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The Mental Illness Stigma Takes a Sexist Dimension

As I myself struggle with a chronic disease of the brain best known as mental illness, I am constantly aware of discriminatory practices towards those who suffer with the same disability as I do.  To make a long story short, I befriended a woman who attended the same support group as I did some years back and she and I have maintained close contact ever since then.

She deals with Generalized Anxiety Disorder and depression, two conditions I have myself.  For many reasons, money being one of them, she's been off her meds for the past several months.  Since she has separated from her soon-to-be ex-husband about the same time, she is reluctant to go to a psychiatrist and be prescribed new meds because she fears losing custody of her three children.  Upon doing research to bolster my argument, I came across this passage

Some state laws cite mental illness as a condition that can lead to loss of custody or parental rights. Thus, parents with mental illness often avoid seeking mental health services for fear of losing custody of their children. Custody loss rates for parents with mental illness range as high as 70-80 percent, and a higher proportion of parents with serious mental illnesses lose custody of their children than parents without mental illness. Studies that have investigated this issue report that:

    Only one-third of children with a parent who has a serious mental illness are being raised by that parent.


    In New York, 16 percent of the families involved in the foster care system and 21 percent of those receiving family preservation services include a parent with a mental illness.


    Grandparents and other relatives are the most frequent caretakers if a parent is psychiatrically hospitalized, however other possible placements include voluntary or involuntary placement in foster care.[1]


The major reason states take away custody from parents with mental illness is the severity of the illness, and the absence of other competent adults in the home.[2] Although mental disability alone is insufficient to establish parental unfitness, some symptoms of mental illness, such as disorientation and adverse side effects from psychiatric medications, may demonstrate parental unfitness. A research study found that nearly 25 percent of caseworkers had filed reports of suspected child abuse or neglect concerning their clients.[3]

 

The loss of custody can be traumatic for a parent and can exacerbate their illness, making it more difficult for them to regain custody. If mental illness prevents a parent from protecting their child from harmful situations, the likelihood of losing custody is drastically increased.

Having mental illness is bad enough, but for women with mental illness, the repercussions are far more severe.  The negative publicity surrounding the Andrea Yates case, in which a mother suffering from post-partum depression and psychosis drowned her children has led many to believe that children must be removed from mothers with any degree of mental illness.  If only it were that simple.  I dislike the phrase "mental illness" because it makes it seem as though all brain disorders are similar.  Brain disorders vary in severity and in their physical manifestation.  Many assume that mentally ill means psychotic or schizophrenic, when those are merely the most severe forms.  Most people who are treated properly with medications lead otherwise normal lives with the need for a few modifications here and then as the case may be. 

In being so draconian about custody rights, government overreaches, assuming a child must be protected from a parent who is likely to abuse her child.  While legislation has been passed to address this matter, laws are only as effective as those who follow them and those who enforce them properly.  To best address this travesty of justice, it will take more exposure and more visibility.  My hope is that through this post, more will take note of the situation and act.

Posted by Nazza - January 04, 2010, at 02:20PM | in Disability Rights
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26 Comments

[0+] Author Profile Page Honeybee said:

I'm struggling to understand the sexism behind this. Are you implying that mothers are better parents then fathers and that children must always go with the mother, and all the rest of the tired stereotypes that go with this?

I'm also unsure how to respond to the gist of your article. While I am sure there are many people who have unfairly lost custody of their children, this sounds like something that needs to be analyzed on a case by case basis. Because at a high level, the idea of removing children from the custody of those with mental illnesses sounds like a good idea. If a parent has trouble functioning and even worse, is unable to protect their child, and there is another parent who doesn't have those same issues, I'm unclear why you wouldn't want to remove custody of the child from the parent.

Having said that, I think that should only apply when there are serious conditions at work. My cousin is schizophrenic for example, and I just can't imagine her having the mental capacity to properly care for a child on her own. But her condition is fairly serious. There are tons of other mental illnesses that have a less drastic impact on your ability to function. so again, it's back to a case by case basis analysis.

Still, I fail to see where the sexism in this policy lies (assuming fathers also lose custody due to mental illness).

