That Dog Won’t Hunt

You might have heard that New Gringrich blamed the Virginia Tech tragedy on liberals. I don’t know why anyone would be surprised at this. The pseudo conservative Right has been blaming liberals for everything wrong with the world for years. Essentially they took the old John Birch liturgy and substituted “liberal” for “Communist.” And they got away with this for a long time.

However, the Right was in total control of the federal government for the past few years, and during that time the world became more screwed up than it ever was, I wonder how well “it’s all liberals’ fault” still works. That might have been persuasive to some back when Democrats had had a majority in Congress for many years. Now it just sounds pathetic.

Also, from Think Progress:

In a new video, the the right-wing American Family Association attributes the tragedy at Virginia Tech to: a lack of prayer in school, a lack of the Bible in school, a lack of spanking kids, a lack of physical punishment in school, abortion, condoms, Bill Clinton, internet pornography, free speech, the entertainment industry, “satanic” music, and liberal culture in general.

An op ed in today’s Wall Street Journal also blames liberalism for the Virginia Tech shootings. Unlike the rantings of Gingrich and the AFA, this argument has a shred of truth. Not the whole truth, but some truth. Jonathan Kellerman writes about the anti-asylum movement of the 1970s that shut down many large psychiatric facilities and made it more difficult for people to be committed against their will.

Kellerman blames some off-the-wall theory floating around in psychiatric circles that “madness could be a reasonable reaction to an unjust society” and even that mental illness did not exist. As I remember at the time, the real impetus to closing many hospitals was the perception they had become little more than warehouses for people who might be better off in some kind of supervised living situation. Yes, some people who wanted to close the hospitals had seen “One Flew Over the Cuckoo’s Nest” a few too many times. Others thought that patients might benefit from something like a halfway house arrangement until they were well enough to take care of themselves, instead of being locked up in a hospital. I think in some cases that’s a valid argument.

The problem was that this plan was only carried through halfway. Hospitals were closed, but the patients in them were not given the less-restrictive alternative they had been promised. They were just turned loose. Many ended up homeless or in jail. A few were a genuine danger to themselves and others.

The other part of the equation, involuntary commitment, is a bit dicier. Certainly involuntary commitment used to be abused. On the other hand, people who are psychotic or delusional are hardly in a position to make informed decisions about themselves.

In my long sorry life I’ve heard of a number of atrocities committed by disturbed people who had been denied adequate medical treatment. One that comes to mind is the murder of a New Jersey boy in 1997. The murderer was a 15-year-old whose parents had attempted to place in a hospital just days before. The parents were afraid the youth was a danger to himself, and possibly to others. The hospital psychiatric screening unit and a family court judge disagreed, and the judge told the family to get outpatient help. Shortly after this the youth sexually molested and then strangled an 11-year-old who was selling candy in the neighborhood.

The famous Andrea Yates who drowned her five children while in a psychotic state had been in and out of psychiatric facilities and the care of various shrinks for years before this tragedy. One limiting factor to her treatment was how much her medical insurance would pay. And, yes, her husband also made some boneheaded decisions, but in the days leading up to the tragedy he also had made some effort to get more aggressive treatment for her, without success.

But the bottom line is that as a nation, as a society, we have not shown much interest in resolving the issue of what to do about people with psychiatric illnesses. If Seung-Hui Cho had not killed himself, right now the nation would be arguing itself hoarse over the insanity defense. Instead, people are mostly ignoring Cho’s obvious mental disturbance and instead are using the tragedy to promote their (usually unrelated) political and social agenda.

I’m not sure what to do about the psychotics among us, either. But I do suspect the solution will require (1) much improved access to psychiatric health care as part of an overhaul of health care generally, and (2) better public education about psychiatric illness.

14 thoughts on “That Dog Won’t Hunt

  1. Oh, Lord… I just had a flashback to 1956, sitting in Mrs. Mears 6th grade class, sometime near the 3:15 bell. The Birchers were in the news, planning to poison whomever it was they were against by putting teflon shavings into their cigarettes. If only the present-day conservatives could be so sane.

  2. The problem was that this plan was only carried through halfway. Hospitals were closed, but the patients in them were not given the less-restrictive alternative they had been promised

    Yah, I remember pretty much the same thing except the reason the community centers were not built was that the damned conservatives would not appropriate sufficient funds to build them. As usual, liberals & progressives in the deinstitutionalization movement got suckered by their erstwhile “allies” on the right. Again. So it goes.

  3. Kellerman blames some off-the-wall theory floating around in psychiatric circles that “madness could be a reasonable reaction to an unjust society”…

    I remember hearing about this in a college psych class in the 70s, the professor (whose name actually was Neil Young, no relation to the musician) commented that those advocating this position “were nuts, and that the mentally ill go through hell.

    I kind of doubt this position got that much traction in the psychiatric community, although this is just a guess on my part. I do know that the right’s penchant for tax cuts caused a lot of mentally ill people to be thrown out onto the streets. I wonder when we’ll read about this in the Wall Street Journal.

  4. I kind of doubt this position got that much traction in the psychiatric community

    I don’t think it did either. I dimly remember the guy who used to claim there was no such thing as mental illness. He got some media attention, but that’s not the same thing as persuading his colleagues. However, I also dimly remember that conservatives were more likely to agree with him than liberals. It seemed to appeal to their notion that psychotics are just slackers.

