We have to start talking about America’s mental health crisis
The first time I saw the mug shot I was at an Amoco station, 15 minutes from the nearest psych ward and 90 miles from home.
I didn’t need to stop for gas. My tank was still three-quarters full. But having just spent the past 48 hours trying to help a dear friend navigate his hometown’s heartless mental health care system, I figured a scalding cup of stale coffee might keep me from drifting into a ditch.
While I was waiting for the clerk to count out my change, my eyes fell on a copy of the daily paper, dated January 11, 2011.
The front page looked like something a newsboy in knickers would be hawking during the second act of a Batman movie. The headline type was extra-large and loud, the accompanying photo swallowed up all the space above the fold, and the subject—eyes wild, framed by pale cheeks, and a hastily shaven head—looked like a patient from Arkham Asylum. He even wore an off-kilter, vaguely villainous smirk.
Jared Lee Loughner: Arizona’s assassin, the new year’s first mass murderer, and America’s bogeyman du jour.
By the time I pulled into my driveway, the coffee was ice cold. I hadn’t touched it. I didn’t need to. Enraged, my head swimming in adrenaline, I threw my bags inside the front door and sought out my unsuspecting wife. I wanted to scream about the banality of cynical sensationalism and wail about our country’s need to reduce everything to a biblical battle between good and evil. And I wanted someone to hear me.
It had been three days since Loughner senselessly murdered six people, including a 9-year-old girl, and shot Representative Gabrielle Giffords in the head. Yet the initial storyline was hopelessly fragmented and predictably off point. As was the case in the immediate wake of 9/11, Hurricane Katrina, the mine collapses in Chile and Kentucky, and countless other made-for-TV disasters, the chance to prompt a broad, meaningful conversation about our culture, our government, and our collective moral compass (or lack thereof) was already being squandered.
The first wave of stories out of Tucson set the table for yet another ideological food fight. On the left, scholars and columnists blamed Loughner’s outrageous crime on the proliferation of hate speech. Bomb-throwing conservatives, who thrive on turning themselves into victims, unleashed their attack dogs. Before the nation had time to shed a communal tear, Rush Limbaugh was defiantly defending his rabid constituency’s constitutional right to spit venom at whomever they want, whenever they want.
Gun control debates dominated the discussion for a few days, of course. There was even a measure of hand wringing over the antisocial webs we weave online.
In the midst of all of this, I kept expecting someone to broach the subject of Loughner’s actual state of mind. Reading between the lines, it was clear that he was mentally ill, as are nearly one-fourth of the people who populate the nation’s prison system. It was also evident that while the screeching tenor of public discourse might not drive a sane person to the nearest rifle shop, a confused, distraught individual might have a hard time distinguishing between Glenn Beck’s hyperbolic theatrics, Sarah Palin’s revolutionary ranting, and an online hate group’s call to arms.
Nearly a week passed, though, before journalists started scrutinizing Loughner’s well-documented history of depression, mania, paranoia, isolation, and apparent breaks with reality. As Pima County Sheriff Clarence W. Dupnick told the New York Times on January 16, “Based on what I’ve seen, [Loughner] is psychotic, he has serious problems with reality, and I think he’s delusional.”
That Times piece, which ran on the front page of its Sunday edition, reported that administrators, teachers, and police officers at Pima County College, where Loughner took classes, were so concerned about his behavior that they suspended him. There was testimony from friends who said they were baffled by their pal’s appearance and occasional tirades against the status quo. There were even details concerning his haircuts, his marijuana use, his favorite beer, and his affinity for the saxophone.
The topic that went largely untouched, and still cries out for attention, is the extent to which the mental health care system, despite all the warning signs and proclamations of concern, failed Loughner and his victims. What’s even more maddening, and seldom addressed, is that even if someone wanted to help the troubled young man (and for all we know, someone did), there’s a high probability that the system would ignore the pleas and insist that “creepy” behavior, as one campus cop in Pima put it, is rarely a precursor to criminal aggression.
Besides a few glancing references on the odd editorial page, no connection was made between the shooting spree in Arizona and the lack of affordable, universal health care. Politicians, who once again made a show of mourning the loss of America’s innocence, also escaped scrutiny for spending the last 15 years systematically severing society’s safety net, forcing social service workers and health care professionals to make life and death choices based almost entirely on the bottom line.
