The Struggle, and the Challenge: Young Adults in Crisis and the Use of Medication

Kenneth Blatt, MD
97
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I face the daily challenge at my urban center in Hartford, Connecticut of working with young adults (18-25) coming out of the juvenile system into adult outpatient care. Most of these youngsters come to us on multiple medications of all classes. Almost all have stories of trauma, abuse and neglect going back some generations. Almost all carry psychiatric labels of bipolar or schizoaffective or personality or behavioral disorders. Very few of them have ever been told of the long-term effects of the medications they have been prescribed.

I see them with their prospective clinician for intake, a complete “psychiatric evaluation,” which for me means “getting their story.” They come with volumes of records — which I don’t view before meeting with them. I want to meet them “where they are at,” and form my initial impressions from my initial contact with them. At least I will record in their record something I have rarely seen in all the records I subsequently review, i.e; their story — their narrative, as told by them, to me. They are the authors of their experience.

Most of the time I simply ask them, after some introductions, to tell me about “Lydell” or “Saphonia.” Most of the time, even with this broad open-ended question, they get into their story, which they then guide me through. Along this initial journey together we develop some rapport and get to know each other.

I work on a team with six clinicians, two MD’s and 30 case managers, with a budget coming directly from our state legislators which was increased after the Sandy Hook tragedy. Of course “the mentally ill are at the core of the shootings,” so a quick fix by the folks at the Capitol — as misguided as it is — provides more money for our services, and activities provided to the young adults.

Once the folks I work with “settle in” and become familiar with all that is offered here as well as in the community (Toivo is a holistic wellness center, high on my referral list). We have talks about medications. I first get from them their experiences on medications and their views of medications as part of their life, their “treatment,” etc., and how they want to proceed. Most have always struggled with being on medications and what being on medications means to them. Usually is means “I’m sick, have a long term brain disease, and need them for the future.”

Most are at least ambivalent about what they have been told. Others more feisty and rebellious, with greater zeal and spirit, want to come off medications. “Now that I’m 18 I can decide for myself right? I’m not a ward of the state right?” Or, “I’m no longer mandated because I’m a minor, right?” Yes to all these questions.

For those who want to work with me coming off medications, we set up a long-term plan of slow tapering. I warn against the ravages of “cold turkey” withdrawal, and warn how others will react to their sudden overwhelming (most of the time) expressions of affects that have become dysregulated.  I discuss with them how the medications might tranquilize their feelings. Most have already expressed to me — when they begin to trust me (since I’m an MD and will hospitalize them if they don’t take medications: they are scared shitless about the power given to MD’s, and rightly so) — how numb they feel at some of the doses they were on.

Then I talk them about the “bad news.”

What is the bad news? Most of these youngsters have been on medications since as early as ten years of age. Most of their behaviors were under medication control while they fought their way  through the DCF system of foster homes and residential placements. Most have had multiple dislocations, never staying long enough in one place to form secure safe attachments with a person who will just listen and be there for them.

(Such persons exist. They are precious folks, scattered throughout the system. One wish of mine is to gather them all up to be part of an alternative network. But I digress.)

So; most have never had the opportunity to feel their passionate feelings — to express them, process them, and cope with them. They have become dependent for affect regulation on medications, and the entire part of the brain designated for that function is undeveloped. So, then; how else do we learn to regulate our affects? You know; with that other affect regulation medicine. It’s called safe, secure, consistent, interpersonal relationships. That stuff we did with our kids. You know; all that pain and heartache, fear if not terror, not knowing how things are going to work out, staying with it no matter the provocations to give up… you know; all that easy stuff! Well how does that all play out in an urban mental health center?

Not well.

To come off medications is an arduous process requiring the people be ready to undergo some painful struggles with the youngster who is going to feel it the most.  The kid whose medications is reduced comes home and gets angry with his brother or mother. The first thing said to Johnny is “did you take your medications?” Now that Johnny can react to his surroundings — which at times might not be all that supportive — and expresses his disagreements, it is seen as part of his “mental illness.”

This is no different than at the mental health center. You would think not, but it is true. Although it is better now than 20 years ago, when I began doing this. Folks then were angry with me for not caring about my clients who were “getting worse since YOU lowered the medications.” The clients began expressing and actually communicating the feelings — perhaps leading to some of the initial overwhelming conflicts — that they had originally not been able to contain in their sensitive souls, and which had came out in disguised “psychotic” ways.

