Health Care

Against Oregon Public Schools’ ‘Mental-Health Days’

How many such days do you think will be spent by students attending to a psychotic break?

A new bill out of the Oregon state legislature — yes, that legislature — allows public-school students to take five excused “mental-health days” off from school over a three-month period. It makes no attempt to distinguish between, say, a manic episode and the stress an ill-prepared student might feel about an impending geometry test. “Mental health” is a euphemism, while mental illness — schizophrenia, bipolar disorder, etc. — has that rather inconvenient feature of meaning something. How many “mental-health days” do you think will be spent by students attending to a psychotic break?

The bill was hawked by a group of ambitious, well-meaning Oregonian high schoolers seeking to improve the state’s dismal suicide rates. While I was initially disposed to join in the obligatory chorus of uncritical adulation that greeted their success — the children are our future, they’re changing the world, etc. — the bill just isn’t good. Regardless of the admirable charm of its backers, it will exacerbate the problems it purports to allay.

It really is a bad bill. In a benign sort of way, sure, but it’s still bad, at least to the extent that it enables statements like the one Debbie Plotnik of Mental Health America made to the AP: “We need to say it’s just as OK to take care for mental-health reasons as it is to care for a broken bone or a physical illness.”

This distinction — between “mental health,” as Plotnik describes it, and bona fide mental illness — is critical. Here, the motte: The acutely suicidal, the delusional, the manic-depressives, and other students with serious mental illnesses should be allowed to miss school to attend to symptoms that arise from their relative conditions. And the bailey: Teenage angst, “stress,” poor self-esteem, and momentary sadness are the same as “a broken bone.”

And what exactly is “mental health”? D. J. Jaffe writes about mental-illness policy for the Manhattan Institute, and even he has noted how elusive the concept can be:

Social goals . . . have been arbitrarily wrapped into the mental health narrative: improving grades, ending poverty, cutting divorce rates, helping individuals gain comfort with their gender identity, decreasing rates of bullying, and increasing employment.

Had she said mental illness, Plotnik might be able to plausibly claim a point. She could argue that schizophrenia, bipolar disorder, and a short list of other conditions have biological components that make them similar to “a physical illness.” But she said “mental health.” And in so doing, she prescribed helplessness in the face of everyday malaise, a helplessness likely to aggravate the very “mental health” problems whose existence, it turns out, is the raison d’etre of her organization.

The very premise of the bill — that days off from school will abate the suicide problem —misdiagnoses the cause of the suicide epidemic. Does sapping kids of their fortitude and resolve, indulging the timid impulse that tells them they’re just not strong enough to go to history class today, really convince them that their lives are worth living? There is a morsel of truth in the drunk-uncle sentiment that “our grandparents didn’t have ‘mental-health days,’ and they turned out just fine.” Because they didn’t. And they did.

If a kid is suicidal — for any reason, whether or not they suffer from a mental illness — they should be in a hospital, not in school. If a kid has a veritable condition such as schizophrenia, bipolar disorder, major depressive disorder, severe anxiety, or obsessive-compulsive disorder, and they are acutely symptomatic, they should not be in school, either. But the presumption that the average student at an Oregon public school, who doesn’t suffer from any such disorder, is teetering on the cliff of mental breakdown is at once untrue and ruinous. It minimizes the student’s internal basin of resilience, saps him of the grit and resolve that the world demands, and assures him that the fleeting emotions of life are clinical phenomena to be dealt with by some nonprofit executive. That type of thinking is evocative of the post-asylum mania that swept the United States, in which psychiatrists all but quit their focus on the severely mentally ill in favor of vague crusades for “prevention,” “emotional wellness,” and “mental health.” Our collective experience with the fruits of deinstitutionalization should disabuse us of their approach.

The students call their legislation a victory against the shadowy forces of “Stigma,” that oft-invoked, always-calumnious indictment of the American public, that implicit derogation of ordinary people for the plight of the mentally ill, as though it is society’s fault that the homeless man at intersection of 42nd and 8th hears voices, as though if America were nicer mental illness would go away. But it won’t. This is a momentary triumph for a non-profit establishment that has lined its pockets with a rhetorical campaign of euphemistic nothings about “mental health” as those same schizophrenics and manic-depressives line the streets in droves, as asylums continue to shrink and ivy furrows up their once-vaunted walls, and billions of dollars are poured into anti-stigma campaigns while the neediest go untreated.


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