Treatment for The Seriously Mentally Ill
Does Jared Loughner, the accused Tucson shooter, have a mental illness? We don’t have an official diagnosis, but we do have a wealth of reports and information from a number of sources that suggest that he might. Assuming that he might, what lessons can we take from this terrible act of violence?
First, while it is true that people with serious mental illness commit acts of violence at a slightly higher rate than persons with no mental illness, in case after case it is consistently those who are not receiving treatment for their condition who commit such acts.
In New York City we had the high-profile case of Andrew Goldstein who pushed a woman to her death in front of a NYC subway in 1999, and more recently a number of other acts of violence, all committed by persons who were not engaged in care or receiving treatment. In the case of Andrew Goldstein, he was desperately and unsuccessfully seeking treatment for weeks before committing the act of violence that made headlines. In fact, when one compares acts of violence committed by persons with serious mental illness who are receiving treatment to acts committed by persons with no mental illness, the mental illness group receiving treatment commits fewer acts of violence.
So treatment is an essential deterrent to violence and as far as we know, Jared Loughner was not in treatment. We have to ask ourselves, if this is true, why this is so, particularly since there have been so many press reports from the community college he attended and from friends attesting to his increasingly troubling behavior.
While we don’t know whether anyone made a serious attempt to have Mr. Loughner psychiatrically assessed, we do know two things about our culture and the state of our national mental health care system. First, we know that there is continuing stigma towards persons with mental illness which often leads to reluctance to seek treatment when it is needed. The stigma toward the mentally ill persists unabated despite almost six decades of progress in treatment and rehabilitative techniques.
Second, we know that there are far too many gaps in our mental health service system. The national vision of the Kennedy administration in the early 1960’s that a national network of community mental health centers would be created to serve every hundred-thousand population area was abandoned long ago. Falling through the cracks in a system with so many gaps, as happened to Andrew Goldstein, is an outcome in far too many cases.
So here are the lessons: we must address the stigma of mental illness so that families and friends will not hesitate to seek treatment for those clearly in need and we must address the gaps in services that leave persons with mental illness, even those who acknowledge their condition and understand their need for treatment, too often stranded without services.
At The Bridge, where 1800 men and women with mental illness thrive, the events in Tucson are especially painful. We know the benefits of treatment and services, we see every day that people with serious mental illness can live productive, positive lives in the community; and we so regret tragedies like the one in Tucson which might have never happened if our social attitudes towards mental illness and our commitment to recovery were more fully realized.
We encourage you to share your reactions on our blog; this is an important discussion for all of us.
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