Just ask the kind, conscientious case manager whom, in a lucky series of coincidences, I managed to reach by telephone on the morning of January 10. She had taken mercy on me—and hours out of her busy day—to talk off the record about my loved one, who was struggling with an intense bout of psychological stress that threatened to steal his job, alienate his support system, and otherwise make his life unmanageable.
“Has he gotten in trouble with the law?” she asked.
“Has he threatened to hurt himself?”
“Not that I know of.”
Well, then, she told me gently, apologetically, there was no way to get him official access to the county’s health care services. They were reserved for people who had already been through the court system. We just don’t have the money or the resources, she said.
Not long after hanging up, grateful that someone had at least bothered to listen, I took to the road in search of caffeine. After I pulled onto the highway, the phone call replayed again and again in my head. And Jared Loughner continued to stare up at me from the passenger seat.
I am an alcoholic. I don’t write that as a confession or as a point of pride. I throw it out here because I can, with no fear of repercussions from my coworkers, my boss, and the company that pays my salary. My family knows. My close friends don’t care. And even if they didn’t approve, I wouldn’t care. I’m not ashamed of the situation and I’m not alone in dealing with it.
If I were suffering from a mental illness, I would not be so cavalier. Not because I would fear reprisal from my superiors—there are laws against that—or think that those in my immediate community would abandon me. I’m confident that my most prized relationships run a bit deeper. Still, watching others struggle with such a revelation, I know I’d be deeply afraid that my chances for career advancement would be hindered, it would be hard to separate my public image from my disease, and no one I cherished would ever treat me quite the same way. They’d always be nervous or unintentionally patronizing, unsure whether they could burden me with their troubles or count on me in times of unusual stress or emotional need.
To be clear, when I use the term mental illness, I’m not referring to mild bouts of depression, garden variety anxiety, malaise, or social inhibition. These are serious maladies, to be sure, and can have disastrous consequences. But they are at least as socially acceptable as alcoholism. If you haven’t taken an antidepressant to dial down the blues, or paid a therapist to help sort out the family tree, there’s a good chance you know someone who has.
What I am talking about are conditions, many of them still hard to predict or accurately diagnose, such as schizophrenia, bipolar disorder, paranoia, and other forms of psychosis. These imbalances put people at risk of losing touch with reality and, even if they’re treated properly, often require an ever-changing regimen of drugs and an understanding between highly trained doctor and willing patient that symptoms can crop up episodically. And the chances of that sort of best-case scenario playing out are slim to none.
Too many mental health patients, and those close to them, agonize in private. Some because they’re too terrified or ashamed to speak up. Others because when they have, it’s turned into a bureaucratic horror show, populated by jaded clinicians and poorly trained doctors.
According to the National Institute of Mental Health, about 6 percent of the U.S. population (1 person in 17) have a serious mental illness. Serious mental illness is also the leading cause of disability in the United States and Canada. When the topic is broached in the public sphere, however, it is often subject to extreme prejudice, and we too often cast off as freaks and losers those who hear voices, juggle personalities, or question reality. The mass media’s increasingly caustic commentators demonize the hospitalized, the homeless, and the criminally insane—turning them into scapegoats and punch lines in the name of ratings. Even otherwise responsible public figures, including President Barack Obama, use loaded words like evil to explain away those who slip through the cracks and destroy everything around them.
Is it any wonder, then, that the sickest among us often hide in public, hoping no one will find out about the voices that haunt their daydreams? Should we be surprised when, every few months, a lost soul lashes out, seemingly out of nowhere?
As a colleague noted the other day, there is a cleverly branded campaign for almost every major disease, from malaria to muscular dystrophy. We have overcome the stigma surrounding homosexuality to organize AIDS walks and rides. The desire to cure all forms of cancer is universal. Nevertheless, you’ll be hard-pressed to find a march for split personalities.
That’s too bad. Because whether these public displays of concern lead directly to a cure, or even raise enough money to pay for themselves, is beside the point. Their very existence builds allegiances and political alliances, giving comfort to those left behind and hope to those still in the fight.
A like-minded crowd with a common cause can even give those who struggle a safe place to tell their stories and, every now and then, get the wider world to stop spinning long enough to listen to their voices, and the voices that they hear.
David Schimke is editor in chief of Utne Reader.
This article first appeared in the March-April 2011 issue of Utne Reader.