I never considered myself a writer until literally just a couple of days immediately preceding the start of creating Breakdown. Rather I considered myself a full-time mobile emergency psychiatric social worker. As I struggled to shake off the sense that something was missing within me professionally, the idea of writing a book about my profession came to me suddenly. I completed an online writing course, researched the difference between traditional publishing and self-publishing, purchased writing software, learned how to cite research, and began researching marketing techniques for books. I felt intrinsically rewarded upon completion of every major milestone. Sure there were obstacles to overcome, such as when the interior formatting company sent me a 20-page sample ridden with mistakes they refused to fix. And when my requests for testimonials to publish at the beginning of Breakdown were ignored. And when the first illustrator I hired plagiarized her work before I quickly fired and didn’t pay her. Writing a book takes intense commitment to the finished product. The recognition I’ve received from people has been priceless.
I had done mental health advocacy work on a national scale for years before beginning to work on Breakdown and was very inspired by advocates’ tragic stories. Their stories motivated me to become a better social worker. I increasingly realized that there is no opportunity to influence legislators to change the system in the clinical setting. I didn’t feel that my employment was enough to make a difference in the world. Certain clinical cases were at the forefront of my memory because they were especially dramatic and shocking. All of a sudden it dawned on me that the world has to know these stories. Very few people are aware of the population I help and what they struggle with. Breakdown aims to close the gap between clinical and legislative settings.
The most common reason that approximately half of people with schizophrenia are unable to initiate treatment independently or adhere to treatment is anosognosia. This means they lack awareness of being ill. Anosognosia is a key factor contributing to the need for involuntary treatment. When schizophrenia goes untreated, the consequences can be deadly. I’ve detailed high profile cases based on media reports and my interviews with family members. These cases have involved people getting killed due to untreated mental illness. This statement is bound to make many people uncomfortable for fear of stigmatizing mental illness by suggesting that people with mental illness are violent. The majority of people with mental illness are not violent. Yet a small subset of the population with untreated serious mental illness, especially involving psychosis, is more violent than the general population. Truth does not enhance stigma. I make a strong case in favor of involuntary outpatient treatment, otherwise known as Assisted Outpatient Treatment. Just three states – Massachusetts, Connecticut, and Maryland – do not allow this while all other states and Washington, D.C. allow this life-saving treatment. Not coincidentally, Massachusetts has a very strong antipsychiatry movement. Groups promoting the belief that mental illness doesn’t exist are funded by the government and supported by the National Alliance on Mental Illness. This is wrong.
The extent of malingering on inpatient and emergency settings is astronomical. According to a study, 12% of those admitted for emergency psychiatric care lied about their symptoms to get admitted to inpatient. The reasons for malingering vary. Malingerers drain health care resources and literally take away precious and limited inpatient bed space from those who truly need it.
Please read Breakdown to learn from example or learn about emergency psychiatry.
I am still working as a full-time mobile emergency psychiatric social worker. I will not write another book, though plan on resuming blogging about my profession in the next few months.
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Lynn Nanos is a Licensed Independent Clinical Social Worker in her twelfth year as a full-time mobile emergency psychiatric clinician in Massachusetts. After graduating from Columbia University with a Master of Science in Social Work, she worked as an inpatient psychiatric social worker for approximately seven years. She is an active member of the National Shattering Silence Coalition that advocates for the seriously mentally ill population. She serves on its Interdepartmental Serious Mental Illness Coordinating Committee committee and co-chairs its Blog committee.
Anthony Avina, (Born March 1990), is an author, a journalist, and a blogger. Born in Southern California, he has battled through injuries, disabilities, moves back and forth across the country, and more, yet still maintains a creative voice that he hopes to use not only to entertain but to inspire hope in even the darkest situations. He writes short stories and novels in several genres, and is also a seasoned journalist for the online magazine, On Request Magazine, as well as the popular site TheGamer. Having grown up reading the books of Dean Koontz and Stephen King, they inspired him to write new and exciting stories that delved into the minds of richly developed characters. He constantly tries to write stories that have never been told before, and to paint a picture in your mind while you are reading the book, as if you could see every scene of the book as if it were a movie you were watching. His stories will get your imaginations working, and will also show that in spite of the most despairing and horrific situations, hope is never out of reach. He am always writing, and so there will never be a shortage of new stories for your reading pleasure. http://www.authoranthonyavinablog.com