Case in point:
At the Sept. 16-17 Ca. Mental Health Planning Council, I was doing my 
homework reading the material on the agenda for the following day.
One of the assignmnts was the draft chapter on System Oversight and 
Accountability for the Master Plan to be shared with the Department of MH’s 
Quality Improvement Committee on Sept. 31st.  As titled the chapter covers 
the Nature of Performance Indicators, Appropriate services, Access, Cost 
effectiveness, Valid Indicator Sets, the concept of Accountability, Data 
Sets, Risk Adjustment, with a good many footnotes.
But embedded in the introductory page were these sentences: Referring to 
percentages of particular diagnoses in 1994-5:

"These illnesses generally all have a genetic component affecting the 
clients’ biochemistry. These disorders typically require life-long 
management, frequently with th continuous use of medications.  The 
diagnoses of children in the mental health system are typically childhood 
disorders and adjustment disorders which together account for approximately 
20 percent of the diagnoses.  These disorders are not usually genetic or 
biochemical in their origin.  They tend to be triggered by maladaptive 
situations in a child’s life."

I read further carefully to make sure there was not some proposal to assign 
greater risk to the offspring of diagnosed parents or to especially track 
the children of the diagnosed. This was the only reference in the whole 
document.

My first thought was to raise my objection to these statements when the 
report from the System Accountability Committee came up on the agenda, but 
that committee’s report was the very last thing, and four consumer members 
of the Council, as well as some Mental Health Directors, left early in the 
last meeting to catch planes. Pearl had gone to receive an award in L.A.

So I went to Ann Arneill, showed her the page and said I strongly objected 
to the genetic statements, that if they were going to be left in, they 
should be footnoted (from a juried article scientific journal), and that 
the statements had nothing whatsoever to do with the subject of the 
Chapter.  She looked at them and agreed, circled the genetic sentence about 
adults and said she would take it out.  I have no reason to doubt that she 
will.

I don’t really object to the two sentences about disorders or problems in 
children (except that they are out of place) and believe the same could be 
said for most adults with a serious chronic psychiatric diagnosis.
It is odd that some of the same behaviors would be situational at age 17 
and suddenly genetic at age 18 . Psychiatrists are as unable to predict 
that someone’s off spring will be mentally ill as they are unable to 
predict violence in a court of law.  My father died in a psychiatric 
institute when I was 3 years old.  I found out when I was 47 years old. 
Until then he was an unmentionable missing person who might appear at any 
minute; I had even been told that he died of a heart attack putting a 
tricycle together for me.  Did I inherit his madness? Or react to the 
family's convoluted lies and shame?   My doctor when I was 21 told me I 
should never get married or have children.   I have two grown married 
creative daughters both completing their Ph.D.’s.  I am proud to say that 
they are not ordinary complaint citizens; they always do the unexpected in 
an extraordinary way.

The most riveting stories I have heard from clients are from those who had 
one or two parents locked up for most of their life.  Believe me their 
stories are about Nuture, not Nature.

David Halberstam in The Fifties (Villard Books: New York, 1993, Chapter 
21) tells the story of Katharine McCormick wife of the heir to the Cyrus 
McCormick fortune.  Her husband Stanley came down with acute schizophrenia. 
This provided the motive, according to Halberstam, for The Pill. 
Katherine gained control of his estate and began to make generous 
donations to Margaret Sanger and Gregory Pincus, a parthenogenic researcher 
responsible for the oral contraceptive, Enovid-10, in 1960.  The Pill was 
developed to stop the genetic strain of Mr. McCormick’s illness.

The Modern Mental Health system of the 1990’s has other ways to stop the 
reproduction of mental health clients: side effects of medication, housing 
design, benefit policies, HUD rules, viewing being in love as a manic 
symptom to be treated immediately.