[0+] Author Profile Page Spiffy McBang said:

I'm with you as far as judging parental fitness responsibly, but I'm not sure how that equates to the issue being used in a sexist way. Obviously this affects women more because mothers get custody more often, but that's a numbers game. Do fathers get away with having custody despite mental illness where mothers would not? Or is your implication that if fathers received custody more often, this wouldn't be an issue?

[0+] Author Profile Page pololly said:

I've got to say - not to be all 'what about the menz' in this post but it does seem to relegate the welfare of the children to things which exacerbate or mitigate the parent's own welfare.

Also, what does this mean

"In being so draconian about custody rights, government overreaches, assuming a child must be protected from a parent who is likely to abuse her child."

[0+] Author Profile Page Lily A said:

I am genuinely confused by this post. Sometimes, some types of mental illness or side effects from medications can make parents incompetent. Not all parents with mental illness lose custody, but some do, as you point out, depending on the severity of the disability and the presence of other competent adults in the home. Honestly, this seems like a completely appropriate standard to me, allowing for discretion while still keeping the interests of the child in mind. Whether this standard is applied effectively or equitably is another matter, but you don't show that mentally ill parents are losing their children unfairly, only that they lose custody at a higher rate than other adults (which, honestly, doesn't seem so terrible to me).

Then you say: "if mental illness prevents a parent from protecting their child from harmful situations, the likelihood of losing custody is drastically increased." You seem to imply that this is unfair? Maybe I'm reading you wrong, but it seems to me that if a parent can't protect their child, then it is appropriate for that parent to lose custody until he or she is able to provide adequate care.

Finally, if you are correct that mentally ill parents sometimes inappropriately lose custody simply for being mentally ill (and not because their mental illness actually makes them an unfit parent), then it is certainly a terrible thing that parents with mental illnesses would be afraid to seek treatment for fear of losing custody. But honestly, there seems to be a additional problem here -- if a parent is mentally ill, she or he SHOULD seek help, because it's not fair to the child to be in the custody of someone with an untreated mental illness.

Hopefully the legal system can find a balance between protecting mentally ill parents' rights, and protecting children. You argue that this balance has not been met, and I wish you the best of luck in your efforts to get more understanding around mental health issues, for the sake of kids and their parents.

[0+] Author Profile Page butterflywings said:

Not to pile on or anything, but I'm also confused as to what the sexism here is.
I have to agree with the others; *sometimes* a parent with mental illness should lose custody. I am only talking about *single* parents who *currently have* a *severe* mental illness. Whatever severe is. But sometimes such parents just can't take care of a kid.
Of course, parents and kids should always be able to see each other, supervised if necessary, and the parent should be supported to get custody back as soon as they are well enough, if they are. I doubt this happens.
Also, I'm sure mental illness may be used against women disproportionately - there is no way, for example, a minor episode of depression that is well in the past should make a mother unfit, but such things have been brough up in custody battles.
So I'm not unsympathetic, and I wish you the best of luck too.

[0+] Author Profile Page mobull said:

I have mixed feelings in response to your post. It is true that a lack of information and bias lead to discrimination against people with mental illness or brain disorders; but separating these from considerations over custody of children is not the answer.

Custody decisions are made in the best interests of the child, not the parent. A temporary condition such as post-partum depression should not permanently end a parent's rights but no child should be subject to abuse or neglect in order to protect the rights of a disabled parent.

I say this as the child of a smart, capable woman with a brain disorder who led a state-wide coalition to help pass the Americans With Disabilities Act in 1994. She was very capable of advocating for her own rights and challenging misconceptions of mental illness and pervasive developmental disabilities. But this did not make her a capable parent.

As a child, I did not have the capacity to advocate for my right to not be severely abused or neglected. It was not until I was 17 and nearly an adult that I was able to advocate on my own behalf and have her parental rights terminated.

I would love to see greater understanding of the nuances of mental illness and brain disorders. There is no excuse for a system that would force your friend to forgo treatment to present the image of the perfect parent if her anxiety disorder posed no hindrance to her actual ability to parent.

However, current state laws only use mental illness, like many other factors, to determine the best interests of the child on a case-by-case basis. The problem lies in prejudice, not those laws which offer children some protection from unfit or abusive parents.