I try to work with staff to tell them what I tell the young adults; that most medications act as an “emotional blanket” (to take a positive approach) covering up intense feelings, thereby quieting them to some extent. This can be useful at the onset of an erupting emotional overwhelming crisis. Unfortunately, once the crisis passes and folks need to process what they went through, people are usually not available long enough and with enough fortitude to go through the next phase. Rather than intense listening and empathic immersion and presence over time;  people simply stay on the medications. ”SEE? THEY WORK AND YOU NEED THEM.”

Thus, the early development of the so-called “chronic patient.”

If we are to avoid the long-term consequences of these medications that we know lessen the likelihood of recovery; we must give every person so desiring to, the opportunity to follow a different path. As the blanket lifts with each dose reduction we have to expect “emotional storms” to brew as the youngster is exposed to the stress of life, to the conflicts never faced unprotected, as they experience “being in the world” with all their feelings, passions and spirit. We have to expect the youngster might be overwhelmed by the intensity of life “flooding in,” not having the necessary coping that was denied them in the years past. Now if they allow us — hopefully with trust secured — to “be with them” in this new crisis, a new opportunity for growth for all of us develops in the space between us.

This is the work. This is the struggle. Since it is all so uncertain as to outcome. We are in unchartered waters without a compass — only the “stars” to guide us, which actually is faith in a process of interpersonal healing. We are triggered by all the pain, tumult, and trauma coming forth, and have to care for ourselves and depend on each other. So our interpersonal relationships and support for each other is on the line too. Can we handle all of this?

It is all too much. I try the best I can with the team we have, but the institutional rigidities, constraints, fears of liability, and risk are major impediments. Additionally, the “love affair” for “evidence-based” approaches to treatment of so-called mental disturbances, the monolithic nature of the medical model, and the primacy of the pharmacological  approach only add to the roadblocks. Cushman and Gilford define evidence-based as “an abhorrence of ambiguity, complexity, uncertainty, perplexity, mystery, imperfection and individual variation in treatment” To that I add an abhorrence of improvisation. No wonder “evidence-based” is the way. Tolerating such affects is not part of anyone’s job description.

I actually went to HR 20 years ago requesting that we put in the job description of mental health workers just such abilities. They laughed… Lovingly, I decided.

As best I can, I inform those I’m privileged to be with about alternatives developing in our community. I encourage visits to the peer-run wellness center, hearing voices groups, as well as alternatives to suicide groups. I inform them about the Maastricht Interview for hearing voices if they are interested. I encourage the “fighters” to consider going to Recovery University — part of the wellness center — to become peer advocates and peer support folks. Hopefully within the next 18 months we will open Connecticut’s first peer respite, and begin developing peer-run Open Dialogue teams, too.

Alternatives to the current institutional or agency models are here and coming forward. I am very hopeful.

97 COMMENTS

  1. Kenneth,

    I really like this essay, and when I first saw it, thought it would make a good MIA entry. Here are my thoughts about it shared previously:

    I thought this excerpt was particularly insightful:

    “How do we learn to regulate our affects? You know with that affect regulator medicine. Never heard of it you say…it’s called safe, secure, consistent interpersonal relationships. That stuff we did with our kids, you know all that pain and heartache, worry, fear if not terror not knowing how things are going to work out, staying with it no matter the provocations to give up…you know all that easy stuff! Well how does that all play out in an urban mental health center? Not well.”

    The trap you describe is real: if the doses of drugs (yes they are drugs, not medications 🙂 …) are lowered, as you described, the young person may become more emotionally volatile; the family or case worker will often respond by saying “this is an expression of your mental illness” and pressure them to take more of the drug. A trusting relationship is not supported by this enactment, because the parent/case worker is not acting as a self-object being responsive to the young person’s genuine needs for affective containment / empathy / understanding. Rather, they are treating the person as an object or a disease needing to be drugged, and not listening to what is really going on with the person emotionally. The parent or case worker thereby reinforces the internal rejected self / rejected object images, over the needed vulnerable self / good object images, to use a little bit of Fairbairn’s object relations language.

    I remember reading a book called Treatment of the Severely Disturbed Adolescent by Donald Rinsley, who was a respected psychiatrist at the Menninger Clinic in Topeka, Kansas. He worked back in the 60s and 70s when people actually tried to engage troubled youngsters in therapeutic relationships instead of just drugging them. Rinsley wrote about “presymbiotic schizophrenia” and “symbiotic psychotic” (i.e. severely borderline) young people from a developmental viewpoint, understanding the young people he worked with according to the quality of their relationships with parents and peers historically and currently.

