Friday, January 21, 2011

Crazy in America

Major events are always determined by not one but several factors. Since January 8, when 20 people were killed and wounded in Tucson, much of the public discussion has focused on the availability and lethality of weapons. That’s a topic worth debating.

But in a recent poll, more than half the people who responded felt that the “mental health system” in America was a primary cause of the tragedy.

What mental health system? In America, the vast majority of people who are mentally ill can be found in one of two places: in prison or on the streets of major metropolitan cities.

People in the grips of a serious mental illness typically cannot hold a job, so the very limited and convoluted health care system we had until last year has left the vast majority with no resources for getting help.

Public funding for any kind of social programs, including those that help the mentally ill, are constantly being cut from inadequate to nonexistent, thanks to a culture that does not see taxation as a legitimate way to generate the kind of income government needs to fund the programs we need or want.

The American culture is about thirty years behind science in understanding the biology of mental illness. The 16th-Century definition of “insanity” used by the courts means that most anti-social actions committed by people who are mentally ill are treated as crimes. In a truly civilized country, people like Jared Loughner would be confined to a mental facility for the rest of their lives. (As of now, there is no cure for paranoid schizophrenia, and those who have the disorder cannot be trusted to manage it themselves.)

As it stands, however, our choices as a society are to lock the severely mentally ill up in cages with the most vicious criminals, murder them by government, or warehouse them indefinitely until they are paroled or released at some future time. None of those are rational or compassionate alternatives.

It’s very common for psychotic disorders to “present,” or become evident, in the late teens and early twenties. That’s why a Jared Loughner can seem perfectly normal to high school classmates but loonie to those who know him after graduation. Many of the most seriously ill who are dangerous to themselves and others commit violent acts in their early twenties—or at least fail to become independent, productive members of society. I can’t count the number of families I’ve known in anguish because a loved one desperately needed psychiatric help but could not afford it.

Under the Patient Protection and Affordable Care Act of 2010, young adults who do not have their own insurance can at least be covered under their parents’ plans until they are 26. That means the Jared Loughners of this world can afford to get psychiatric help.

It’s not a complete solution to the problem by any means—but at least it’s a very good start.


Six said...

I actually agree with much of your post on this - as a society we have done an awful job in understanding mental health issues.

What I find disgusting though is your over-reach (again) in trying to make some sort of political point out of this horrible tragedy. I guess the administrations meme of, "never let a crisis go to waste" is alive and well with you. As it turns out, Loughner had public mental health services available (and recommended) to him, but neither he nor his family sought them out (against the recommendation of everyone from school officials, friends, etc). From all that I have read, this young man had signs of mental health issues for many years, and from what has been written, appears that it truly turned in to what sounds like full blown schizophrenia around 18-20. A time when he would have been eligible for remaining on his parents health plan. Certainly the college he attended would have had available at the very least the most basic services (probably more) which were never sought out.

So please stop with trying to score some cheap political points. If you want to advocate for the Affordable Care Act, slam on Palin, hammer the NRA and so on... go for it, but do it on the merits of the above mentioned ideas (I can give you plenty to hammer the NRA about, or slam Palin for without going here!!). But do not stoop to this level... you really are a much more insightful and all-around better blogger than this.

Citizen Jane said...

Six, I’m sorry if you’re offended by my partisan point of view, but it’s one that has evolved with the country. Today’s radical-right GOP is not the same as it was when my grandparents voted for Eisenhower. Especially since the advent of the Tea Party, it has become an extremist organization, oblivious to human needs and fueled by virtually unlimited money from big business. (See, for example,

The Republicans have Rupert Murdock and Goldman Sachs to defend their interests. They don’t need me.

It saddens me, frankly, that many of the sharpest, most insightful people in America have adopted the libertarian view that all government is bad, all politicians are dishonest, and the two parties are equivalent in their aims and effects on people and the planet. That’s just not true.

As for mental health, it’s true that most people can afford counseling, thanks to free clinics and private organizations, like Lutheran Social Services and Catholic Family Services. But counseling is a far cry from a competent mental health evaluation and medical treatment, including medication and, if necessary, hospitalization.

I can’t count the number of people I’ve worked with—and still do—who have been diagnosed with clinical depression, bipolar disorder, or other disabling conditions but can’t afford medical treatment. Cognitive therapy can go only so far in helping them. It’s like putting a bandage over a festering wound without treating the infection.

The GOP has done nothing for the past two years but try to obstruct progress, on everything from health care to Wall Street reform to DADT. Their only goal now is to try to reverse the progress that was made in spite of them. (Just ask Mitch McConnell—at least he’s honest about it.)

Sorry, but I have no respect for that.