Commentary on the Death/Suicide of Robin Williams and Mental Illness

In the book "The Tipping Point: How little things can make a big difference", author Malcolm Gladwell (2000) writes about the impact a famous person committing suicide on an island community had upon the culture of the young people there. The rate of suicide jumped from zero to an accepted act that has claimed hundreds of lives over the years. "The central observation of those who study suicide is that, in some places and under some circumstances, the act of one person taking his or her own life can be contagious.  Suicides lead to suicides."  Gladwell goes on to credit the work of David Phillips, a sociologist at the University of California at San Diego, who had done several studies on suicide.  "In the case of national stories, the rate jumped nationally.  (Marilyn Monroes's death was followed by a temporary 12 percent increase in the national suicide rate)" (p. 222).  The purpose of this blog is to inspire others to speak out about the act of suicide and to reflect upon how we view it.

Robin Williams was and always will be appreciated for his work and contributions, however, we should worry about the message his act may send to others who find themselves depressed or ill. As a culture and society, we need to address the obvious lack of attention mental illness has in our society. We all will become ill eventually at some point in our lives. Millions of people live all around us with disabilities and endure in their struggles contributing to our lives and communities. 

The choice of committing suicide simply because the quality of our life has been and will be diminished is something that humans seem to struggle with.  Is there ever a time when it is okay to take one's own life?  Is there really any way to stop someone or to help an individual that is intent on ending their life?  What are the consequences upon the rest of us that remain behind after the individual has passed?

Life is not permanent and we all will eventually meet our demise. One of the most humbling aspects of life can be to learn to accept help from others and the reality of both the fragility and the endurance of the human condition. Life should not be simply a matter of checking out when the quality of life no longer suits us, but rather dealing with the curriculum that is part of the human experience.  Gladwell (2008) in his work "Outliers" points out "...our notion that it is the best and the brightest who effortlessly rise to the top is much too simplistic" (p. 30).  No one successful achieved success solely on their own merits.  We've all had help along the way; we all rely on each other to survive.  It is in our relationships that we prosper.  To "climb the ladder of success" and to reach the top only to decide life is no longer worth living simply because one must descend back, has a flavor of selfishness and egocentricity to it.

When my parents died, they made it clear that they wanted to do so on their own terms.  They had severe medical problems.  They endured them up to the end.  They were proud and independent people.  I always regret not having been more mature and aware of the opportunity at the time of being there with them and helping them.  I lived far away and was just making my own life.  Afterward they died, I felt I missed something in not having experienced caring for them.  I missed the experience to care for them, as they had cared for me as a child, but maybe that is exactly what they wanted to avoid.  In the end, they chose to die at home.  Not everyone wants to be surrounded by friends and family in their final moments, as hard as that may be for some of us.  How people die impacts us all.  I know it made me stop and consider my own death and mortality.  Working with individuals that have disabilities is humbling and it makes me appreciate the abilities I have and that my own children have every day.  In the end, the lesson here may be that none of us have control and we must accept the fact of transitioning to life without control.

Life is difficult.  To care for others is challenging.  To accept to be cared for by others is probably one of the most difficult of all experiences in life, but millions of people do so each day.  Death and suffering used to be a common experience, but today, in the United States death and suffering seem to be more sanitized and shocking.  To be sick almost equates to being isolated.  Is this the Western European cultural inheritance that Michel Foucault (1965) spoke of in his work "Madness & Civilization: A History of Insanity in the Age of Reason" (p. 64)?  Are we all condition into this idea that being sick is a sign of weakness that requires us to cut ourselves off from others?  In my experience, I have found sickness to be one of the greatest examples of human strength.  I am constantly amazed by my students and parents that have no other choice to endure their circumstances and to push on.

Robin Williams in his final act ended his life on his own terms, leaving us all behind to deal with our own challenges. He will probably be remembered as one of the greatest actors and comedians in our history, who ended his life, and thus will be immortalized. One can only hope that his work with the mentally ill and disabled will be remembered as a commentary to encourage others to help and recognize the variety of forms humanity exists all around us and not as something that is a reason to end one's life.