    Rinsley said that even when he could see a young person in intensive therapy 3 or 4 times a week, and involve the family, it was still very hard work, and it would often take 3-5 years of building a trusting relationship and working through difficult feelings to help a very disturbed young person to become more functional, and this in optimal conditions. And, this was when the culture of drugging everything, and the focus of ejecting people from secure hospital settings as quickly as possible, had not taken hold yet. So I imagine it is even harder for you to work with young people now…

  2. Kenneth- thanks so much for this insightful post. From the perspective of working w/ traumatized young adults for the past 20 years – I couldn’t agree more.
    I particularly applaud your point; “the institutional rigidities, constraints, fears of liability, and risk are major impediments. Additionally, the “love affair” for “evidence-based” approaches to treatment of so-called mental disturbances, the monolithic nature of the medical model, and the primacy of the pharmacological approach only add to the roadblocks. Cushman and Gilford define evidence-based as “an abhorrence of ambiguity, complexity, uncertainty, perplexity, mystery, imperfection and individual variation in treatment” To that I add an abhorrence of improvisation. No wonder “evidence-based” is the way.”
    That nutshells it pretty well! Despite all of these roadblocks – I share your sense of hope. thanks again

  3. Humanity and capitalism don’t mix, so good luck with that.

    Perhaps people such as yourself could start considering initiating a massive class action suit, with punitive damages requested, from the APA and pharmaceutical industry based on both the documentable destructive results of psych drugging and the deliberately fraudulent “science” used to justify this.

  4. Great article! I’ve spent my life, first as a peer in the late 70s (before we were ‘peers) then 30 plus years working in our field and in recent years a Mom of teenage and young adult children who have had some bumps in the road. One of these ‘bumps’ was a 2 week period of psychosis, 2 years ago that we successfully got through at home using an Open Dialogue approach as a family. Mindfulness has also helped us, including me. There are better ways. You really get it and I so appreciate your perspective!

  5. Thank you for reminding us that wisdom, empathy compassion and commitment to listen – (to those whose lives, health and future have been destroyed by the cult like adherence to the delusion of “safe and effective” -) still exists in your field of my profession.
    You must have been persecuted by your peers for being both correct and courageous.
    How many of those you care so deeply about never had any real “psychiatric illness”?
    How many were pilled, poisoned and their adverse experiences plus akathisia used to justify the labels for lifetime failure applied as misdiagnosed serious A.D.R.s?

    SSRIs —-> Akathisia ——> Biologic Psychiatrist = “Psychotic Depression” = Life Chances Devastated.

    ADHD drugging —–> Spiral of devastation to hopes dreams and aspirations.
    Of course there are survivors and your inspirational approach offers some hope of that.

    Better be “guided by the stars” than the Science Fiction evidence base of a cruel and destructive form of psychiatry which has become medicine’s Enron.

    The “experts” are utterly incompetent at differentiating life threatening ADR’s (with their bizarre psychologic and behavioural features) from serious mental illness.

    It is a professional disgrace.

    • “The ‘experts’ are utterly incompetent at differentiating … ADRs … from serious mental illness.” So true. Glad to hear “alternatives to the institutional or agency model are here and coming forward.” Anything would be better than the “professional disgrace” that is today’s gas lighting, then poisoning psychiatric system.

      I had not seen the Maastricht interview before, it was interesting, and it would have been helpful to my psychiatrist had he given it to me when I was experiencing anticholinergic intoxication syndrome induced “voices” – at a minimum he would have garnered insight into the fact that my “voices” started AFTER I was drugged.

      It’s a shame the psychiatric industry is seemingly completely unaware of the fact the neuroleptics can create “psychosis,” via neuroleptic or poly pharmacy induced anticholinergic toxidrome. And the neuroleptics can also create the negative symptoms of “schizophrenia,” via neuroleptic induced deficit disorder. Given the reality these psychotomimetic illnesses already have medical names, and they are caused by the psychiatric drugs, one would think the psychiatrists would be aware of these adverse effects of their drugs.

      Information is power, and when an industry utilizes information to intentionally harm human beings for profit, truly this is a “professional disgrace.” I do hope change comes quickly.

  6. An once of prevention is worth a pound of cure… Maybe the majority of the energy should be spent stopping them from drugging kids just coming into the system.

