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. 

Sheridan Hill House for the Psychiatrically and Medically Frail

Sheridan Hill House (SHH) for the psychiatrically and medically frail is another unique asset of The Bridge. We know of no other housing like it in the city or state. It is a specialized residence offering permanent housing for adults with both serious mental illness and serious physical conditions due to aging or health issues. This residence officially opened its doors on March 6, 2007 and offers a community care environment, staffed 24 hours per day.

The staff provides case management services, medication monitoring, referrals to community resources, nurse assistance and one nutritional meal a day. A Care Manager is responsible for the coordination of medical and psychiatric services for all of the residents. The Care Manager also serves as liaison between healthcare providers, evaluates residents, and provides referrals for needed services and specialists. Nutritional meals are coordinated with the chef based on residents’ dietary needs. Through medication monitoring and management, training for staff, groups for residents and benefit assistance, the treatment tenants receive is extremely comprehensive.

Sheridan Hill House is a HUD 811/Section 8 development. There are 24 residents living in studio apartments. There are 16 NY/NY (homeless) designated beds, 8 of which are for long-term shelter-stayers (LTSS), and 8 community beds for those coming from Bridge transitional housing programs. The facility costs only $27,800 per bed annually to run versus a typical Medicaid nursing home, which costs $123,400 per year according to the NY State Partnership for Long-Term Care. Tenants are required to pay 30% of their income towards rent. This type of cost-effective housing saves on emergency care costs for residents who otherwise would not receive similar round-the-clock care nor would they be able to remain in the community.