Isn't it ironic that those born with a disability and no choice tend to accept their conditions without protest; yet individuals who develop a disability later in their lives will most likely struggle with the transition. More discussion and awareness of mental issues and disabilities needs to take place. If the result of Robin's death results in a change of paradigm for the positive, then perhaps his death will mean something more than a sad loss of life and talent.

Resources:

Debate about Suicide and Robin Williams Death


Foucault, M. (1965). Madness & civilization: A history of insanity in the age of reason.  Random House. New York, NY. 

Gladwell, M. (2000).  The tipping point: How little things can make a big difference. New York: Little, Brown and Company. 

Gladwell, M. (2008). Outliers: The story of success. Little Brown and Company. New York: NY. ISBN: 978-0-316-01792-3

Book Review of Michel Foucault's: "Madness & Civilization: A History of Insanity in the Age of Reason"

In today's society, there are accounts, as recently as 2013 and going back to at least 2007, of Nevada hospitals "shipping" off mentally ill patients to California by bus or train (Bellisle, 2013).  Up to 1,800 individuals or more were given some snacks, medicine and a one way ticket and told to seek treatment in California.  As a result California sued Nevada and Nevada's legislature suddenly increased its budget by $3 million dollars to deal with the lack of resources (Mukherjee, 2013).  What makes this revelation poignant is the historic and cultural practice that is documented in Michel Foucault's work entitled "Madness & Civilization" (1965).   

Foucault's work is considered by many as a significant contribution to the history of disabilities because of the primary research Foucault conducted and because he took the unique approach of  describing how people and societies of the past viewed and dealt with the issues of "madness".  As a result, Foucualt's work provides us with an insight of how European civilization changed over time in their perspectives and actions with populations of individuals that were considered "mad", "insane" or disabled.  One reads accounts of early European civilization, in which individuals were considered part of the community and integrated, but as populations increased and societal expectations changed due to religion or technologies, individuals with disabilities became more isolated and marginalized, cultural legacies that we evidently still carry on today in parts of the United States. 

What makes Foucualt's work such an important contribution is the documentation of how cultural perspectives and society can impact the lives of individuals and further stigmatize them for hundreds of years.  The reader of this work will be interested in reading the accounts of how people with disabilities in various town ships throughout Europe were put on ships and sent away to rid the towns of beggars or individuals that simply were sick.  Today, the saying  that has been used in a variety of songs and poems,"ship of fools",  is a surviving relic from this time period (p. 8).  Foucault describes how the creation of hospitals that were designed originally for lepers returning from the time of the crusades eventually became the solution for dealing with the sick and mentally ill (p. 7).  At one time, the General Hospital of Paris, after one year of being created, held more than six thousand individuals, or one percent of the population of city at that time (p. 45).

Religious convictions framed many beliefs that we still carry with us in present contemporary times. In earlier attempts to try and understand the source and purpose of disabilities, individuals turned to the bible for answers, coming away with cursed souls, or demonic individuals who were less than human and needed to be saved (p. 61).  Concerned with saving the souls of the damned, the churches influenced and were given responsibilities to treat and care for the mentally ill from a perspective that was based on biblical interpretations, rather than scientific knowledge.

As times changed along with technologies, European society found not only ways to keep individuals with disabilities isolated but busy as well with routines and work.  Hospitals continued, but "work houses" were now created to provide revenue and routines.  Accounts of individuals being sequestered,  chained and isolated were common; treated more like "beasts of burden" than as human beings, these individuals were obviously cast down into the lowest depths of a class society that frequently feared the conditions they did not know how to explain or wanted to deal with (pgs. 48- 63).  In the 18th century, medical beliefs contributed to the idea that individuals with disabilities needed to be "cured".  The establishment of medical institutions to which individuals were sent to and "cared for".  Doctors started to develop medicines to treat the ill, of which more than one physician would die from "their own remedies" (p. 192). 

