January 27, 2011

What are we going to do about it?


After the latest tragedy in which a seriously mentally ill person murdered random citizens engaged in peaceful pursuit in Tucson, there is finally some attention being paid to the fact that there is little or no protection in this country for the mentally ill, or for those who may be fatally impacted by this lack of protection and help. Families like mine, who have encountered all the difficulties and impossibilities of trying to get help for the mentally ill, may finally have some hope for somebody else's future, even if it's too late for us.

There are several reasons why there is so little help for the mentally ill in this rich and powerful country. To go back in history a bit, in many countries it used to be possible for a person to be involuntarily committed to a mental institution with little or no due process. In the Soviet Union, political dissidents were sent to mental hospitals. Before women had many rights anywhere, a husband could declare his wife crazy and off she'd go. Anybody who didn't conform to social norms could be regarded as insane. To correct this situation, in the 1960's in the U.S. the rules were changed and suddenly mental hospitals were emptied in the name of Civil Rights.

That was good, except no provisions were made to give help and take care of those who were seriously mentally ill. Governmental units were pleased to get rid of the expense of caring for the mentally ill and closed mental hospitals. Unfortunately, this seems to have resulted in spending more money on building prisons. The statistics are astonishing, but it seems that 70% of juveniles in jails and prisons have at least one mental illness and at least 20% of inmates in adult prisons are mentally ill. 

Laws make it difficult for families to get help because many times these laws are based on the Tombstone Theory. That is, until the mentally ill person does something awful, such as bringing a gun to school and killing people, there's no way to involuntarily commit him to a hospital where he could get help. In many states a parent or caregiver has to go to court to declare their loved one a danger to himself or others in order to get him committed. This is a very difficult experience to go through.

And in the end, the stay in the mental hospital doesn't last long. The average stay at the Human Services center in Yankton, SD is 15 days. In my experience, that's typical. The person is stabilized, is back in his right mind, compliant, and the crisis is over. He can be referred to other outpatient services and everyone wishes him well. On C-Span's "Washington Journal" earlier this month, Michael Fitzpatrick, executive director of the National Alliance on Mental Illness (NAMI) said that most mentally ill people are taken care of at home, by parents, spouses, siblings because there is nowhere else for them to go. When they leave home, which they often do, they are homeless, wandering America. Fitzpatrick said we must have "public discourse and education" on the problems of mental illness in this country.

In terms of being able to get someone help whether he wants it or not, Arizona seems to have more effective laws than many, but people don't know what the law is, don't have access to help, and of course the budget for mental health in Arizona has been very sharply cut in recent years. One report said it was cut 65%.

 Help for the mentally ill is generally in the hands of states and counties, so how much help families can get depends on where they live and how much state legislators and county commissioners are willing and able to spend. Fitzpatrick said that half of the mentally ill people in the U.S. get no help at all, and that untreated mental illness has a tremendous impact on the community. He called this a national tragedy. It's a tragedy for families, too.  So, what are we going to do about it?

Lorraine Collins is a writer who lives in Spearfish. She can be reached at collins1@rushmore.com.

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