The news stories about Jared Loughner shifted from the horrific crime to his state of mind; his strangeness, writings, posts and interactions with others. His mental health status fascinates the media. They cover the story as if it's a new idea that mentally ill people walk around untreated.
On Sunday, Chuck Schumer and David Gregory talked on Meet the Press about how mentally ill people shouldn't be able to purchase guns. Gregory brought Senator Coburn into the conversation who said it was important to focus on the "real" problem. Common sense tells us schizophrenia and guns are a poor mix, but no one wanted to talk frankly about mental illness and that the U.S. only treats those who can pay for their mental health care. The "real" problem is that if you're broke, you can't get consistent mental health care in the U.S.
When the conversation moved to the attempt to repeal the health care reform bill. Neither Senator nor Gregory mentioned that PPACA gave mental health care a boost and how beneficial that part of the law is to everyone.
Coburn's focused on preventing mentally ill people from getting guns. That's an anemic policy position, but consistent with Republican values.
Mental health has always been an afterthought of public policy. It makes it to the forefront only after a tragedy or happening no one can ignore. People struggling with these issues often do so in silence with no help, afraid to tell co-workers and friends their trouble for fear of the stigma. For fear of being marginalized for admitting to a psychological problem. The U.S SOP for people with mental health issues is to ostracize, restrict and/or isolate them; then forget they exist until the next tragedy.
Some people have no trouble admitting and talking about mental health issues. Some have no choice, their behavior outs them. Once outed, questions like, "Did you take your medicine?" or "Do you need to take a break to calm down?" are meant to be helpful, but all too often are thinly veiled fears that the patient will do something violent. Studies show that the mentally ill are far more often crime victims than they are criminals. Except for the most severe mental health issues, most can be competently treated in the out patient setting and the patient can lead as normal a life as their symptoms allow. Think about it, if someone you know tells you they have chronic hypertension do you think less of them? Would you avoid giving them a promotion? Now, what if someone told you have obsessive compulsive disorder or clinical depression, but it's under control. Now what do you think? Would you give them a promotion? Yep, that's why psych patients try to fly under the radar. That's why they change jobs when they're outed.
If you have a mother, brother, sister, uncle, grandmother with a psych issue, it can be just as difficult. "Why can't you be normal!?!", is the common lament. Not that it helps or works mind you, but that is often the family's response to anyone that has a mental problem, cognitive deficiency or a history of brain or psychological trauma. Sometimes the family can't think of their loved one as having a psych disorder. They're "high strung" or "feeling low". They "get worked up". "It's just a phase". "They'll grow out of it". "Give it time." Ignoring psychological symptoms, like a lot of physiological symptoms makes the problem worse, not better. Parents hate to admit their child isn't going to be an over achiever and often make excuses and ignore or deny the problem. They deny it until they can't.
For extended family, the solution is easy, lose their phone number. Find a way to limit contact to only the holidays. Develop a keen ability for making excuses. "I have plans" or "Sorry, this isn't a good time" is how we ditch our less welcome family members. Again, little if any respect and a lot of impatience, condescension and little or no support. How different mental health patients lives would be if their family members had access to quality mental health services that could help them be a resource instead of an impediment.
We make fun of people with mental issues as if their ailment deserves no empathy. We deride people's phobias and disorders and strip these people of their dignity. We laugh at the phobic's fears. We make sitcoms out of people with anxiety disorders. We talk about dignity then get off the bus when confronted with people who talk to themselves. We avoid the corner where the homeless person rants at the world. We avoid them and laugh at them. Because, we find people in this predicament so amusing, their families suffer too. People are very careful who they confide in about their bi-polar bother or sister. People don't want to explain they were late because their SO spent 30 minutes rechecking (for the 5th time) that every door and window was locked before leaving. Others take care to conceal their mother with borderline personality disorder, they'll make excuses for her absence, "She's not feeling well".
Although this is better than what societies have done in the past; (people used to declare the mentally ill possessed and burned them at the stake, later people would incarcerate them as "mad", then someone wanted to preserve the gene pool and had them neutered, and for the last 40 years or so, we've kicked them to the curb with no resources to fend for themselves until they commit a crime and are jailed or killed by a police officer), we still stumble badly when it comes to mental health in this country. It's cheaper to blame the victim and say they could stop being "nuts" if they wanted it bad enough. It's cheaper to push the personal responsibility button. It's cheaper to ignore the mental health problem until it can't be ignored any longer. We do too little mental health care and it's usually done after a crisis when the prognosis is poorer.
Sometimes the psych patient thinks everyone else is the problem and only seeks help, so the rest of their family will get off their back. Many seek care in desperation. They lost contact with their family. Lost too many jobs. Lost too many relationships. When the pain of staying the way they are exceeds the pain and fear of changing is when many turn for help. Our public mental health services are patchy, but Schumer, Coburn and Gregory didn't touch that concept on MTP. Private sources of help try to fill the gaps, but there are too many gaps and no one wanted to go there on MTP. The "real" problem is, if you have no job and no home and no family because of mental illness, rationing mental health care according to your ability to pay for it, is stupid counterproductive. Rationing public mental health treatment only after a crisis or a brush with the law is even more stupid also counterproductive. Again, David Gregory blithely ignored our ineffective mental health care policy and stayed on the idea that mental illness and guns is a bad idea. Their discussion was anemic. It ignored the real problems facing uninsured mentally ill patients trying to access competent care.
We laugh at people who have to deal with the fact that their brain isn't working the way the rest of ours do. If we don't laugh at them, we fear them. We're afraid of what people who talk to themselves or express strange thoughts and have little use for authority will do. We push them away. We'll pity these people, we'll restrict them; but we won't help them. Especially now and especially if it will cost us public tax dollars. We just want to keep them from owning guns, which (IMO) is sensible in a lot of cases. It's just that it's not enough. We have to do more than place limits on the mentally ill, we need to help them attain some functionality and not limit that help to only those who can afford to pay for it.
I have a student who the rest of the class avoids. The class thinks he's weird and rolls their eyes when he talks in class. He had a traumatic brain injury a couple years ago. He's partially deaf (probably has PSTD too) and needs constant reminders of how to stay on task. He needs a lot of repetition to master new skills. His brain doesn't work like it did, but at least he's aware of his problem and is trying to work around it. He gets therapy regularly and he takes medication, but he gets no respect from his peers. He knows he's irritating and tries to blend in, but he can't. Thankfully, he's a pretty easy going guy and shrugs off a lot of crap.
Neither Senators Schumer and Coburn nor David Gregory were helpful to the mentally ill Sunday morning. They didn't talk about how we ration mental health care to only people who can afford it. They simply focused on keeping guns out of the hands of people with drug use history and the mentally ill. Yeah, they missed the "real" problem all right. They had a chance to have a rational discussion about a real health policy problem and totally blew the opportunity. We are going to stick to the insane mental health care policy of doing nothing while expecting a better result.
UPDATE:
Thank you all for dropping by and lending me your thoughts. It's a pleasure to read it - even the areas of disagreement.
Sorry about the poll not have some sort of "all of the above option". I did it too quickly.