Luckily, in addition to the darker descriptions Foucault discovers in his research of European history with "madness", he also comes across moments of illumination that document more human and effective practices.  There are several accounts of the positive impact upon individuals with mental issues being outside in "natural" environments and given the freedom to exercise".  The practice of routines and activities to distract and help to train a sick mind was also suggested in helping individuals to overcome their challenges with mental illness.  "If one can discover objects or persons who may be able to distract the attention from the pursuit of deranged idea and who may be able to fix it somewhat upon others, they must be presented often to maniacs; and it is for this reason that advantages may often be obtained from travel, which interrupts the sequence of former ideas and offers objects that fix the attention" (Cullen, W., 1785 as cited by Foucault, p. 175).

"Madness & Civilization" is a relevant work to read for anyone seeking perspective on "madness" or any disability for that matter.  Foucault's work provides the reader with an opportunity to see what impact society and culture has had on individuals with illness.  It offers present society a chance to compare how we deal and treat individuals today and brings to question why as a culture and society still may fear and isolate those who may be strange to us?   Foucault's work can offer us a glimpse into the past, in the hope that we do not repeat the same mistakes and accept the responsibility for caring for our human family members, rather than conveniently disposing of them to places of isolation and suffering.

Resource:

Bellisle, M. (2013). Nev. hospitals accused of shipping mentally ill patients to Calif.  Nevada. Gazette Journal.  Retrieved from http://www.usatoday.com/story/news/nation/2013/08/21/nevada-california-patient-dumping/2681593/

Foucault, M. (1965). Madness & civilization: A history of insanity in the age of reason. New York. Vintage Books.

Mukherjee, S. (2013).  Nevada gets sued for dumping homeless patients onto buses. Retrieved from http://thinkprogress.org/health/2013/09/11/2602391/san-francisco-sues-nevada-patient-dumping/

Moderate/Severe Isolation in School

Am I wrong in feeling isolated as a moderate/severe special day class case manager?  Am I unique in my experience that to work with marginalized students is to be marginalized yourself?  I love the challenges that come with working with students that have moderate/severe challenges and their parents, but in the past ten years, I've frequently found myself isolated simply because my students are so different than the other students, even withing the special educational groups.  My students are 14-22, non-academic, destined for group homes or living at home.  Their medical and behavioral challenges make it difficult for them to have opportunities to be included.  How many staff meetings have I attended that are focused on API or common core standards that really have little to do with students that are just trying to survive another day?  It stings and hurts every time I go to a a meeting and someone says, "All students will go to college."  It is like a denial that my students even exist.  It took me years to realize that my students and I are different and most teachers and staff haven't a clue as to what we do or why we are even in the school. 

Over the past ten years, I've seen a lot of change at my school, not directly from any suggestions I've made, but from just being there and advocating for my students.  There is a lot to be said for sitting at a table that isn't exactly the most welcoming.  If you sit there long enough, others have no other choice but to acknowledge you and offer to pass you some of the food on the table.  

I wish that there were post academic programs to work with for students that have severe challenges and I wish there were more support for their families.  By writing and advocating, I have found that the class is not so isolated and that we receive more help and attention than if nothing was ever shared.  It is a tough job advocating for students without a voice, but it is only by doing so that they can have one.  One day at a time; one year at a time; one decade at a time and we make progress along the way.

Inclusive Practices: Braga 2014: The Right to an Inclusive Education: Arlene Kanter

July 11, 2014

I am presently attending a conference in Braga, Portugal with a theme of International Special Education Practices.  Arlene Kanter is a professor at the Syracuse University College of Law and the opening speaker. She has served on many committees domestically and internationally designed to improve conditions for individuals with disabilities.  She has written over 100 articles and chapters in books.  The purpose of this blog is to share some of the information I gathered at the conference in hopes of improving the outcomes of students with disabilities and their families.

