Programs Promote Ill Effects for Offspring?

To the Editor: In the February Open Forum, Seeman (1) posed the question of whether psychosocial programs for young people with psychosis promote assortative mating. She presented data from research indicating that assortative mating—the idea that individuals choose to mate with those who are similar to them—may hold true for people with mental illness. This point is important to consider in light of what we already know about the increased biological predisposition to mental illness among children whose parents are ill. However, Seeman went further, questioning whether psychosocial programming does recipients a disservice in this regard.

The implication that mating between individuals with serious mental illness is the equivalent of “inadvertently causing misery to a future generation” is blatantly offensive. This type of thinking created the eugenics movement. Currently, it prevents parents with serious mental illness from receiving appropriate assessment and needed supports. As director of a clubhouse program and a clinician who has done research on the experiences of mothers with serious mental illness, I find the author's assumptions to be flawed. Research has shown that parents with a mental illness are at higher risk of losing custody of their children by virtue of their illness alone, not because of acute symptoms or impaired functional status (2). This sort of bias has no place in psychosocial programs, where the focus is on reducing stigma and promoting recovery. I understand that Seeman was posing questions for consideration rather than stating conclusions. However, I fear that introducing eugenics concepts into current discourse on mental health recovery and rehabilitation will halt further progress.

Questioning the value of psychosocial programs simply because two participants may mate is naive. A different perspective is offered in the January 2012 issue, where Whitley and Siantz (3) suggest that recovery centers should be considered an emerging best practice. Should we consider a support group for cancer survivors or people with diabetes a bad thing because members might meet and fall in love? Should we save their potential children the misery of having parents who share a chronic illness, likely increasing their chances of inheriting the condition? If such arguments sound ridiculous or even offensive, why would we entertain them for mental illness? Perhaps the development of parenting supports and skills training to assist people with mental illness who choose to parent would be a topic for discussion more useful than questioning the existence of programs that allow for socialization and bonding.