    The biggest breakthrough for me was learning that psychiatry is scientific fraud, There are no lab tests, brain scans, X-rays or chemical imbalance tests that can verify any mental disorder is a physical condition. This is not to say that people do not get depressed, or that people can’t experience emotional or mental duress, but psychiatry has repackaged these emotions and behaviors as “disease” in order to sell drugs.

    You are not “broken”.

    “Now that I’m 18 I can decide for myself right? I’m not a ward of the state right?” Or, “I’m no longer mandated because I’m a minor, right?”

    That is so horrible, not even having the right to the contents of ones own bloodstream, no right to not have unwanted chemicals inside of your own body. It’s like a NAZI atrocity. If a nation wanted to use drugs to extract information from terrorists or to keep enemy combatants quiet in prisoner camps they would call it a war crime.

    Is it murder if you force someone to take drugs and they die at 60 yo instead of 80 ? Seems to me that if someone is forced to take lithium and then dies of kidney disease then all the people involved caused the death.

    If you fire a deadly shot at someone from a thousand feet with a gun your action results in there death in about 0.35 seconds depending on muzzle velocity. If you force someone to take drugs that results in there death maybe from complications of drug induced diabetes even 35 years later your action still killed them it just took longer. Dead is dead.

      • When it comes to the fundamental failure of biological psychiatry: – It is their inability to differentiate the profoundly injurious effects of psycholeptic drugs from serious mental illness which is the cause of such catastrophic physical, psychological and social destruction to individuals, their families and loved ones.
        Might a commitment to critical self vigilance, a return to scientific credibility and the re-discovery of honesty and humility within psychiatry begin to contribute to a necessary conflict resolution?

        • Nonsense. It is people’s insanity that causes them to suffer. Whatever means are available to help a crazy person should be employed. That may require sedation. Just stating the facts. Let me tell you a story about my own struggles with bipolar mania:

          Fernwood Inn/Victoria City Police
          Penny Farthing Pub
          Bon Sushi/Oak Bay Police
          Pandora Assertive Community Treatment Team
          Vancouver Island Crisis Line

          Contact any of these establishments and have them email me at [email protected] I will give them full permission to release their files to any journalist who cares to write about the issue. My vote is for Susan Inman of the Huffington Post or, better yet, of The Walrus (a Canadian magazine).

  7. We, the survivors of the middle-class family, need to set up our own foster care group homes. The present set up is horrid because it is designed to be so, otherwise it would undermine the justifications for the middle-class family. Brilliant political leaders have come out of orphanages. To prevent this from happening, is why our foster care is horrid.

    Drugging of kids, just like scapegoating them by using psychotherapy, is child abuse. And as it is intentionally being directed against children, it is also Crimes Against Humanity. And it violates Mandatory Reporting, a felony.

    We must not be doing anything which gives kids more psychiatric medications, as that is like trying to use alcohol to cure someone who has been turned into an alcoholic.

    I agree with Oldhead and Cat. And people have to learn to feel their feelings and regulate themselves. You don’t get that with more prescription meds, more street drugs, or more alcohol.

    Nomadic
    http://freedomtoexpress.freeforums.org/free-expression-f2.html

    • Psychiatry and Psychotherapy must be responded to with lawsuits. When the newspapers fill with stories of parents losing all their money and having it go into trust funds for their children, then the use of therapists to help them abuse their children will stop.

      And likewise when the papers are filled with stories of Psychiatrists and Psychotherapists being imprisoned because they are helping parents to abuse their children, then they will stop.

      So attorneys and strategic lawsuits, plus some legislative changes are the answer.

      “The fact that internal law does not impose a penalty for an act which constitutes a crime under international law does not relieve the person who committed the act from responsibility under international law.”
      https://en.wikipedia.org/wiki/Nuremberg_principles#Principle_II

      Nomadic

      http://freedomtoexpress.freeforums.org/capitalism-and-socialism-use-the-family-t308.html

  8. Yours is a truly unenviable position to be in. To know what the better option is but only be able to offer it on a limited basis, with the risk of making the situation worse by raising hope in these young adults and then having it eroded by financial and bureaucratic constraints. No matter that it is a false economy in the longer term (not to mention incredibly destructive to individuals) to manage the problems arising from trauma and abuse through drugging, hospitalisation and detention.