Mrs. Kanter pointed out that according to UNESCO over 776 Million adults have not been taught to read or write; 100 million don't attend school, 2/3 of which are girls, 1/3 of the 67 million are children that don't attend school.  Some of the reasons why students with disabilities don't  attend school include:

• Stygmatization
• Families that hide their children
• Governments that aren't aware of the existence of individuals with disabilities

Over the years, international attempts have been made to improve conditions for individuals with disabilities by creating international laws.  International development has come to agree on the following points:

1. Education is a human right
2. United Nations have affirmed this right
3.  Prohibitions

CRC. Article 29 of the U.N. emphasizes the development of the child to the fullest potential.  According to Ms. Kanter, most countries have agreed to this point and signed to support it, however, the United States is one of the few exceptions.  The argument made by the United States has been that existing laws go above and beyond the U.N. agreements, however, the real reason, according to Ms. Kanter is political.  A small, but influential right wing group of Americans advocate for less government control and more freedom of individuals to determine school selection for themselves.  This argument has no basis according to Kanter, who points out that whatever agreement the federal government makes regarding schools, states have their rights to decide whether or not to allow charter schools, home schools or any other type of educational program to meet the needs of their citizens.  As a world power, it is a shame for the United States not to sign and agreement with the majority of other countries to support and uphold the rights of individuals with disabilities to an education.

Students with disabilities should be integrated.  The point of an education is to improve the outcomes of individuals.  If people with disabilities are denied an education they lack any chance or opportunity for a more independent life.  The more care they require, the more expensive it is to all of us as a nation.

There are many international documents that support inclusion of the people with disabilities into the educational system, however the reality of most countries is that many or most people with disabilities are not included.  One reason for this is the present paradigm of education that is based on an 18th century model.   Most teachers that are presently working in education lack the training and experience required to include students with differences and as a result, students with differences frequently fail to succeed in general educational settings.

Historically, the United States is attempting to change its system of educating people with disabilities from from a "medical model" to a "social model".  The medical model is one that tends to see students with disabilities as challenged by their disability, whereas the social model sees the same students as being challenged by their social environment.  Changes to the school culture per training and resources can improve student outcomes as well as educational practices.

Important outcomes for countries that engage in inclusive practices include:

1. Their societies become more accommodating towards individuals with differences.
2. Money is saved by reducing the cost of separate facilities and redundant resources.
3.  Society overall benefits from an increase in individuals that have more independence and less reliance on help from the state.

Some proponents of inclusion cite the wishes of the parents over those of the child, however the legal rights to an education are with the child not with the parent.  Efforts to improve inclusive practices in schools that educate students for improved outcomes must be given priority.

Every individual with a disability has the right to live with their family and not an institution.   Helping students with disabilities learn and transition helps students to develop independent skills outside of the home and to become stronger advocates for themselves.  Syracuse University merged its general education and special education programs together as one.  Teachers that graduate as teachers from this school are expected to be able to teach to student with challenges and not just to the ones without.

One professor at Syracuse University has gone as far to offer her help to school districts that are willing to change their systems to more inclusive ones.  Her promise is that the changes will not cost any more than is being spent on a schools present system.  However, in order to receive such help and guidance, the professor requires that 99% of the staff and teachers must agree they want to commit to such a change in culture.  Emphasis is placed on "Universal Design Instruction" that supports all learners in a classroom.  This is something that may be hard for some schools to commit to, especially if their staff is set in its ways and unwilling to change.

Barriers to inclusive education internationally and domestically include:

1. Attitude
2. physical environment and communication
3. Poverty

4. Lack of funds that support families and encourage children to stay at home
5. Teacher resistance
6.  Lack of accommodations provided by schools
7.  Absence of legal mandates

Kanter is a professor of law at Syracuse that specializes in special education.  She points out that "Laws are just words and unless we [people] advocate for change, nothing will change."  People can make a difference locally by writing to their local school boards.  Internationally, one can help by writing to one's local senator and congressional representative to encourage the United States to agree to the United Nations' articles on inclusive education for individuals with disabilities.   More information can be found below.