Folks I think we also need to keep in mind the inherent ableism and discrimination behind many of these determinations about who is "fit to parent."

Those decisions are not cut and dry, whether the circumstances are because of mental illness, disability, or lack of resources.

The system itself is a set-up--rather than provide parents with the support they need to care for their children, whether that be social services, counseling or some forms of support even more radical than I can imagine, folks lose the ability to parent at all.

[0+] Author Profile Page Edgy1004 said:

I do take your point that merely being diagnosed with some type of mental illness does not in itself make one unfit to parent, however all of my experiences with in the social service organization of both Utah and Kansas (much less than some but much more than most) is that the state's very limited resources require specific and pressing circumstances to remove a child from a parent's custody. Obviously there are circumstances where a child may be removed and then it is later determined that the environment posed no threat to the child and he/she is returned.
If a child is being neglected or abused then the child should be protected.
Are you saying the children who are not being neglected or abused are being removed? If so please add a link to an article or something.
If your point is that there are a lot of children who's parents are addicts or something other than mentally ill and their children are not being removed at the same rates that is the same as saying lots of people steal but only some people go to jail for it. All children who are neglected or abused should be protected and really we should be complaining about the children who are not being removed not talking about abusive/neglectful parent's right. I am not equating mental illness with abuse/neglect, I am saying that all of the social workers I have known are really trying to protect children and only use removal as a last resort.

Really? People are having that hard of a time seeing it?

We all know that women make less money and are less likely to have health care. Furthermore, health insurance coverage of mental illness can be spotty, at best, and the stigma involved is intense.

...So what we're left with is that the people most likely to shoulder the main burden of raising children are also the people leas liley to have access to appropriate care for mental illness, PLUS there's the kneejerk "OMG, let's yank the kids!" reaction to mentally ill parents, which again, makes people reluctant to seek treatment.

Nobody else sees the problem?

[0+] Author Profile Page monkey_doc replied to ak33yu :

I think the problem could have been more clearly stated, but you are on to something interesting. The point about access to health coverage is well taken. Here is a link, for those interested, that covers some other less well known facts about gender differences in mental health:

http://www.who.int/mental_health/prevention/genderwomen/en/

In the article is a link to a more thoroughly referenced PDF covering the same topics.

Particularly relevant here is that men and women differ in what types of problems they seek treatment for and what provider they seek it from.

[0+] Author Profile Page meeneecat said:

Miriam summed up my feelings pretty well.

'we also need to keep in mind the inherent ableism and discrimination behind many of these determinations about who is "fit to parent."

The comments seem to all back up this inherent abelism by making assumptions about who is "fit" or "unfit" to parent and specifically targeting disabled and MI people.

Aside from all the commentary about how people with mental illness can make unfit parents...I would be willing to bet that 99% of people with disabilities/mental illness, when given access to treatment, make perfectly "fit" and loving parents.

I have bipolar disorder, a serious mental illness by all considerations, I've attempted suicide and have had paranoid fits and episodes, I've had the deepest depressions and the highest manias. However, there is a treatment for this, and the reason I take medication and see a psychiatrist, is to prevent all these symptoms. On medication I am a completely different person, I do not have any of these destructive symptoms. Does my history make me unfit to parent? Does the fact that I seek treatment and get an official diagnosis that could be used against me, mean that I should reconsider getting treatment to avoid this stigma? I know many people with MI that also happen to have kids. Should the government get involved to take kids away from disabled people because of non-disabled people's assumptions about us being "unfit" to parent? Does a diagnosis automatically mean that the parent needs to be "investigated" for "fitness"?? Are you starting to see how this could be a bit abelistic?

I think the sexist part comes from the fact that child custody issued affect women differently than they do men. Women tend to be the primary caretakers, thus these "investigations" of the mentally ill would primarily affect women. Women also have higher rates of depression, and are more likely to suffer from post partum depression.

The figure that rates of children being taken from their parents are as high as 70-80% among those with a mental illness strikes me as incredibly high, especially considering that the vast majority of people with mental illness, when allowed access to treatment, lead normal lives. So why are we being targeted when it comes to parental "fitness"?

