This is a controversial and emotional blog post. It is my
opinion based on my 25+ years of experience in the field of psychology.
The recent school shooting in Connecticut has given
politicians another reason to push gun control. So many people in social media
outlets like Facebook have been at each other’s throats arguing about this
issue. However, I’m here to tell you that guns are not the issue. Cracks (and
sometimes canyons) in services to the mental health patients are really to
blame.
When I started going to college, I began working at the
Stockton Developmental Center, which was a locked facility that had been around
for years housing some of the most mentally disabled people in our community
including the “criminally insane.” I had seen disabled people in public, but I
had never seen people like these. Many of them were nonverbal and were no
better than animals. I’m not saying that to be mean, it’s just the facts. They
were infants in adult bodies. It was difficult to keep clothes on them and some
even ate their own feces. Imagine a two year old mind in a large, adult male
body. During my employment there, I saw many staff members sent to the hospital
after patient rampages. I myself was hit, kicked, scratched, and bit several
times. One time, a patient bit me in the face because I told him it wasn’t time
to smoke yet.
These people needed constant care and supervision. They received
three meals a day, had a warm bed, clean clothes, daily showers, activities, medical
and dental care. They were not fit to be in the community. Not because we were
mean as a society, but because they were dangerous and could not care for their
basic needs. The problem was that the people making the rules didn’t actually
work with the patients. We were given programs designed to make their days seem
“normal.” Meaning, they were made to get up early, eat, walk to another
facility on grounds (if they could walk), do different jobs or leisure
activities, go back to their units for lunch and back to the “work” facilities
in the afternoon. I spent much of my time on the floor holding rampaging clients
down or trying to avoid getting beat up. Why? Because they weren’t normal. You
wouldn’t plan a day like that for a 12 month old, but the powers that be
insisted on using the patients’ chronological age not their mental ages. They
made silly rules like the patients couldn’t watch cartoons because that wasn’t
age appropriate. I still watch
cartoons. Stupid.
The politicians and other people involved in
de-institutionalization in the 1980’s were reacting on feelings and not
reality. “Those people shouldn’t be locked up.” “They deserve to be free.” So,
they turned them out and closed many of the developmental centers. Some of the
worst went to the few centers still open while many were sent to care homes
unequipped to deal with these severely disabled patients. Many of the mentally
ill patients were turned out on the streets unable to care for themselves. Help
was available, but they had to be responsible enough to access it for
themselves. Politicians said they had the right to refuse treatment. It was an
uneducated decision that had horrible repercussions.
While I was working on my graduate degree, I started
working for a program that provided behavioral services to severely mentally
ill adults diagnosed with schizophrenia. What I learned working with this
population could not be contained in this blog, but I will tell you this – when
they were sent to us, they were psychotic and unable to care for themselves.
With treatment and medication, they improved significantly and would readily
acknowledge the fact that they were incapable of making decisions about
treatment when they were in that state. They couldn’t even provide for their
basic needs much less find their way to mental health. The people who came to
us were there mostly due to suicidal or homicidal behaviors. The rest were left
to suffer because they were not deemed a danger to themselves or others. I beg
to differ.
As a professional in psychology, it makes me sick to walk
around downtown (San Francisco is especially horrible) and see these poor
people walking around in the winter without shoes, no coats, no way to care for
themselves. Who in the hell thinks it’s their “right” to live that way? If they
had the proper treatment, they wouldn’t choose to live like that. I know. I’ve
seen it firsthand.
I understand the ideal of allowing people to refuse
treatment (or not seek it for whatever reason), but we don’t do lobotomies or
drill holes in people’s heads to let out demons. Today’s professionals in
psychology are much more capable of treating patients and helping them live
better lives. Sometimes, they are not well enough to make that decision for
themselves. Developmental centers were not warm and fuzzy, but they provided
for people’s basic needs and gave them the medical care the needed. They were
certainly preferable to living on the streets.
Mental health care here in our county is affordable. We
have a vast network of mental health programs here, but the patient has to seek
out that care. Unless they injure themselves or someone else, treatment will
not be forced on them even if they need it. In some states, even the most basic
mental health services are not available, and families struggle with mentally
ill family members looking for help they’ll never get.
We have to address mental health issues in this country.
