Bethany Yiser, founder of the CureSZ Foundation, talks to Lawyer Monthly about the importance of working with mental health care professionals and developing an understanding of how diagnoses of mental illness and treatment options often coincide with the law.
When I was diagnosed schizophrenia in 2007 I was sure my psychiatrist was wrong. I saw schizophrenia as an emotional illness, a sign of personal weakness and an indication of a flawed personality. Little did I know that schizophrenia is actually a treatable brain disorder characterized by physiological changes in the prefrontal cortex and a chemically abnormal limbic system.
The first antipsychotic medication I took had serious side effects without eliminating the voices in my head. I stopped taking this medication, which led to my second hospitalization. Fortunately, the psychiatrist I met at the hospital threw me a lifeline: He explained that the right medication power allow me to return to my university studies.
Prior to schizophrenia, I majored in biochemistry and molecular biology and won a scholarship to the University of Southern California. The opportunity to go back to school made me adhere to therapy.
I tried several antipsychotics over the next year with little success. The side effects of some of these drugs included sleeping 16-18 hours a day, weight gain, muscle stiffness, anhedonia, and akathisia. Finally, in 2008, I saw a new doctor, Henry Nasrallah, MD, who was passionate about my recovery and willing to do whatever it took to bring me back to life.
My hallucinations pretty much disappeared when I started on a drug called clozapine for treatment-resistant schizophrenia. In 2009, I enrolled at the University of Cincinnati where I completed my bachelor’s degree in molecular biology with a 3.83. In 2014 I published my memoirs Mind alienatedto document my journey from schizophrenia and homelessness to recovery. Dr. Nasrallah and I have the CURESZ Foundation in 2016 to educate and help patients, families, health professionals and the public understand schizophrenia and how to successfully cope with and even recover from it.
The intersection of psychiatry and law
One of the first to read my memoirs was a law professor at the University of Cincinnati. This professor invited me to share my journey each fall semester with his law students who study the intersection of psychiatry and law. According to the American Bar Association, law firms place a high value on “soft skills” and can help law students empathize with this community, hone their sought-after skills, and prepare for their professional work. I am fortunate enough to help his students navigate such a complex and nuanced space and have had the pleasure of meeting his students eight times. There are several key messages that I share with his students each year. Here are a few:
1. Schizophrenia is a brain disorder and a physical problem
People with schizophrenia generally need an antipsychotic throughout their lives to correct the chemical imbalance in the prefrontal cortex and in the limbic system. There is usually no diet, exercise, or other life changes that can completely eliminate psychotic symptoms such as delusions and hallucinations.
2. People with schizophrenia cannot overcome their illness through willpower
I remember attending a dinner party years ago where a law student suggested that people who hear voices are guilty of their behavior because they can choose to do what the voice says or not. This was not my experience. If I could have just ignored the voices in my head, I might never have been diagnosed with schizophrenia.
3. People with schizophrenia generally do not belong in prisons and prisons
Although they are vastly overrepresented. In 2006, after I dropped out of the University of Southern California, I wandered aimlessly around campus, homeless, looking for discarded food to eat. I was delusional and convinced that since I was going to win a Nobel Peace Prize, become a prophet, and be given billions of dollars, I was welcome to look for discarded food. On October 16 and 18, 2006, I found myself in jail for allegedly trespassing on the same campus where I had once attended classes.
My experience in prison was different from what I had imagined. I was locked in a cell for one or two women, with three or four other people. Most of the rooms I was locked in were pitch dark. I remember having to sit in a small room for 15 minutes with some translucent light coming through the roof before being taken to the cell without any light. And despite being acutely psychotic during my incarceration, I was never evaluated or offered mental health Services.
The mentally ill incarcerated are more likely to exhibit behavioral problems, resulting in them being held in solitary confinement. Solitary confinement can be a horrible experience for anyone, but it’s even more debilitating for people who are mentally ill.
4. There is hope for people with schizophrenia
When I was apprehended by the police on March 3, 2007 and taken to a hospital for the first time, my doctor determined that I was permanently and completely disabled after observing me for about 36 hours. He predicted that I would never work, attend college, or live independently again.
The belief that individuals with schizophrenia do not recover is prevalent among the public, and unfortunately I have seen it in the medical community and even among psychiatrists. The assumption is that people with schizophrenia generally don’t recover, so why bother? My first psychiatrist never even thought about underutilized and advanced drugs. But today there is hope. My recovery is no exception to the rule. The CURESZ Foundation contains 32 stories of people thriving despite schizophrenia, and there are so many I have yet to meet.
Lack of education about schizophrenia is common in our society and it is imperative that we pass on relevant information to our medical and law students. Every medical and law student should know that people with schizophrenia are ordinary people suffering from a biological illness with the potential to recover.
I hope we will raise a generation of leaders who will better understand the mentally ill population, reject labels and stigma, and fight for justice for the marginalized.