Monday, December 17, 2012

Mental Health Care Reform

Yesterday, I read this post from a mother of a boy with a mental illness--a boy she loves, a boy who frightens her, a boy who might one day do the kind of thing that causes a nation to weep. For now it is the mother who weeps. If you haven't read it yet, do so. Now. Don't even finish this post. It will change how you think.

I said in an earlier post that we need a serious national conversation about easy access to guns in this country. We also need a serious conversation about how to improve access to and quality of mental health care for those who suffer.

The gun lobby has this slogan: "Guns don't kill people. People kill people." The obvious response is that people kill people with guns. And guns make it so much easier to kill. The more powerful the gun and the more ammunition it holds, the easier it is.

The person with suicidal thoughts is so much more likely to act on those thoughts if there's a gun in easy reach. A person in a jealous rage is so much more likely to kill if there is a gun right there.

If a tornado rips through a school, children's lives are at risk. But there are people with tornados in their heads. Whether they become as dangerous as actual tornados depends on what weapons they have available.

But there is something right about the gun lobby's slogan. A gun, without a human at the trigger, is inert. When death happens it is because something human has been added to the mix: negligence or malevolence, hate or jealousy, fear or desperation. Or madness. In a perfect world, a wold purged of all sickness and sin--that is, in a world that we will never see this side of death--guns would pose no danger to anyone.

Because a perfect world is impossible, we need to talk about sensible ways to make it harder for guns to fall into the hands of those who would use them to harm the innocent. But because we can do better even if we can't purge all the forces that drive people to murder, we need to talk seriously about doing what we can to reduce impulses to violence--not only to nurture a more nonviolent spirit among those of us who are of sound mind, but to extend desperately needed help to those of us who are not.

This is a dimension of health care reform that must be explored seriously by everyone. The invocation of mental illness and mental health care reform cannot and must not be reduced to a diversion tactic by opponents of greater gun regulations--a way of turning attention away from one of the issues we need to wrestle with. It must be something that all of us regard as a high priority. And those of us who favor greater gun regulations cannot ignore the cry of the mother who finds herself struggling to help a beloved child who terrifies her. We cannot think that all has been solved by making sure her child can't get hold of an assault weapon. We cannot leave that mother out to dry.

In a world where the mental health care of children depends on the benefits package that the parents might or might not receive through their employer, our world will have more people growing up with tornados in their heads than there have to be. We can do better. We must do better for the sake of children like those slain at Sandy Hook, for the sake of those mothers who find themselves responsible for children who seem like ticking time bombs. For the sake of those children who don't know what to do with the tornado in their heads, and who sometimes imagine it will all be better if they just let it loose in the world.

1 comment:

  1. Great post, Eric. One point, however, is that "mental health care" functions as a sort of mantra that can mean much less than we all hope. Mental health care is in a very primitive state, which is why so many families are struggling with intractable mental health issues. Even the more garden variety maladies (say, depression) are very indifferently and sporadically treated by the current standard of care, however conscientiously applied. We have a long way to go before people can be "treated" in a truly effective way, and indeed it may be biologically impossible to treat many conditions that are developmentally set in the wiring. For example, I stutter. I don't think there will ever be a magic pill for that.

    What this mother is interested in is institutionalization, which the country turned against several decades ago, reaping a harvest of homelessness and family trauma, not to mention financial distress and bankruptcy. And criminality, or at least incarceration. It was part of a libertarian anti-government ideology of freedom and autonomy for all, even for those manifestly incapable of handling it. Of ruthless competition where we all agreed to ignore those who couldn't hack it.

    Institutions like this are going to be mediocre solutions, crosses between prisons and halfway houses. They are never going to satisfy a family's dreams of empowerment, compassion, protection, and holistic care (not to speak of actual "treatment", which may be a mirage). So even if the institutional structure were in place, this mother would face an agonized choice, when the time comes. And it sounds like it is coming quite soon. My heart goes out to all concerned.