The Right to Fail
The right to fail. To live our lives as people that are flawed, diagnosed, mentally ill the the way we see fit to do so. In New York State, and many other states in the United States, unless you are mandated, or in a AOT (Assisted Out Patient Treatment) or forced treatment program, you can fail out of society and be admitted to an hospital for psychiatric rehabilitation. Unless you have been labeled V-SPMI (violently and persistently mentally ill) you can cycle back into the system, from hospital to independent living, and the converse, over and over again.
I don’t think it should be any other way. This is a privilege not all of us have in the United States. There are states that operate differently, offer less freedoms, and in practice, offer less supportive services to people who want to live on their own. We must protect this privilege. The endorsement of this freedom and dissemination of this privilege, the right right to fail must be defended at all costs. We can never give it up. Next to the modern mission of dignity, hope, and recovery by NY-OMH, and other state mental health regulatory bodies, we must write into law and inscribe it with the right to fail.
This addendum in the history of our mental health system must read clearly. It should reflect the all important pendulum, some might even call it a continuum. This is the abstraction, the theory underpinning a right to fail put into practice. Professionals have another name for it. It’s called “Dignity in Risk, and Risk of harm”. This expression has been debated for years. And the debate still rages on. Since de-institutionalization, people just aren’t sure about the future of people living with diagnosed mental health conditions living out in the community.
Whenever you hear, should this person or that person be allowed to live independently, or be discharged from a hospital, it boils down to essentially where the identified patient falls on this continuum of being more of a risk, or capable of maintaining stable living? But what does stable living look like? What does failure look like? Clinicians can do their very best to assess and predict outcomes but do we never really know what people are capable of, do we? I truly wonder.
And yet, still, I wouldn’t have it any other way. Sure, clinicians assess for lots of concerns. Discharge planners in hospitals look at the full clinical picture of a person before they are released into the community. Depending on the precipitating event of the identified patient, the length of stay in the hospital will be different. Lethality, homicidal ideation, violent ideation, suicidal, strengths, weaknesses, past history, all of it is assessed, right? But is this enough? I am licensed clinical social worker with a mental health diagnosis, and I still wonder about the answer to this debate.
I have done unfathomable things during the tenure of my mental health disorder. This is why I truly wonder. I have done things I still cannot express regret for, or live down. And yet, I still, even as a clinician, wouldn’t want the system to be set up any differently. This is because I have have also done wonderful, beautiful things in my lifetime, since my diagnosis, and would never want to ever forget these memories. The light simply outshines the darkness, every time my freedom is involved. This is why we cannot ever give up this privilege.
For there is dignity in risk. Dignity in having choices. Dignity in failure.
I support the right to fail.