Mental Illness & the Tyranny of Forms

I was recently contacted by a Warrior Mom, one who once sought and received treatment for her PPD as one should, who had to fill out some forms for something that is very important to her family. As she was filling out one particular form she came to this question:

“If either applicant has received treatment for a nervous or mental disorder, explain and attach.”

She told me how much she was concerned and even upset by the question, noting it made her experience with maternal mental illness feel worse to her somehow. She was afraid to answer truthfully as though it meant she might not be worthy of what she was seeking.

Ahhhh, the tyranny of forms. There’s nothing that makes me stop and pause like having to filling out an important form—often one required by some agency of government—for me to get something I want or really need, and arriving at ye olde mental illness question.

Why are they asking me this? What business is it of theirs? Why do I have to explain to anyone that I have suffered anxiety and then explain and attach? When you say attach, exactly how much of my experience do I need to explain to you?

ANDPLUSALSO, why the hell does this question seem to come up adjacent to the section where I’m asked if I’ve ever been arrested or convicted of a crime?

Do these form making people not know that my mental illness—anxiety/OCD—is just an illness?

I notice that none of these forms ask me if I’ve ever had strep throat (yes). Or hepatitis (yes, but not the dangerous one). Or mononucleosis (yes). I haven’t had to explain and attach a list of the surgeries and hospitalizations I’ve received (three for my spine and two outpatient for kidney stones, plus two babies, thank you very much). No one has requested a dissertation from me on that time I got pleurisy.

You get the point. When you ask someone a question about mental illness on an important form, what you are saying-without-saying is that it’s a problem. Mental illness is different. Separate. You have a problem. You yourself may be a problem. It’s inferred loud and clear.

I notice no one asks me the good things about myself on these forms—not whether I got good grades, or am a nice person, or if I volunteer or am helpful to others. When you only ask if I’ve ever done anything bad on this form and then you also ask me about mental illness, it’s like you’re saying, “Wink, wink and all, but if you answer yes to this question then you may be an issue. You may not get what you’re trying to get, which you may still 100% deserve. We’ve now got a get-out-of-jail-free card when it comes to you and what you’re asking for. It’s a crapshoot from this point on.”

I don’t like it. I don’t like it one bit. I think it’s unfair and also crappy. And I don’t deserve it. Yes, I sure as hell have received treatment for a mental disorder, and you sure as hell have have no business stigmatizing me, ESPECIALLY when you are a federal or state government which spends gobs of money on reducing stigma!

And don’t get me wrong, I realize in certain cases this question needs to be asked. You want to make sure I’m not in a position where I might do harm to myself or others. But why not ask me that then? Or some other question? Why ask the blanket “Have you ever received treatment for a mental disorder?” as though all of us are lurking around the corner ready to pounce?

I recently attended an event at the Scattergood Foundation where we talked about trauma informed care. It’s all about the idea that you shouldn’t re-victimize people who are already victims. We were taking a look at a variety of forms that elderly in poverty in the Philadelphia area would need to fill out to access much-needed services, and we were asked to redesign those forms using the principles of trauma informed care. How hard are they to fill out? How will the people filling them out feel or be impacted by the questions they’re asked? Will they decide not to fill out the form to get something they truly need because they are afraid of answering?

As described by the Trauma Informed Care Project, “Becoming ‘trauma-informed’ means recognizing that people often have many different types of trauma in their lives. People who have been traumatized need support and understanding from those around them. Often, trauma survivors can be re-traumatized by well-meaning caregivers and community service providers.” Yes. A million times over, yes. I see this happen to mothers with maternal mental illness so often. I’ve watched women suffer the PTSD in that sixth stage of PPD for years after they fully recovered from the PPD itself precisely because of that kind of lack of understanding and application of trauma informed care in every corner of this nation and the world.

The exercise at Scattergood was fascinating and it made me think about how often mothers are traumatized by the questions they are asked. Every form, script, brochure, and communication needs a good going-over, and not by people who are healthcare experts but by the women who have lived experience. I know one of the reasons for Postpartum Progress’ success is that we’ve always operated from a position of trauma informed principles, mainly because we are survivors ourselves and we know how crucial it is to connect in an authentic, understanding and trustworthy way with each mom who struggles.  

Still, we have a long way to go.