[humanser] Now What

[Mary Ann Robinson]

I got this from another list and hope list members find it interesting.

Mary Ann Robinson

Now What?
  Mona Charen
  Some good has come of the tragedy in Tucson.  President Obama
has issued a de facto rebuke to those in his camp who attempted
to use the murders to discredit and smear their political
opponents.  It was no more than decency for the president to rise
above that extremely low threshold -- but rise he did and for
that he deserves credit.
  But a call to high-mindedness such as the president issued is,
in the nature of things, not likely to be effective for very
long.  If any lasting good is to be achieved out of this horrible
episode, it will require addressing the question that Obama
mentioned only glancingly, but that really is the heart of the
matter -- mental illness.
  Dr.  E.  Fuller Torrey, writing with a rare combination of
compassion for the mentally ill and concern for the general
public, has analyzed the failure of our system for dealing with
mental illness in "The Insanity Offense: How America's Failure to
Treat the Seriously Mentally Ill Endangers Its Citizens." Anyone
who is serious about preventing the next Tucson massacre should
read this book.
  In 1955, when the U.S.  population stood at 164 million,
558,000 people were living in mental institutions.  Over the
course of the next 30 years, nearly all would be released as
deinstitutionalization swept the nation.  The mental hospitals
were closed, leaving former residents to make do on the streets
and (increasingly) in the prisons.  Today, roughly 4 million
Americans suffer from serious mental illnesses and about 1
percent of them, 40,000 individuals, are violent.
  Deinstitutionalization began not as a money-saving measure
(though it doubtless appealed to some for that reason) but as an
idea.  Psychiatrists like Thomas Szasz ("The Myth of Mental
Illness") and sociologists like Erving Goffman ("Asylums") argued
that symptoms of mental illness like raving, hearing voices, and
paranoia were actually responses to being institutionalized.
Asylums, claimed lawyer Bruce Ennis, were places "where sick
people get sicker and sane people go mad." Szasz even denied that
mental illness was real, preferring to see inmates as
nonconformists.
  Such were the '60's.  At this moment of reduced partisanship --
if we really are in such a moment -- perhaps Democrats and
Republicans can summon the humility to recognize that this
disaster was a bipartisan one.  Politicians of both parties
agreed that subjecting people to psychiatric treatment against
their will was immoral and un-American.  And so a flood of deeply
impaired human beings was loosed on American society.  Numerous
studies have found that about one-third of homeless men and
two-thirds of homeless women have serious mental illnesses.
Among the "hardcore homeless" or "permanent street dwellers,"
close to 100 percent are mentally ill.
  On the streets, the homeless have been granted the freedom to
be assaulted, to "sleep under bridges," as Anatole France once
mocked in another context, to freeze to death, to be robbed and
raped, to be lit on fire, and killed.  They rummage through trash
bins for food and park their filthy shopping carts under
highways.
  Autonomy and individual liberty are cherished ideals --
achievements of Western civilization.  But there can be no true
autonomy for those with unsound minds.  To insist upon the right
of the mentally ill to refuse treatment is cruelty masquerading
as respect.
  Most mentally ill people are not violent, but among the
mentally impaired we do find 40,000 or so deeply disturbed and
dangerous psychotics -- out of whose ranks we have gotten the
mass killers of the past 50 years -- from Son of Sam to Seung-Hui
Cho (Virginia Tech) and sadly, too many more to list.
  A study of "rampage killers in the United States reported a 46
percent increase in such tragedies in 1990-97 compared with
1976-89." Most of those who suffer violence at the hands of the
dangerously psychotic are not strangers but family members of the
ill.  Tragically, those family members have often pleaded for
help only to be told that nothing could be done until the ill
person committed violence -- by which time, of course, it was
often too late.
  Workable alternatives are available.  Torrey recommends a
national database that would track the most problematic patients,
alerting emergency-room physicians and gun sellers.  Programs to
force compliance with treatment by withholding SSI payments, for
example, or on pain of imprisonment, have been effective.
Torrey's book overflows with common sense reforms.
  The best that we could do to honor the memories of Christina
Taylor Green and the other Tucson victims would be to address our
shameful and disastrous mental health policies.
  Mona Charen is a syndicated columnist, political analyst and
author of Do-Gooders: How Liberals Hurt Those They Claim to Help.
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