[0+] Author Profile Page meabsolutely said:

I am having some difficulty with this post. It is making feel defensive.

I am in my final year of school for social work. If there is one area that people want to talk to me about most it is child protection. In this day and age most social workers are taught that the best place for the child is with their own parents- it is less traumatizing and less expensive for the state. When working with a family, we are taught that removing a child from a home should be the last resort in a series of interventions. It is important to try to give the family the tools that they need so child are not taken away and to work with them throughout the process.

However, social service agencies are highly underfunded and the people who work for them have huge case loads. Also, child protection is such a hard job that counties often have trouble finding people to do the work in the first place. In some cases, counties (especially in rural areas) will hire graduates with no social work background, such as history majors.

While it is important that our ideas about who is a fit parent be revised, we must remember that these situations are really about a society that does not value women. Whether it be traditional women's professions such as social work or parenting - also traditionally female - this is a way that the United States doesn't show support.

[0+] Author Profile Page eva_g said:

"The loss of custody can be traumatic for a parent" - in a custody case, I think the focus should be on not traumatizing the CHILD.
In a custody case, it's supposed to be the welfare and interest of the child that's paramount.

I'm a little confused by your post too. As a general rule, I will boldly state that I do think that the most healthy and able parent should get at least physical custody (custody is divided into legal and physical). How and when what degree of which mental illness make someone an unfit parent is almost impossible to generalize about. The guiding principle must be the best interest of the child though.

From personal experience, which of course is only mine, and can't be extrapolated into anything more than my personal experience, family court is actually one of the few places where women are not outrageously discriminated against. There is still, I think, a rather large bias towards the mother as the best primary caretaker and parent, and fathers are still seen more like breadwinners and less able to fully provide a nurturing home for their children.

I don't wish for my worst enemy to go through the wringer that is family court. It's a tremendously imperfect system and I have much more to say on that, in a different post - but I'm not sure that I agree or understand the sexism the OP is alluding to in her post.

I've got mixed feelings on this article as well. It doesn't seem to go far enough, as there is no comparable discussion (no statistics, for instance) of the rate of men vs. women with mental illness who are/aren't granted custody of children. If those numbers are severely disproportionate (more men with mental illness granted custody than women, for instance), I'd more readily understand the importance of this topic. As it stands, I don't think the problem is one of sexism, but rather one of determining the level of illness itself. Sure, the mental illness of one parent can be used against them in court, but unless it happens more often to women than it does to men, I'm skeptical of the article's premise.

That said, I do not believe people should be demonized for seeking help. In fact, as long as it's working, and the parent is involved in his/her own health, there should be no custody dispute beyond who gets the kids for what holidays!

This one hits home for me especially because I grew up around people with various mental illnesses, including people in my immediate family. Mental illness strikes differently in different people, and as someone who grew up around a lot of it, I can safely say that some types of mental illness SHOULD be closely monitored, and that for some mentally ill parents this may need to include stricter custody arrangements.

Case in point: I lost a really close bipolar girlfriend of mine to a self-inflicted gunshot wound. She shot herself in her car at a local beach after dropping her 5-year-old son off at daycare one morning, and honestly, after spending years around her and seeing the dizzying highs and lows (occasionally dangerous ones at that) she went through, there were a few times when I seriously doubted her ability to fully take care of her son and herself. Sometimes a judgment regarding mental illness is just that: a judgment, for better or for worse. It's not sexist, but rather for the health of the child/children.

[0+] Author Profile Page MzBitca said:

Nobody's bringing this up but instead are focusing on the state removing the child but what about in custody cases between a mother and a father where mental illness can be brought up as a reason to strip another of custody. I work in mental health in the substance abuse area and I constantly have women coming in for what their lawyers call a "preemptive" evaluation. Basically if the women has any time of drug/alcohol arrest charge in their past or any history of depression and they are in a custody battle they get an assessment to show that those are not current issues because many spouses will use this as an excuse to take sole custody and with a stigma against mental illness I can definitely see this being a problem for women.

[0+] Author Profile Page qtiger replied to MzBitca :

Basically if the women has any time of drug/alcohol arrest charge in their past or any history of depression and they are in a custody battle they get an assessment to show that those are not current issues because many spouses will use this as an excuse to take sole custody and with a stigma against mental illness I can definitely see this being a problem for women.


