Thursday, December 20, 2012

Thoughts on Newtown

When the new broke Friday morning, my mind was shooting off in twenty directions at once.  The hurt and grief I was feeling can only be compared to my first reactions on 9/11, just overwhelming.  As I tried to find out as much as I could and weed through the errors in reporting (how I hate body counts), I kept coming back to the how.  How could anybody do this?  As so very soon, my focus turned to mental health.  There would be a need to discuss assault weapons and gun safety and school security and a myriad of other aspects and tons of questions that were going to need answers.

So why did I get so fixated on the mental health issue.  Well for one thing I’ve always felt that murder is committed by someone not in control of reason, even if only for an instant.  That those who plot and carry out killings make an irrational decision at some point and then stick to it.  Others commit crimes of passion, where a moment’s anger blurs that rationality I keep coming back to.  Killing 26 people, with 20 of them 6 or 7 years old has to take an inability to distinguish right from wrong.
My exposure to the Mental Health system was in the 60’s and 70’s, when the state was still warehousing mental patients in places like Morris County’s Greystone State Hospital.  My first experience with such a place was actually Greystone, but it was followed by other state and veteran’s administration hospitals.  Some were better than others, none were good, all were intimidating places that seemed to medicate patients heavily and keep them locked inside.  They stunk of urine.  At Greystone I had to pass through a maze-like series of wards, no doubt housing a unique category of patients in each – some had stronger urine smells that others.  They all had people standing in hallways, rocking back and forth, others leaning with their foreheads on the walls, muttering or singing.  An uneducated person like myself assumed the word for these people was “crazy”.  Today the huge lines for an iPad are “Crazy” and rush hour traffic is “Crazy” unless its a bad day and then its “insane”.  How we’ve lost the language!
Through that time a movement was building in the health profession that favored reintroducing these patients into society while under supervision and medicated.  That movement was prodded along and supported by politicians until it resulted in closing the warehouses down and saving tons of money.
To accomplish this, we changed the criteria for commitment to an institution to make it nearly impossible and all through this the stigma of mental illness grew and grew.  Now they walked among us and the fears that resulted made people very protective of their loved ones and very secretive as well.  If people were to find out a person was mentally ill, a shame would be visited on the whole family.
Things continued to change as more and more diagnoses were for Autism and Bi-Polar disorder and fewer and fewer diagnoses of the more serious conditions were made.  Today, if you can get help for your suffering relative (cost and access are issues),  They get evaluated, labeled and categorized, prescribed and maybe counseled.  If we get a confirmed diagnosis of ADHD or Asbergers, we’re done, get the pills.  Unfortunately, mom and dad lack the letters after their name to do their own diagnosis and must go along with what they’re told.  If the patient regresses, we find another diagnosis box to put them in and just give different meds.
The problems become easier to see when a Newtown occurs, and the experts come out to tell us that Asbergers doesn’t lead to violence.  I can’t dispute that, it wasn’t in Psychology 101.  But let’s assume the Asbergers box was entirely right for this case.  Other issue are present, or as they say Asbergers patients don’t generally manifest such behaviors.  So to my way of thinking, if a patient exhibits behavior “X” and Asbergers patients don’t exhibit behavior “X”, then Asbergers isn’t the right diagnosis.
Many have had to fight for Mental healthcare for their children, and many don’t get it, or get inappropriate treatment.  Keep in mind that parents need to get past the stigma to even seek treatment.  Then if your child needs constant care, the only way you can get it for him/her is if there are criminal charges against them.   The California Prison System operates the largest Mental health Program in the United States.  Get your child arrested and they’ll get the help they need.  Most parents I know would tend to shy away from that (stigma again).
So where’s the answer?  I think it must lie somewhere between treatment in society and treatment in an institution, but we need much more humane institutions that we had before we closed them all.
We need a mental health system that can reach the larger audience, properly identify those that need hospitalization and commit them, and closely treat the rest with an eye toward changes in condition.
Then we can change gun laws, security systems, parental education and anything else we can identify that will move us forward.

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