance, or women, are commonplace and acceptable. Even now someone reading this is protesting that I am overly sensitive. I think not.

We joke about our own behavior sometimes. But there is really nothing funny at all about the experience of serious mental illness. Coping with it requires an outstanding level of strength, willingness, motivation and commitment. Most people could not survive it; in fact, many of us don’t. I, personally, thank God every day for the new generation of "atypical" psychotropic drugs; they have freed me from the nightmare of cognitive confusion, misperception and emotional deadness that I lived with for almost half a century, whether acutely or in relative remission. But I have paid a price for the use of the drug that changed everything for me: my body thermostat has been ruined and I suffer regularly from overheating and feverish states. This long-range effect was not known when I started on it. This is a typical example of the kind of trade-offs we are required to make in exchange for the blessing of being functional and feeling well.

In spite of infighting, we emphasize our segregation by the inclusion of only each other in our social lives. Why should we struggle valiantly to blend in with and facilitate the rest of the people in society? We accept each other as we are and meet each other where we are. We do not have to constantly explain ourselves or strive for some vaguely understood kind of appropriateness or redeem ourselves for the sin of being subjected to a condition we can manage but not cure or control. We can live, work and socialize within a group in which each individual is faced with the same dilemma.

It is trite and cliché to say, but the world itself is insane. World and local events are dominated by acts that are profoundly inappropriate — that is, inhumane — from genocide to child abuse and molestation to wars fought for the sake of territory and resources. It is almost amusing because the behaviors that find us relegated to the mental-health system (very early on in our lives) seldom involve violence against other human beings. As a group, we are no more violent than society at large; in fact, we are more likely to be victims of violence. Sickness and health are determined mostly on the basis of peculiarity — not a moral standard, not a measure of our respect toward the rights of others. To "fit in" — somewhere — is the more and the mantra in this society. It does not pay to stand out. And neither is it easy to stand out. Thus, our sub-community is open to those who do not belong, and closed to those who do.

There is beginning to be movement in our community, as there has been for some time already in the ranks of the physically disabled, toward a kind of solidarity, political involvement and awareness that we represent an important voting bloc. My personal mission is to write and act toward the goal of not only establishing and maintaining concrete "patients’ rights," but educating society at large about the image and the needs of the mentally ill — in all of their various circumstances, from life in the larger community to homelessness to institutions and facilities. I know without a doubt there are people who have read this far saying, "This cannot be a person with real mental illness, she is too logical and articulate." And this is precisely the point I have endeavored to make. We are talented, we are verbal, we are interested in things; we struggle with a handicap the majority of people don’t have, but you make a grave mistake to dismiss and outcast us.

In any case, we will be heard, and we are here.

Mael Anne Dinnell is a Santa Cruz resident.

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