    I know from personal experience what it is like to come off long term psychiatric medication and have to deal with a long and horrible withdrawal followed by emotional dysregulation and then to have to deal, unmedicated, with the underlying traumas that led to the “mental illness”, while repeatedly facing criticism of my decision to discontinue drugs and pressure to recommence them because I am now perceived as a difficult, time-consuming and risky patient. From working with a good therapist I understand and appreciate the healing power of a safe and supportive relationship and of being heard, but it is a very slow process, and there are big risks of retraumatisation if this level of support is not available for as long as is needed – it has the potential to simply repeat a life-long pattern of loss and betrayal. I am a middle-aged professional with the necessary personal and financial resources to make this option work for me, and I still struggle immensely. I can only imagine how much more difficult it is for those who do not have these resources.

      • “Where is the trauma in medical care?”

        Well often medical care is an integral component of middle-class child abuse. We used to call this Muchausen’s by Proxy. But now we just call it Medical Child Abuse. The parent is getting some payoff by finding fault with the child and making the child believe that there is something wrong with them.

        And then when you look at psychotherapy and psychiatry, the parent is using the pretext of completely nonexistent illnesses to have the doctor to break and suppress the child, rather like the ways that primitive societies use sharp stones and hot coals to convert children into what they see as adults.

        The main concept the middle-class family works on is the Self-Reliance Ethic, a Capitalism originated adaption of Original Sin.

        Now there are two main groups of professional child abusers, the first uses drugs, and the second is anti drug. Both groups hire themselves out to the parents. And today these two groups are in competition for market share. Some of this second group advertise by posting on MadInAmerica.

        But almost always, when these types of therapists and doctors are treating children, they are committing the felony of Violating Mandatory Reporting, they are committing the felony of Child Endangerment, and they are committing the felony of Psychological Child Abuse.

        Now sometimes adults will walk into the office of a psychiatrist or psychotherapist on their own. They don’t understand that the anxiety and helplessness they are feeling is the direct result of childhood exploitation and abuses. And the doctors are not going to help them find this out either. Drugs help nothing. And psychotherapy is designed to reinforce the feeling that the problems lie in your own head, rather than in the absolute reality of living in this world with a nullified social identity.

        Nomadic
        http://freedomtoexpress.freeforums.org/must-reject-psychotherapy-it-is-just-like-drugs-t304.html

  9. I’m compelled to respond. (Of course, that might give me a diagnosis.) Thank you for your heartfelt and honest sharing. I work in Juvenile Court where I wrestle with how to give information about drugs and diagnoses when it’s too often a fact of how life is managed. Giving this information is asking for people to step into the less charted water with those of us who are seeking and trying to create affordable, accessible alternatives that are not here yet. It’s why people keep trying to make sure I’m not anti-medication since there just don’t seem to be a lot of alternatives. I helped start a Holistic Mental Health Network in Cincinnati so we can have these conversations. We are looking to start a peer respite center and/or open dialogue team. I am writing this because it all seems like a dream unless we keep speaking these truths and sharing our visions.

  10. Dear Dr Blatt – this is a great story. I can only imagine what it’s like to be medicated since childhood.

    I found it was possible to have my cake and eat it. It was possible to drop down to a reasonable drug dose – and then deal with the ‘rebound’ (or underlying difficulties) before moving further.

    I tried cold turkey at the start – but it didn’t work for me.

      • DEADLY MEDICINES.

        I had 2 Suicide attempts (akathesia) and 4 years of neurological disability on ‘medications’.

        THE MEDICATIONS
        Maximum doses Largactil, Haloperidol +
        Fluphenazine decoanate depot injection + Lithium months (+ECT) 1980/1981.

        Then Fluphenazine Decoanate 25 mg depot per month on its own until October 1983.

        Then Cold Turkey withdrawal (with permission following my complaints regarding extrapyramidal side effects). Then 4 hospitalizations until April 1984 culminating with an injection of Depixol.

        Post 1984 just oral medication – and Recovery.

        By 1990 25 mg mellaril per day (suitable for very mild anxiety).

        In 2005, 25mg Seroquel per day – which became nothing.

        In 1986 after I had recovered – I broached the subject of medications, suicidal reactions, and drug induced disability with my Psychiatrist – he acknowledged all of these.

        But he went on the produce promotional research papers on their benifits:-

        http://ps.psychiatryonline.org/doi/abs/10.1176/ps.49.10.1361-b#/doi/abs/10.1176/ps.49.10.1361-b

        He had a long association with the manufacturer….

        http://www.nuigalway.ie/our-research/partners/
        (€9.6 million)

        …and a high death rate.

