July 25, 2012
It Can't Work That Way

Every time some lunatic cracks and pulls out a gun, someone explains, again, that having crazy people wandering the streets is a bad idea. I worked for the National Alliance on Mental Illness, NAMI, for fourteen years as their IT chief. They're the ones who represent the other side of this tragedy, the families and victims of mental illness. While I wasn't directly involved with their advocacy efforts, when you work for a place like that for as long as I did, you end up learning a lot, like why the state-managed system the article's author advocates was dismantled.

His point that people under 40 have become desensitized to mentally ill people in public is true, as far as it goes. What he neglects to talk about is how people over 40 should have very, very bad memories of what was found in the late 60s when a close look was taken at state-managed mental health institutions. Here's a hint: the institution portrayed in One Flew Over the Cuckoo's Nest was a really, really nice one.

People were warehoused at best, with brutality and humiliation extremely common. It was his exposes of the conditions at Staten Island's Willowbrook State School that brought a young, and unknown, Geraldo Rivera national fame and a Peabody award. Everywhere anyone looked people would find chronically underfunded, almost criminally unsupervised institutions filled with over-medicated and neglected mental patients. In the heady days of the late 60s and early 70s, the inescapable and, in light of the facts at the time, completely understandable solution was to set these people free.

What's worse is that, when the state is provided with the hammer of involuntary commitment, a whole new set of people start looking like nails. Local political machines are legion and when a hard-headed mule of a person showed up and demanded to know... anything... about how a city, county, or even state was run the mere threat of institutionalization was plenty enough to silence them. Locking up the ones who didn't back down took care of the rest. And it did happen, all the time.

Was it taken too far, trading abandonment in a hole with abandonment on the street? Yes. With the exuberance and naivety so tragically typical of progressive causes in the 60s and 70s, the old system was destroyed without any serious thought for what should replace it, and there was absolutely no follow-up when the inevitable unintended consequences started picking up guns and shooting people. It is no coincidence that NAMI, originally formed by family members desperate to find some other solution to the problems their children represented, was formed less than ten years after aggressive de-institutionalization started.

Finding those alternate solutions has not been easy, but there has been great progress made. Medications have improved and will continue to do so. Educational programs for family members, law enforcement officers, and "consumers," NAMI-speak for those who have mental illness, are both popular and effective. I watched from a particularly high seat as tireless advocacy changed the popular perception of mental illness from something not to be discussed, something to be feared, into the more humane and realistic idea of another set of diseases, something that can be treated.

Unfortunately these efforts are ongoing. The hard truth is that, until mental illness and addiction can be cured outright, incidents like the tragedy in Colorado are simply another price we pay for a truly free society. We can and should try whatever we can to prevent them, but these must be new ideas. Institutionalization was tried and it failed. There's no going back there this time.

Via Instapundit.

Posted by scott at July 25, 2012 09:50 AM

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