When I was in a college I had a friend named Henry. He wasn’t my closest comrade, by any stretch, but he was part of our little posse and was as friendly to me as anyone else in the group – eye-to-eye handshakes, hugs, pats on the back and pints of beer. Never a cross look or an ill word. Until one evening.
I was in the campus pub with the gang, our group holding court at our usual corner table. Henry entered swiftly, determined, his head darting around, clearly looking for someone or something. After a moment he turned to me. He had obviously found what he was looking for. Without hesitation, he pushed his way through the crowd, moving furiously in my direction. Suddenly he left his feet, diving through the air, up across the table, knocking over beers, screaming obscenities, every inch of his body dedicated to causing me harm. I pushed my chair backwards and crouched in the corner, stunned and mortified as my friends pulled him away, struggling just to hold him. As I saw him disappear back into the crowd, I looked for some hint of meaning from his eyes. I got nothing. I searched my own mind for a reason. I came up empty.
I saw Henry a few more times that semester. He seemed subdued, always moving slowly, never looking at me. He would immediately leave any room I entered. Before the end of the year’s classes he was gone. I later found out he was sick. Manic depression. Despite my usual “what did I do to deserve this?” it all had nothing to do with me. It turned out there was no “meaning.” There was only illness.
In the wake of the Arizona shooting, our nation has scrambled for meaning. Why did Jared Lee Loughner open fire on Representative Gabrielle Giffords in a rampage that killed six people and wounded 14 others at Tucson grocery story on January 8? What did Giffords represent that lead him to commit such a heinous act? What point was he trying to make? How does this reflect on national politics? How about gun control? There are so many questions and issues here, one hardly knows where to begin.
Of course, it’s entirely appropriate for an incident like this to spur debate on topics like gun control (I’m imagining now the transaction at Sportsman’s Warehouse and the moment when Loughner’s fingers first touched the deadly semiautomatic Glock ) and the impact of violent political rhetoric (what kind of imbecile uses crosshairs over names to make a political point). But if you’re looking for meaning here, consider these two things: First, the lives and loved ones of the dead and injured. And second, our nation’s dysfunctional relationship with mental illness – our lack of education around the subject, our stigmatization of those who suffer from its various forms, and our unwillingness as a society to address these illnesses in a concerted and informed manner.
There are a number of forms of mental illness that affect untold millions of our population. To gain a basic understating of the subject, the National Alliance on Mental Illness (NAMI) offers a wonderfully informative site that would do us all some good to explore. Here are a few of the most common forms of mental illness that could lead to violent behavior, along with information on diagnoses and treatment.
- Bi-polar disorder
- Borderline personality disorder
- Dissociative disorders
- Schizophrenia
- Schizoaffective disorder
Our society’s failure to control the use of guns in crime continues to befuddle every civilized nation on Earth. Likewise, the entire democratic world is stupefied by the way we conduct our political selves. (Says “The Daily Show” host Jon Stewart: “It would be really nice if the ramblings of crazy people didn’t resemble the way we talk to each other on TV.”) But the state of our mental health system – a system that is clearly failing to deal with the many Americans who suffer from the above illness – receives disturbingly little attention.
NAMI recently conducted a study on “The State of Public Mental Health Services Across the Nation.” The results today are the same as they were when the group conducted its last study in 2006: We received a “D.” (Note that the Virginia Tech shooting, where a mentally ill man murdered 32 and wounded so many others, occurred in 2007.)
“State by state, this assessment of our nation’s public mental health services finds that we are painfully far from the high-quality system we envision and so desperately need,” reports NAMI. “While some states are making consistent efforts to improve, the great majority are making little or no progress.” Their conclusion: “The state of mental health services in this country is simply unacceptable.”
Jonathan Cohn, writing for The New Republic, adds this: “Mental health, unfortunately, is probably the illness most likely to go untreated in the U.S. The stigma around mental illness isn’t what it once was, but it still exists. Private insurance rarely provides enough coverage for the seriously ill, overwhelming public systems to the point where people who could benefit from therapy, drugs, and community supports – frequently living totally normal, productive lives – instead end up without treatment and sometimes without homes. Inevitably, some of these people end up committing crimes, overloading a criminal justice system ill-equipped to handle them. We don’t warehouse the mentally ill in asylums anymore. Instead, we warehouse them in jails.”
A key word in Cohn’s astute assessment is “stigma.” Our lack of education (let alone understanding) as individuals and a society leads to myriad false characterizations of the mentally ill – and their families. These erroneous notions prevent many from seeking, being lead to or being required to receive treatment. This is not only to due the negative connotations associated with those who suffer – and the progenitors of those who suffer – but also from a institutional world that remains underfunded and misguided in part as a result of those same stigmatizations.
So families and others (question are being raised, for example, as to what school officials who suspended Loughner from Pima Community College for bizarre and violent outbursts might have done to ensure he received treatment), continue to try to deal with a problem with what amounts to decreasing guidance and few protocols made available by a society that wants to sweep the issue under the rug.
But despite system failures, we can and should educate ourselves. There are things we can do when we become worried about a friend or loved one, and Arizona should be a wakeup call, says NAMI Medical Director Dr. Ken Duckworth. He offers a few suggestions:
- Maintain your support and connection with the person – if that is impossible then work to get help to understand why.
- Many people trust their general practitioner, who may help or find a psychiatrist or mental health professional who can help.
- Get support for yourself from people you trust or in a support group as you engage in the challenge to find the right path.
- Always see if you can find a way to get your loved one help with consent and collaboration. If you do need to put someone into an evaluation or treatment against their will, they may not thank you. But you may make a difference.
- Call the department of mental health in your state to get information about resources for services.
- Substance abuse can increase the risk of violence and complicates treatment efforts. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) for a substance abuse treatment facility locator.
- Most important, he says, “families and communities need to work together to create a situation where there is no prejudice against seeking mental health treatment or towards people who live with mental illness.”
In the aftermath of Henry’s attempted attack on me that night so many years ago, I wanted nothing more than for my “friend” to disappear. I didn’t want to talk to him or see him and, as it came to light that he had a mental disorder, I wanted to deal with him even less. Most of us know what to do with bullies (personal and political) because we have some orientation regarding their motives. Our responses can be framed in the context of those motivations, and outcomes can be measured. But we don’t know what to do with mental illness. We want it to just go away.
Unfortunately, it will never go away. But our first best hope is to inform ourselves – as individuals and as society– by taking the initiative to learn and teach. Only this way will the stigmas disappear and the right choices about treatment and institutionalization policies become clear. We will never be able to prevent instances like this from ever occurring. But we can prevent some of them. And that would be a lot. Just ask the victims’ families.
“Henry” is not my attempted assailant’s real name. I don’t know where he is today, or if he ever received treatment for his illness.
Image: Medill DC