The only way I can see this being a gendered issue is if you view women as the default caretaker of children and men as 'taking' custody from women in custody battles.

[0+] Author Profile Page voluptuouspanic replied to MzBitca :

I think that's a really good point. Given our society's near canonization of the ideals of motherhood (based on sexist notions of passivity, nurturing, and docility), mental illness accusations are a good way to strip a woman of her children.

I think there is a difference between the lived experience of mental illness and the stigma (social control) of the mental illness "specter".

[0+] Author Profile Page Marj said:

The idea that anyone would avoid medical treatment in order to escape the 'stigma' of mental illness shows just how effed up our society is in this regard. It's bad enough that insurance coverage can be spotty (thankfully that should be improving this year--mine is, at least), but to have the choice between being treated, and living in the way you want (in this case, with your children)...that's just wrong on oh so many levels. It's hard enough to find the courage and strength to seek help without these compounding issues.

[0+] Author Profile Page Charybdis said:

As someone who struggles with a mental illness myself, and who has chosen not to have children largely because of this illness, I also have mixed feelings.

This isn't about the mother. It's about the child.

I strongly suspect my mother was as mentally ill as I am today. She was constantly depressed and raging, and alcoholic. She made me want to die. We lived in chaos. I only wish that someone had taken me away from her.

Because of what I went through with my mother, I had a tubal ligation, to make sure I would never get pregnant and have a child at a time when my judgment was less than sound. I got the operation at the age of 24. I explained to the gynecologist that if I ever had a child, that child would be in danger like I was. They gave me the surgery.

I'm sorry, but this is one area in which I prefer to be stigmatized as a "bad mother" (which I know I would be, at least occasionally, and believe me, growing up with this kind of mom, I know that one occasion is far too many) than to put a child at risk.

[0+] Author Profile Page margaret said:

I work in crisis mental health, and I live in minnesota. Minnesota is a state that works very hard to maintain families. I have clients that have had multiple suicide attempts in one year and are disoriented. They are continuing to parent their children. I do not think it is the healthiest environment for their children to live in. I do not believe that it is based on them being a woman. I do think there are issues when a woman gives birth and is depressed, but children are not taken away. In Minnesota, that is when supportive services are offerred. WIC, Public Health Nurses, etc. There are other ways in which gender is an issue in mental health. Certain personality disorders are diagnosed in women more often than men, but some are diagnosed more often in men than women. None of this is perfect and none of this is easy to work with. I wish that we had better non-medication support options for those with severe and persistent mental illness. But, frankly, to have children taken from a home is much much more difficult than the writer would suggest. Perhaps in custody situations it is different, but even then, courts are generally more sophisticated than one would expect.

[0+] Author Profile Page daveNYC said:

Taking away custody from a parent who is mentally ill, but is doing fine on meds is bad. A parent going off his/her meds in order to avoid the mental illness stigma when fighting for custody is also bad.

[0+] Author Profile Page Phenicks said:

I'm going to go ahead and stir the pot.

Banita Jacks is a woman from DC who had mental illness. She did not seek help in fear of (allegedly) losing custody of her children. ALL OF HER CHILDREN are currently dead, she relentlessly abused them and then killed them and lived in teh home with their corpses until the authorities came to check out ctruancy complaints. While her right to parent was protected, her children's right to live wasn't.

Sometimes it really is just that cut and dry.

ANY parent in ANY situation where they can not protect ther child has the selfless responsibility to either seek help to be able to protect their child or relinquish custody to the other parent or a trusted adult who can and will give the child the love, care and protection they need and deserve.

This isn't limited to MI, if the children's father or stepfather is relentlessly abusing the children and someone who will NOT abuse them is seeking custody and for whatever reaosn you can't leave the abuser its in the best interest of the child(ren) to be in a household free of abuse. Whether that household includes you or not. If someone has a drinking, drugs or gambling problem those are very harmful to children. These situations where the best solutions make everyone a victim. The children want to be free of abuse but they can't be in the same household of the current custodial parent and the parent may not be able to provide a safe home for the children because they are being abused or because they have addiction problems (making them victims) but letting them keep custody only means the victim who will suffer the most is the child.

