One missed paycheck from mental health crisis

A new piece inĀ The Atlantic examines the relationship between mental health and long-term unemployment. As they point out, it is a chicken-and-egg problem- does long-term unemployment cause more mental health problems, or are long periods without work a symptoms of existing illness?

That’s a tough relationship to investigate, but it does relate to issue that people with mental illness can have- a much lower tolerance for stress and loss. Losing a job is hard for everyone, but it can trigger a serious episode for someone living day-to-day with schizophrenia or bipolar disorder. Even two years of constant stability have not created any kind of illusion. I am still walking on eggshells. A very stressful set of situations, a few days without access to medication, these things can be the difference between being in recovery and being in crisis.

This piece also brings up another component of mental illness- economic hardship impedes growth and recovery. It’s not just those that work losing their job. Millions living with a diagnosis are on disability or otherwise living on a fixed income. The squeeze is bringing plenty of people to the brink, but mental illness just adds a whole set of other complications.

Every stressor that exists has its own extra, sinister side. And in an America that’s in year eight of a recession with no broad recovery for the most vulnerable, the stressors are many, multiplying, and always just a few wrong turns away.

Crisis: sometimes you gotta hit a brick wall

As I’ve said before on this website, I am a member of Stamp Out Stigma. It’s a speakers’ bureau dedicated to putting a human face on mental illness, and countering negative stereotypes that stigmatize those who deal with their disease.

Today we spoke at a training for a crisis line. The work that these organizations do is incredible; even though I have bipolar disorder, dealing with the pain of others in my community can be overwhelming. Just because I can understand doesn’t mean I can handle other people’s desperation. I am glad there is something I can help them with, because I can’t do what they do. It would be a serious threat to my present stability.

What our conversation eventually led to is how those in crisis can feel trapped when looking for help. What is important to know is that overcoming the fear of stigma and seeking professional help is only the first step in treatment. There is the fear of powerful, sometimes dangerous medication. Therapy is now commonplace, but it can still be a point of alienation. And when you ‘come out’ to family or friends about what you go through, you have to educate each one – because what mental illness is and is not are just not taught or discussed about.

So when someone calls a crisis line, it may not come from a lack of resources. Yes, a person may not know where or how to get help, but they may also fear the help they get. Unmedicated you can end up in crisis, but also after months or years of trying treatment and finding it only partially effective.

A friend of mine was diagnosed as bipolar not that long ago. She was older than me, so she got the news 12 years later in life than I did. She, like me, feared the side-effects and power of the medication. Ultimately it took a crisis to remove that psychological barrier and embrace treatment.

In the end, it’s a series of difficult choices. Mental illness evolves, and people are at different points in the process of understanding, denial, anger, and acceptance. Crisis can be necessary for transition, but not everyone lives through a crisis. That’s why crisis lines and trained staff is so important. The way forward is blocked by a sense of desperation and isolation, both physical and psychological.

Mental illness is a maze, but sometimes you need to bust through some walls to get out. My crisis in 2012 led to me hitting a brick wall – a massive increase in antipsychotic dosage that slowed me down to a crawl. But with that collision the chaos stopped, and a new, better life could be put together from the pieces.

Sometimes you gotta hit a wall. And there need to be people to make sure you get out safe on the other side.

For sale, office space, never used

The long recession has led to a discussion on economic statistics. In particular, what is evidence of a recovery and what is not. The Dow Jones index isn’t a reflection of the national or international economy, just the health of thirty large companies. And employment statistics as usually reported in the media aren’t useful- the U3 rate doesn’t count “discouraged workers” who leave the labor force due to the economy being too bad to look for work. The rate can go down in a very good economy (more jobs), and a very bad economy (so few jobs people don’t bother to look). And in the event of the latter turning around, the rate spikes as people get back into the labor force. Oy.

When I went to see prominent socialist economist Richard D. Wolff speak two years ago, he recommended a metric reported by the Federal Reserve every month. Called “industrial production and capacity utilization,” it measures how much capital, land, office space, etc. is actually being used to create goods, and how much is standing idle.

Capacity utilization rates over time

The above graph shows the difference between what is being produced and what can be produced at that point in time. The production measurements are set at 100 during the highest level of production- right before the 2007-08 recession. At that time, actual capacity was about 125% of current output. The bottom graph shows the percentage of capacity being used. Historically it’s around 80% in America, but it fell to 66% after the economy cratered. It’s still weak- even a couple percentage points below average is a massive amount of capital and land- and thus a massive amount of jobs.

My anecdotal evidence to support this comes from office space in Silicon Valley. After the economy crashed and credit dried up, many companies based in the Bay Area either went under or contracted dramatically. That led to whole office buildings- big ones, often new- being vacant with large signs advertising bargain-basement space. In 2013, a lot of these buildings have tenets, but rarely are they full on all floors. It’s clear that there is still capacity available- you could expand your business quite a bit without having to actually build anything- but conditions are not what they were before the crash.

It seems that unemployment is more explainable though this than the often contradictory unemployment figures. If a large amount of space, land, tools, inventory is still sitting idle from five years ago, that leads to a corresponding gap in labor use versus capacity.

Now, there are good reasons that capacity utilization is never 100%. Businesses are failing all the time, even if the economic climate is good. Just because you have tools doesn’t mean they’re good enough to compete with. And running machines 24/7 causes wear and requires expensive replacement- which may not be ready. It’s also clear that putting people to work is not a question of physical stuff- it’s also about competition, and how a corporation works. Just because you could employ more people and fill up all that cheap office space doesn’t mean it’ll be more profitable. It’s why economists who advocate for infrastructure projects have a point- some useful employment doesn’t fit into a business model. Capital is sometimes used because of government incentives and subsidies, rather than a calculation by the finance department.

As time goes on, the unused machinery will become obsolete, and the buildings will become dilapidated. Getting little use out of them just makes the investment for the future all the more costly.