Resources:

http://www.mdac.info/en/olivertalks/2013/09/03/why-should-united-states-ratify-un-convention-rights-persons-disabilities

http://www.law.syr.edu/deans-faculty-staff/profile.aspx?fac=72

http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2109768

Dealing with the Public School System and a Son with ADHD

by

Peter Dragula, M.Ed.

Today, after a full day at work, I received another email from my son's newest teacher.  I wish I could say it is the first but I can't.  It resembles almost word for word the same concerns and describes the type of behaviors most of my son's teachers have had over the past 13 years he has been going to school.

The teacher wrote:

Hello Mr Dragula,

My name is xxxx and I'm M's Technology teacher. I felt that it was necessary to contact you regarding his behavior in class. He talks/interrupts me when I'm talking and other students have complained to me about his behavior.  I've discussed this with him (as early as yesterday - keeping him after class) and he said that he would change and act as a middle school student is expected. Unfortunately, there was no change today. After removing him from a computer activity, he asked if he could work on his rocket... I agreed. The next thing I see is that he has open glue bottles, pretending to squirt them at other students. Please have a talk with him.  I don't want to write up a referral on him.

Mr. X

As a parent and an educator, I felt depressed by the email and frustrated.....the literature suggests to parents of ADHD kids to try and keep a good relationship with the school and the teachers, but after so much time, it becomes a delicate balancing act to maintain the school relationship and advocate for your child.  According to at least one research study:  "In our research we have found that secondary students with ADHD tend to exhibit a pattern of declining grades from the first to the last grading period in each school year. That is, without intervention, students' grades are typically strongest at the beginning of the school year, but then weaken to varying degrees by the end of the school year (Evans et al., 2005; Evans, Serpell, Schultz, & Pastor, 2007). Students who experience failure and do not receive adequate intervention can conceivably fall behind their peers in the curriculum, and this discrepancy can grow over time. Indeed, children with ADHD tend to exhibit increasing academic deficits when compared to their peers over several school years (e.g., Latimer, August, Newcomb, Realmuto, Hektner, & Mathy, 2003).   Similar trends may occur within a school year, as it seems likely that once students fall behind it becomes increasingly difficult to recover as the classroom curriculum moves forward. Thus, the timing of failure events is consequential because the sooner the occurrence, the more likely intervention will be needed to ensure that the student benefits from instruction and ultimately earns credit for the class."

Resource: Schultz, B. K., Evans, S. W., & Serpell, Z. N. (2009). Preventing failure among middle school students with attention deficit hyperactivity disorder: A survival analysis. School Psychology Review, 38(1), 14-27. Retrieved from http://search.proquest.com.library.capella.edu/docview/219656530?accountid=27965

I wrote back:

Dear Mr. X,

Thank you for contacting me regarding your concerns.  I don't know how long you have been teaching, but I want to say that I understand the frustration you must be feeling at not being able to get the results you want with Marco.  You are not the first and you probably will not be the last.  I teach at ABC High and I am trained in technology and special education.  I've been teaching for over 15 years and I am working on my doctorate.  The year is almost over and I will speak with M., however, I feel as though you have been set up to some degree to fail yourself.

Your email implies that you have not read, been trained, been given support, resources or researched M's disability.  Yes, he does appear to be capable of behaving at times doesn't he?  Yet in 13 years, he has had the same problems and behaviors you have documented, which is what has brought him to your class and your school.  You have the legal right as a teacher to "write up a referral on him" and to repeat the conventional punitive practices that evidently have not worked before you, or you can try to change your teaching strategy to accommodate a student with ADHD.  It takes time to make a shift in paradigm and become a transformational teacher, so be patient with yourself.  I've attached a resource for you in case you are interested in trying a different approach.

Thank you in advance for your consideration.

Resource:  (Teaching Children with ADHD: Instructional Strategies and Practices. (2004). Retrieved from http://www.ed.gov/about/offices/list/osers/osep/index.html.)

 If it is this difficult for a parent with a degree in education to try and get through to the public school system, I can well understand the frustration other parents must face.  All we can do is to plug away, advocate, and change the system for the better.