The fallacy of the notion of human rights is its pretense to universality. Human rights may exist, but they are culturally defined and their enforcement is an advocacy for a specific social system. We pass laws relating to custody and to child welfare in large part because of a desire to effect a vision of the morals/ethics underlying whatever society is applying such rules. So, for example, in the U.S., mental illness is characterized by behaviors that are divergent from a loosely circumscribed set of acceptable behaviors. It's true, we take kids away from adults who are diagnosed with mental illness, not only because we "fear" for the child's "safety", but also because we don't want the child to grow up learning that such behaviors are acceptable-- we empower parents with social support networks (like extended family) and with jobs or money or education or clean criminal records because we seek to reinforce these behaviors and both reward the adult and provide a specific model for the child.

So there are a few human rights that are worth thinking about here, for what they really represent: the right to be a parent to your own children, the right to desire to raise your children a specific way, and the childrens' rights against harm. How we define harm and parental rights is intensely social: how we privilege educational opportunity and religious upbringing, how we privilege a married parent versus a single parent, and how we privilege health, fitness, and lack of burden on children. Many societies feel that children properly bear the burden of accomodating their parents' illness, be it physical or mental, but there's a specific ethic being asserted by western civilization, or by U.S. culture, that says that the children are more important in this equation, and raising them with a model of acceptable behavior is desirable.

That ethical assertion isn't wrong or morally repugnant. Kids should have stable parental models who are capable of preparing them to be competitive in an environment where many of their peers will have had fewer burdens and mroe advantages for specific types of growth that are deeply relevant to social, economic and physical wellbeing in U.S. society. It's not only that mentally ill parents may be a danger to their kids-- many, if not most, are not a danger to their kids, especially under treatment-- but that they may not have the resources to provide as many opportunities, they may not present a model that prepares the children for success in U.S. culture, and they may present an increased burden to the children that puts the children at a disadvantage to their peers in terms of economic/educational success, success in forming emotional connections that assist with creating social support structures, and success at managing the child's own typical or atypical emotional and physical health.

[0+] Author Profile Page baftaboo said:

While I can see how ableism plays a role here, I just really cannot get on board with the spirit of this post. Kids are not objects that are "taken" from adults and have to be fought over with the state. They're people, dammit. If they want to stay with a parent who happens to have a mental illness, and they're dragged away, THAT'S a tragedy. And if they don't want to stay (whatever their reasoning)... then I can't really see an issue.

[0+] Author Profile Page daytrippinariel said:

I just want to make a few points:

Mental illness is very common, the NIMH estimates that 1/4 of all American adults suffer from a mental illness during a given year. I've read in my psychology text books that half of the population will develop a mental disorder, by definition of the DSM-IV, at some point in their lifetime. Personally, I'm willing to bet more than half of the population will develop a mental disorder in their lifetime but that's just an opinion. For many people these disorders are mild. Otherwise stable people develop mental disorders in response to high levels of stress and trauma all of the time. So, to me, it is a great misunderstanding of mental illness to stigmatize people who suffer from it since at some point it may be you.

Also, as a person who went through custody battles in court as a child I just want to say that it is a very imperfect system. There is so much I could say about it, but it's difficult to know where to start. Courts make mistakes, they don't always listen to the children. Then again, they shouldn't always listen to the children because despite how wise they may be they cannot always process what is going on in a sophisticated manner (unless the child is talking explicitly about abuse, then definitely, children need to be listened too). Each case is individual. It's hard for me to make an opinion about where a child should go. Custody battles can make stable people make irrational decisions because of the high emotion involved. Yes, we should do what's best for a child. However, making that call is not easy or black and white. Children get separated from siblings during these battles. They get put in unstable foster care systems, which could be worse.

So, it's a very complex topic with no easy answer. And, yes, I could see how this would be a woman's issue considering the high number of single women who aren't going to lose their children to an ex-husband (if they ever even had on) but to the state.

[0+] Author Profile Page sue said:

Thank you for this posting. Mental illness is just another excuse for many to take away the rights of a human being. I know I have been there.

Sue

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