We have to provide for those among us who are not able of caring for
themselves. Families and care homes are not equipped to deal with extreme
aggressive behaviors, and their pleas for help fall on deaf ears. Politicians
and others want to make it an issue of gun control, but I can’t tell you how
many people I have seen injured by mentally ill patients using their fists, knives, and even a three pronged
garden tool. Many mentally ill patients are harmless (to others if not themselves). If they are psychotic, and focused on hurting someone, they will
use whatever is available to them. I will say it again – we have to address the
mental health issues in this country. Until we do, we will continue to
experience tragedies like school shootings and other acts of violence by those mentally ill people who have “slipped through the cracks.” Gun control alone is not enough.
Right on Michelle! Vilifying the gun is not the answer. I know people will say, but if there weren't guns this wouldn't happen. Fine take always ALL guns and see if murders cease. In the end it was human being who chose to bring harm to others. Guns, knives, rocks, arrows, gas chambers, rope, electric chairs, lethal injections ALL require human hands to operate them...and even those can be used to strangle someone.
ReplyDeleteExactly, in 1927, in Bath Michigan, a man beat his wife to death, set fire to his farm, and blew up the school in town killing 38 children and six adults and himself using dynamite he bought at the hardware store that also carried other explosives. These problems are not new.
DeleteCain didn't have a gun...
ReplyDeleteVery true.
DeleteI once had a patient who worked at a facility for schizophrenics. In the 10 months I treated her for an initial back injury I documented at least 10 additional injuries. She was slugged in the head several times, kicked, slammed against the wall, punched, etc. Her initial injury occurred when she was bending forward to change a male patient's diaper. He balled his fists and slammed her on the back. Her treatment there was brutal.
ReplyDeleteIn my experience, that was very common. Thankfully, my injuries were minor. I was never hospitalized myself, but I knew many people who were. Thank you so much for sharing this story, Everett.
DeleteWell said, Michelle. I couldn't agree with you more. We do not address the mental health issues in this country. But unless we acknowledge that the violent acts committed by mentally ill people are in fact due to the lack of health care they desperately need, nothing will change.
ReplyDeleteThanks so much for sharing your knowledge with us.
You're right Janna. While we are lucky to have funding in this county, many places have minimal or no mental health services available at all or are too expensive. Even though we have funding here, it is up to the patient to seek out treatment. In many cases they are too ill to do so, or they don't know how.
DeleteThank you, M.E. You and I are on the same page. The mentally ill need help, not condemnation. I remember well when the government shut down almost all of the long term mental health facilities. My mother was a volunteer at one of them. She was so upset, because she saw what the future held and it was downright scary. My mom was right. Individuals like those you have described need to be inpatients where they can get the care that they need, and society can be protected. I wrote about this from the perspective of someone who lives with PTSD, and I really hope you'll read it. Bright blessings.
ReplyDeleteI read your blog, and I am so sorry you have been scarred by violence. You are right, mental illness is still has a stigma attached to it causing some to hide their symptoms/diagnoses from others. Even though the vast majority of those suffering from mental illness are harmless to others, the few who are violent make it seem as though the percentage is much higher. I know people want answers/want to understand what happened in Connecticut, but I do believe we have to be very careful about speculating as to what may have caused Adam Lanza to act the way he did since we have so little information to go on. Thank you for taking the time to leave a very thoughtful comment. I wish you the very best.
DeleteI'm so glad you are my friend! Bravo! Like you I worked around the field in the 80's, but I did data research for a Psychologist and some department heads. I spent practically 2 years pulling records and quantifying patients status'. The goal was to show that patients were functioning just as well or better since they closed all of those facilities. The study (grant funded I want to add) was still going on when I left college. Years later I bumped into the Psychologist I worked for and asked him what ever became of the study. He boldly told me that it did not give them the results they were looking for so they destroyed the data before auditors could ask about it. (After all it was a grant funded study...auditors would ask questions)
ReplyDeleteAnother sad reality is no one wanted to admit they made a mistake after they closed these centers. Instead of going forward and showing that oh no we made a mistake, they just buried (or destroyed) the information so no one else would know.... But they all still received their nice salaries.
When they finally address this, then they can actually try to address bullies in the schools too!
I don't know about everyone else, but I'm making you my next write in candidate for President!
I don't know why that can't admit that de-institutionalization was a huge mistake. I don't know the powers that be think it's okay for people to walk the streets dirty, starving, confused, and begging people for change. You know I love San Francisco, but that city is one of the worst for allowing people to be "free." Many of them self medicate with alcohol and illegal drugs. The government just gives them money and lets them suffer. It's cruel and stupid. It used to be one of my favorite places to visit, but now I can hardly stand to go there. Lawmakers need to pull their heads out of the butts, stop throwing money at them and actually provide them with real help.
DeleteMe...president...kekekeke ;)