Scream Dement

If you call the people at ComCare's crisis line, and manage to be incoherent enough for them to think you're crazy while being articulate enough for them to worry that you might be aware of your rights and able to make a nuisance of yourself if they just blow you off, this is where they refer you.

It's on Thomas Road in Phoenix, and if your taste in entertainment inclines toward gothic horror, it's well worth a visit. The waiting room provides scenes more appropriate to a 19th-century asylum. A man curses and yells while a woman stands in front of the TV, rocking back and forth, moaning and drooling on herself. The show on the screen is Roseanne.

An old woman sits with her family. She seems demented, and doesn't know where she is. The family wants to have her committed, to have her cared for 24 hours a day, but is told that because the woman can't understand what's going on around her, she can't give her consent to it, so there's nothing to be done.

People in so much emotional pain that it seems physical are seen by a nurse, then left to wait, then seen by a counselor, then left to wait some more, then seen by a psychiatrist.

It's not really the waiting time that makes it so heinous--that's the norm in just about any emergency room--it's the attitudes of the staff members. They don't bother to conceal their distaste for the patients.

One nurse, a man, was so aggressive that he frightened people. A young woman thought he might be the psychiatrist she was waiting to see, and was terrified. She sat there like a little kid, nervous and eager to please, her eyes wide behind her glasses. The frames of the glasses were broken, but her clothes were clean and she didn't smell and she wasn't obviously demented, which set her apart from many of the people waiting to be seen. She told the counselor, "There's a man out there being really mean to people. Is he the psychiatrist?" She was told that he wasn't the psychiatrist, but the counselor didn't deny that the guy was mean. As I listened to her tell the story to the friend who was taking care of her, the friend didn't say anything. I wouldn't have known what to say either.

It's easy to defend the behavior of the staff members by saying that their job is stressful. There's no doubt that many of the people they deal with are so sick that they're repulsive. It's hard to imagine anybody wanting to be near such people.

The most revolting thing about them is that you're scared of being like them. When you know that a quarter of the people in this country suffer from mental illness during their lifetimes, and when you know that more than 51 million Americans have a mental disorder in a single year, then you also know it could be you.

You know that if you didn't manage to get up, wash yourself, use the toilet properly, go to work, remember to pay your bills, then you could be there in the waiting room for more than journalistic reasons. There have been times in my life when my behavior probably wasn't much less crazy than that of anybody mentioned in this article. So you don't want to be around those people--you want to go and be normal and sane with your normal, sane friends and colleagues.

But, although you can't blame staffers for disliking the clients, you can and should blame them for making that dislike so obvious. It's a miserable job, but nobody's forcing them to do it.

Some years ago, I told my Buddhist teacher that I felt guilty because I was repulsed by the homeless and mentally ill people I was working with. He said I shouldn't worry. "Compassion is in your actions, not your feelings or thoughts," he told me. "If people need help, it's not important how you feel about them. What's important is what you do to help them. Be repulsed by them--just don't treat them as though they're repulsive."

If people working with the mentally ill can't contain their revulsion and manufacture some compassion and respect, then they shouldn't be in the job.

How did a situation like this--such vulnerable people being so abused--come to be? Starting with $165 million to spend, how did ComCare end up in such a mess? Michael Balch's answer is simple and horrifying. "I could give you story after story of the shameful, disgusting way they throw lives away. $165 million can buy a lot of health care. They chose to pay top dollars to the upper management and hire untrained staff, pay them terrible wages and give them massive case loads they are not prepared to serve."

If you have no money of your own and you suffer from mental problems such as separation anxiety, inappropriate aggression or a tendency to throw yourself out of windows, there is a place in Phoenix where you will be taken seriously and treated with care and respect.

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