        • Sounds like an awful lot of meds. Holy shit! Don’t recognize some of the names. Are you in North America?

          Haven’t experienced that kind of withdrawal. Guess my body chemistry is just different from yours.

          Was your ECT voluntary? Or was it “voluntary”? Or was it forced? Those are actually 3 different things. Are you aware of Linda Andre’s wonderful book “Doctors of Deception”? I highly recommend it (although it will likely make you angry).

          Anyway, I’m so glad you made it through for yourself and also the world so that you can speak the truth. You’re a hero. I truly mean that. Best wishes,

          Francesca

          • Thanks a lot Francesca.

            Largactil is the same as chlorpromazine which is much the same as mellaril.
            Fluphenazine Decoanate in the US is the same as Proxlin (I believe). Seroquel you might know and Haloperidol you might know as well.

            The ECT – I couldn’t tell you exactly whether I did or didn’t give permission.

          • Very familiar with Seroquel. Last time I was in the bin, I was offered breakfast and I declined, saying offhandedly that I preferred to starve to death. Well, that’ll only get you more drugs, right? The stupid bitch gave me a Seroquel & Ativan combo to stave off my latent anorexia. (Sorry to be so flip but I have just had enough of this bullshit for a lifetime. I’m sure you have, too.) By the way, I weigh 130 pounds, not the least bit underweight.

          • Hi Circa

            I was treated in Ireland but I moved back to the UK in 1986.

            As regards Doctors of Deception:- My ‘Psychiatrist’ registered in Ontario (57892) in 1986 but returned to Ireland after a year (and after he retired he took up a longterm position on the Irish Medical Council).

  11. Kenneth,
    I am a patient under the blanket of medication. Although I have dealt with some pretty terrible emotions….lifting the meds puts me in crisis and absolutely terrifying emotions. I become very unstable and even do self injury. I feel I am stuck for safety reasons….and for the fact that I may be stuck in a hospital and abused as usual. I also don’t know if I can tolerate the onslaught of emotions.
    Medicatedme

  12. I am not able to have normal emotions on these meds.I worry I can’t clear my trauma completely if I am unable to feel . I do have emotion….but it is remarkable that I am unable to cry…..I used to cry non stop. They certainly put a stop to that. Without the meds I go into panic,excessive crying etc. I suppose a trail reduction is in order. I just hope my therapist can handle that. I hope I can handle that. Thank you for your response….I think the peer respite is a brilliant idea. I wish you luck. You are not disruptive, you are smart. It is about time a Dr. Thought differently about the system.

    • Hi Medicatedme,

      A great source of information and support regarding stopping psych meds is survivingantidepressants.org. Don’t let the name fool you as there is excellent information on very slowly stopping other classes of meds besides antidepressants.

      Lots of luck in getting off of meds.

  13. Hi Kenneth

    Thank you for sharing this story, and for your work.

    I especially like your reference to the movie “The Blob” I often cite it . Younger folks may remember on of the four or five dismal remakes more than the magnificent original b-movie with 17-yr old Steve McQueen.

    Of course The Blob represented all kinds of menace , notably the cold war and living on the cusp of all that M.A.D. madness but also that then-new cultural phenomenon and menace to society – The Teenagers.

    Still afraid, today we call teenagers the “mentally ill” and visit all kinds of unspeakable horrors upon them.

    Yet, in the movie it is the teenagers who come to take the lead in figuring how to tackle The Blob and so save us from the menace. Meanwhile, on set, the fearsome blob was easily contained in a single galvanized steel bucket.

  14. I was institutionalized at 14 and kept until so many days before my 18th birthday. After that, I would be admitted off and on until a judge ordered my mother out of my life. She had told me to leave her house, and I did. She reported me as a runaway, but I was so sheltered that I went to school the next day…I was sent to a runaway shelter, and upon hearing what medication I had been taking, I was moved to a psychiatric facility. I was smart enough to claim to be a drug addict even though I had never even seen a drug, and that kept me off the more unsettling wards for 90 days. I took the MAPPI, IQ tests. etc. No one ever talked to me. They accepted the original diagnose and shoved me to the next facility, and they got more and more dangerous as the years progressed. I caught a treatment doctor giving nonsense focuses in group… quotes from Alice in Wonderland, and I called him on it in group. Being smart in an institutional setting is not encouraged. They told me that now that I was “fixed” everything else in my life would be. I didn’t even know what year it was or how to balance a bank account. I didn’t even really figure out how to be with people…