Mental Health & Violence – The Great Disconnect

The other day a woman taking a picture of three homeless men holding up signs using profanity was stabbed to death in front of a high-end retail store on Hollywood Blvd.

I had just been in the neighborhood the week before. Standing and waiting to get into a Tom Petty concert at the Fonda Theater, it could have been one of those same hustlers with the same sign accosting the crowd. They are street drunks and junkies who have hit rock bottom and just don’t care anymore except for the next buzz.

The mother of the murderer, a police officer in Arizona said that she was not surprised at what her son had done and that he had to pay the price for his actions. She had tried for years to get him the help he needed, but our mental health system failed him.

In Aurora, Colorado and in Newtown, CT and in Tucson, Arizona the crazies with guns have focused attention on the state of mental health care in America. But the same primal urges and demons drive people like Dustin James Kinnear, the Los Angeles murderer.

You can find them muttering to themselves or fighting over imaginary slights or a bottle on any skid row. They litter our penal system. These are our violently mentally ill. Only when they commit an atrocity do they come to our attention.

But this happens every day. The cops scoop them up and maybe dry them out and then they’re back on the street in 90 days or less. If the crime is homeless on homeless it doesn’t reach the papers.

Back in the 1960’s and 70’s Thomas Szasz argued that societal reaction to mental health problems violated the human rights of the mentally ill, and in fact that mental illness was a construct of control. He ignored the reality of the mentally ill and those closest to them, as well their effect upon society at large in favor of a libertarian interpretation that the rights of the individual supersede those of society.

My grandmother had a nervous breakdown in the mid 1930’s and never came back. She was committed to the notorious Creedmoor Psychiatric Center in Queen’s, NY. She lived there for 35 years. It was the state’s answer to a pressing issue. What to do about those who are incapable of caring for themselves and  are a danger to themselves or others. The failings of the mental health system were as much in funding and management as for the one size fits all governmental model. If anything, the nature of mental illness is that it sometimes requires the most complex and individually based treatment.

In reaction to Szasz and other campaigners, and in response to medical professionals seeing patients who had fallen through the cracks and were in the “snakepit”, as it were, politicians sought to both reduce costs and solve the problem of too many patients held against their wills.The New York Times had an article in 1984 on what went wrong.

29 years later, nothing has changed.

In 1959, California had 37,500 mental patients in state facilities. By the time of Jerry Brown Jr., there were less than 20,000. By 2011, there were 4,300. The population of the United States has grown from 226 Million in 1980 to 308 Million today and we are losing facilities, not gaining them.

And the pundits and politicians wonder why and how the violently mentally ill are abroad and without supervision. There is no wonder at all. It is public policy.

It ties into narcotics abuse and other social issues as well. But instead, politicians argue for gun control.

The original planning for community treatment and local services was cast aside, and the psychiatric community freely admitted that their plans were misguided. And what has been done since to ameliorate the problem. Nothing.

It doesn’t matter whether it is an unknown street crime or a mass shooting or a sensational murder on Hollywood Boulevard. We must address the issue of the violently mentally ill. Their families know this. Mental health professionals know this. But our political class knows this as well and refuses to address it. What is to be done?

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