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The Failures of the Mental Health System and the Heartbreak of Caregiving

Author: Poalina Milana

Committed: bound or obligated to a person or thing, as by pledge or assurance; devoted. ~ Dictionary.com

The term “committed to a mental institution” refers to a formal commitment of a person to a mental health facility by a court or other lawful authority. This includes involuntarily committing a person for treatment due to mental illness, mental defectiveness, or other reasons such as drug or alcohol abuse. Importantly, it does not include admission for observation or voluntary admission to a mental institution ~ Law Insider

All Paolina has ever wanted is a moment of unburdened normalcy. A moment where she can be a young woman, not keeping secrets or hiding her mother’s degenerating mental health, but having lunch with friends, picking out college courses, dreaming of a future. For one year, she makes this happen: a gift to herself. One year in a college far, far away from her family. She knows it won’t last. She just wants a taste of normalcy. A moment where she isn’t defined by the secrets of her family, by the endless care of her mother.

At the end of that blissful year, punctuated by painful letters from home, calling her back, she gives in, goes back, and submits to her duty. But she still has some hopes. She has seen another world. Then her father passes, and now, as the sane one, the older one, the responsible one, she must take on his lifelong obligation. She must care for her insane mother, and she must look after her younger sister, who is showing worrying signs of that hereditary paranoid schizophrenia. All the while, she must worry that the glitch in their collective genes is hiding in herself as well, and she must fight a desire to simply die. It’s too much . . . but it’s her job, her obligation, to give all of herself, to be devoted, to be committed.

Following The S Word: A Memoir About Secrets, Committed picks up on the Milana family’s brokenness and Paolina’s desperation.  Committed could, however, be easily read as a stand-alone. Paolina is grown-up in this one, a little more stable, yet just as torn. She thinks back to when she tried to kill her mother, and she is torn between love and the cloying, oppressive nature of around-the-clock care for a paranoid schizophrenic. The family has tried the system, has begged for help from police and medical institutions. No one is there for them, and while Paolina’s gentle father seems to have made peace with his lot, with this life of looking over his shoulder, of constant fear of being killed by his own wife, who is certain they are all plotting against her, Paolina has grown up in this shadow too long. She never got the opportunity to make a choice. Instead, she was given this legacy, and everyone has come to understand that she will, of course, carry out the care her father sacrificed himself to provide.

But Paolina does not want to be a sacrifice, and her own mental health is taking endless hits, one after the other. The one year in college is absolutely heartbreaking. She describes having friends for the first time; she describes how she has lied about her family, her background, so that she could just be normal. She describes the excitement of pretending that there is a future, an escape. Her dreams are not big. She just wants a break from the endless agony of caring for her family – something that has been her duty since childhood.

Image by Daniel R from Pixabay

In this memoir, her hope, her enjoyment shines through as we see each letter from home, including those sent by her mother, shatter this temporary refuge she has created. We are enraged at the unfairness of it all, and yet we feel alongside her. Her mother, her sister, her family cannot help the tragedy that befell them. They are not bad people. They are all tired, exhausted, hurt people trying to do the right thing. It’s a complicated mess, and they are all in it alone.

This is where Milana’s memoir writing truly shines. She is honest, forthright about the hardships faced by caretakers. Even when the truth is ugly, she openly shares it, and the strength of her narrative, and of the later work she has championed in her life, is to raise awareness both of the tragedy and needs of those with severe mental health issues and their families and friends who are often left to suffer (and support) in silence. It truly does take a village, cliched as that old term is, for people in these situations to be helped, and yet so many of us with “normal” lives merely react with the “by the grace of God, their go I” shudder without actually providing any help. The system, especially the mental health system, is broken, and it can only be fixed through the effort of many. That effort begins with awareness, compassion, and empathy.

Like Milana, we, as readers, waver. Does another person really owe their happiness, their life and hopes for the future, their sanity to someone else? By the same token, however, is it fair to abandon someone to the ruthlessness of a mental illness – an illness for which they never asked and which equally tortures them? There is no clear answer of course, because life is complicated, and readers are left, through Milana’s honest telling and introspection, to understand both sides and to ultimately realize that the only true answer is that no person can or should do it alone. That we must help one another, that we must raise awareness about mental health, clear the stigma and secrecy, and try to help. Is committing a person such a bad thing – perhaps not, if they truly got help. But, often times they don’t, and the family is left, failed by the system, to suffer in silence and misery. Committed again tells this story in heartbreaking detail. It makes us think. It makes us empathize. And, most importantly, it shatters the silence. Highly recommended.

 

– Frances Carden

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Frances Carden
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