Bethany Yeiser, founder of the CureSZ Foundation, talks to Lawyer Monthly about the importance of working with mental health care professionals and develop an understanding of how mental illness diagnoses and treatment options often intersect with the law.
When I was diagnosed with schizophrenia in 2007, I was sure my psychiatrist was wrong. I saw schizophrenia as an emotional illness, a sign of personal weakness and indicative of an imperfect 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 initial antipsychotic medication I took had serious side effects without eliminating the voices in my mind. I stopped this medication, which led to my second hospitalization. Fortunately, the psychiatrist I met at the hospital gave me a lifeline: he explained to me that the right medicine could be able allow me to resume my university studies.
Before schizophrenia, I was majoring in biochemistry and molecular biology and a scholarship recipient at the University of Southern California. The possibility of going back to school made me comply with the treatment.
I spent the next year trying different antipsychotics with very little success. Side effects of some of these medications included 16-18 hours of sleep per 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 ready to do whatever it took to bring me back to life.
My hallucinations almost disappeared when I started taking a drug called clozapine for treatment-resistant schizophrenia. In 2009, I enrolled at the University of Cincinnati where I graduated with a bachelor’s degree in molecular biology with a 3.83. In 2014, I published my memoirs Insane spirit, to document my journey from schizophrenia and homelessness to recovery. Dr Nasrallah and I established the CURESZ Foundation in 2016 to educate and help patients, families, healthcare professionals and the public understand schizophrenia and how to successfully cope with and even recover from it.
The intersection of psychiatry and the law
One of the first people to read my memoir was a professor at the University of Cincinnati School of Law. This professor invited me to share my journey with his law students who study the intersection of psychiatry and law, each fall semester. According to American Bar Association, law firms value ‘soft skills’ and being able to hear first-hand from someone with lived experiences can help law students empathize with this community, improve 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 been delighted to meet his students eight times. There are several key messages that I share with his students each year. Here are just a few:
1. Schizophrenia is a brain disorder and a physical problem
People with schizophrenia typically need an antipsychotic drug throughout their life to correct the chemical imbalance within the prefrontal cortex and in the limbic system. There is usually no diet, exercise program, or other life changes that can completely eliminate psychotic symptoms such as delusions and hallucinations.
2. People with schizophrenia cannot overcome their illness by 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. not do it. It was not my experience. If I could have just ignored the voices in my mind, I might never have been diagnosed with schizophrenia.
3. People with schizophrenia generally have no place in prisons and prisons
Even if they are largely overrepresented. In 2006, after dropping out of the University of Southern California, I found myself wandering aimlessly around campus, homeless, looking for discarded food to eat. I was delusional and convinced that since I would win a Nobel Peace Prize, become a prophet, and receive billions of dollars, I was welcome to search for discarded food. From October 16-18, 2006, I ended up in jail for allegedly entering the same campus where I had previously attended classes.
My experience in prison was unlike anything I had imagined. I was locked in a cell made for one or two women, with three or four other people. Most of the rooms where I was held were in complete darkness. I remember having fifteen minutes to sit in a small room with translucent light streaming through the roof, before being taken back to the unlit cell. And although I was deeply psychotic during my incarceration, I was never assessed or offered Mental Health services.
The mentally ill incarcerated will more frequently present behavioral problems, leading them to be placed in solitary confinement. Solitary confinement can be a horrible experience for anyone, but it is even more debilitating for people with mental illness.
4. There is hope for people with schizophrenia
When I was arrested by the police on March 3, 2007 and taken to the hospital for the first time, my doctor determined that I was permanently and totally disabled after observing me for about 36 hours. He predicted that I would never work again, attend college classes, or live independently.
The belief that people with schizophrenia do not recover is widespread in the public and, unfortunately, I have seen it in the medical community and even among psychiatrists. The assumption is that people with schizophrenia usually don’t recover, so why bother? My first psychiatrist never even considered the underused and advanced drugs. But today there is hope. My recovery is no exception. The CURESZ Foundation presents 32 stories of successful people despite schizophrenia, and there are so many more that I have yet to meet.
Lack of education about schizophrenia is rife in our society, and it is imperative that we communicate relevant information to our medical and law students. Every medical and law student should know that people with schizophrenia are ordinary people with a biological disease with the potential for a cure.
I hope we will develop a generation of leaders who better understand the population with mental health problems, reject labels and stigma, and fight for justice for the marginalized.