‘Dr Mark and The Village’ by Mark Ragins

Unknown-3Here is an article by one of my favourite people in the mental health field, Mark Ragins on Mad in America. Mark is the Medical Director at the MHA Village Integrated Service Agency, a model of recovery based mental health care.  His practice has been grounded in 20 years+ with some of the most underserved and difficult to engage people in our community.

‘My name is Mark Ragins.  Most people at The Village call me Dr. Mark, except those who have known me long enough to forego that pedestal and just call me Mark.  I’m a psychiatrist, a story teller, and the kid who used to drive his parents and teachers crazy asking “Why?” unendingly and then, never satisfied with their answers, looked for my own answers and returned to tell them that their answers were wrong.

When I meet someone new I usually try not to tell them I’m a psychiatrist too soon.  There are so many strange and scary ideas about psychiatrists and mental illnesses out there that I’m afraid I’ll be rejected before I even have a chance.

Some people will suspect I’m crazy myself.  I must have become a psychiatrist to try to figure out my own problems or I must have had a disturbed family.

You can meet my family and decide for yourself, but to be fair you have to compare us to your own family, not the Cosby’s.  One very judgmental retired school teacher suggested to me, only half jokingly, that at 5:00 psychiatrists should be locked in the hospital along with our patients.

Other people will suspect that I have some special powers to know their deepest secrets; perhaps one of those third eyes in the center of my forehead that can see right inside you.  As it happens, I do notice things other people wouldn’t notice, like a contractor notices things about your house when he comes to visit or a park ranger notices things on a walk in the woods, but that’s not really that amazing a super power.

If I’m asked directly what I do for a job I will reluctantly admit I’m a psychiatrist.  I rapidly add that I’m not the kind of psychiatrist who sees people lying on a couch.

I work with people with severe mental illnesses like schizophrenia who would’ve been locked up in hospitals years ago.  I work with drug addicts on the streets and with badly abused kids who leave foster care at age eighteen with nothing trying to help them to make it in our world.

I work as part of a whole team working on getting them money, housing, food, some friends, even a job so they can be part of the community.  Sometimes that means getting them a Christmas tree and some presents to give to their kids.

That description usually changes people’s reactions.  That sounds like honorable work helping people who really need it.  Maybe I’m not sitting there psychoanalyzing my wife’s friends at PTA meetings.  “That’s good.  We need people like you to help them.”

But, their next comment is almost always, “That must be very difficult work.”  I tell them that it is hard at times, but that it’s very rewarding because many people do so well.  That takes them totally by surprise.  “I thought they never get better.”

Most of the people I work with have experienced an enormous amount of rejection in their lives, from schools, families, jobs, landlords, police, and even doctors.  Everyone “normal” would walk to the other side of the street to avoid the people I’ve spent my life with.  Maybe I am “abnormal in just that certain special way” that causes my heart to go out to them instead of rejecting them.  Maybe you are too.

One of my sons once called me a “crazy person magnet”.

We had just gotten off a four hour public bus ride across the high desert of Peru and I’d spent most of the time talking with the man next to me about his struggles with mental illness and substance abuse while he was in the army.  After returning from Vietnam he’d had a hard time, but he eventually recovered enough to be a peer-staff member helping other veterans in Massachusetts.

“Why do you talk to crazy people like that?” my son pleaded in a voice familiar to all parents who have embarrassed and somehow permanently ruin their child’s reputations.

“Because I’m interested in their stories.  I think that people who are different, who live on the edge, may see things that people in the middle can’t see.”

“No they don’t.  They’re just crazy.”

“Besides that, it’s not how I talk to people that’s unusual. It’s how I listen to them.  They tell me stories they’d usually keep hidden.”

He rolled his eyes, “So what.”

“And another thing:  There are a lot less ‘normal’ people in this world than you think there are.  You didn’t know he was a “crazy” person, whatever that means, until you heard him telling me his story.  You thought he was just another middle aged American tourist far from home.”

My son shook his head hopelessly and walked off.  He’s not going to be a psychiatrist.

I’ve spent over twenty years working at a very special mental health program, The Village, in Long Beach, California.  Over those years we’ve gone from being an exciting startup program to being one of the most respected and award winning mental health programs anywhere, but that description doesn’t really capture who we are.  I think we’re really the Island of Misfit People.

Remember the Island of Misfit Toys in “Rudolph the Red Nosed Reindeer”?  Rudolph had been rejected by all the other reindeer because of his strange red nose.  He couldn’t hide it no matter how hard he tried and “they wouldn’t let him play in any reindeer games.”

After wandering in a blizzard he ended up at the Island of Misfit Toys along with the Abominable Snowman, an elf who wanted to be a dentist, a Jack-in-the Box named Stanley, and a host of other misfit toys.  There they all accepted each other as fellow rejects.

It would be a stupid story if it ended there: Rudolph with your nose so bright, won’t you find a sanctuary to hide out in tonight?  Instead, in that atmosphere of acceptance, they began to discover their individual gifts and they each found unique niches and ways to contribute back in the real world.

The Abominable Snowman puts the star on the Christmas tree, the dentist elf fixes a toothache, Stanley finds a little girl to play with him, and Rudolph leads Santa’s sleigh through the fog.

The Village isn’t a place to live.  It isn’t a place to hide out.  It’s a place to be accepted, find your gifts, and participate in the community.

Most of what we’ve learned at the Village can’t be simplified as proscriptive lists of “The Eight Steps to Overcoming Mental Illness.”  They are nuanced, messy, relationship-based, hard earned wisdom.

Often it runs contrary to what we’d heard and what the experts taught us, but it makes sense, it connects to people’s actual experiences, and it works.’