  5. I AM in the psychiatric community, and I can tell you, we take mental illness seriously. The biggest problem is a simple lack of resources, and right-wing thinking is largely to blame for that. The mentally ill do not have a strong lobby, and so very little money is apportioned for their care, plus the endless drive to cut taxes hurts all social services. See, eg, the NYT article about how Medicaid cuts in Mississippi have led to an increase in infant mortality. Many mentally ill people also depend on Medicaid for their medications. Don’t even talk about psychotherapy; that’s hard for even middle-class people to get these days, thanks to managed care. It’s idiotic to talk about changing the commitment laws when we don’t have any place to put these people. A huge percentage of them end up in the justice system these days, where they get very little care and are often victimized by other inmates.

  6. Perhaps my memory is faulty, but wasn’t the turning out of mental patients unto the streets one of President Ronald Reagan’s initiatives? Just as he did in California as governor.

  7. I still think everyone’s missing the larger point. Conservatives want to lock ’em up. Liberals want to put in gun control laws & treat them.

    The problem is, either way, Cho would still have existed. The problem is that our society creates people like Cho. But no one wants to address that. People just want to throw their favorite political footballs at it instead.

    See, here’s what I get out of this, after reading up about this. If I meet an individual, specifically male, who evinces any form of homophobia especially coupled with misogyny, then I need to stay the hell away from this person for my own personal safety.

    Problem: I can’t figure them all out. There are thousands of Cho’s passing me by on the street, at the campus, in the store.

    When are we going to start looking at how and why we create monsters like Cho?

  8. I’m from a medical family and that idea had approximately ZERO TRACTION with the medical and psychiatric communities.

    Reagan era policies turned mentally ill people out into the streets, continuing conservative policies have kept this going.

    Compared to the access to mental health care in Mexico, we have much less available in this country for low-income people. Of course, the mentally ill do not vote much so their needs get short shrift governmentally.

  9. From what I understand, mental illness incurs a great deal of stigma in the Korean as well as many other immigrant and working class communities. When you compound this disinclination to seek help with the high financial and red tape thresh hold it is a wonder we do not see more masacres.

    I am a staunch supporter of gun control. Registration, training and licensing should be a part of the process of gun ownership as it is with owning and driving a car. That said, I doubt these provisions would have made a difference in this case. Even if guns were abolished who would prevent a determined individual from becoming a bomber or suicide bomber.

    Serious consideration has to be put towards creating a sane mental health policy and by that one could be saying a sane health policy since they are truly the same thing.

  10. anon — it’s fairly obvious that Cho was deeply disturbed, although I suppose a precise diagnosis is impossible now. But my understanding is that most psychosis, like schizophrenia, comes from a physical disease of the brain. They can run psychotics through a CAT scan and see that their brains aren’t working properly. It’s not something “we” do, and it’s unrelated to character/social maladjustments like homophobia and misogyny.

  11. #7 … Cho was one sick puppy. Totally bonkers. My dad’s a shrink, and he assures me those are technical terms, “terms of art” as they say. The form of our society MAY have had a hand in shaping exactly what form his bonkerness would take (that’s debatable, it depends on a lot of things that aren’t yet known), he was always going to be a danger to himself and others in one way or another.

    The difference between our current society and the ideal society is that in the ideal society, there would have been PLENTY of help and care available for him for free, there would be little to no stigma attached, and, on the off chance that he refused to avail himself of the help, there would be a mechanism in place to FORCE the help on him. In the ideal society he’d still be bonkers, but he wouldn’t hav been a danger to himself and others, because he’d have been helped by now.

    The difference between our current society and the ideal society is the ONLY sense in which it is accurate to say our society “creates people like Cho”.

    And the way to address that issue is by [i]treating[/i] people like Cho, and by putting in enough gun control that people like Cho would not be able to get a gun.

    That is in no sense a “favorite political football”, it is the [i]remedy to the problem[/i].


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  13. Oh, I wasn’t clear. Obviously he had some type of psychosis. I’m talking about the manifestation of this psychosis, though. Like so many other men who have gone on these kind of rampages, there’s a clear pattern of misogyny, homophobia, insecurity about their own masculinity that seems to feed into the psychosis to erupt in this particular way. Why is that?

    Gun control, involuntary psychiatric commitment, etc, are not addressing THAT problem. We, as a society, are not even recognizing or talking about that aspect of it, all that much (there’s some exceptions out there). That’s what I was getting at. Why does the eruption take that form?

  14. The suggestion that medication sparks violence reminds me of the conclusion that laboratories cause cancer in mice. There is a direct correlation but…..

    That’s not to say that drug manufacturers will always tell us or even tell doctors about side effects, etc. But to pull a medication that has huge benefits for 99% because of side effects for 1% – is idiotic to say the least. You manage possible side effects by supervision and follow-up.

    What I wold like to see is a blue-ribbon panel of experts from a variety of disciplines, medical & legal, convened to study the problem and make recommendations.Thare’s a lot of aspects to the subject, patients rights, rights of the public, personal freedom vs incarceration for treatment, what facilities we need, and where, and who pays. I think there are a lot of professionals who would like to be part of shaping a solution. The goal would be to provide lawmakers with a framework of recommendations to implement at federal, state & local levels. Who can argue that it’s not needed?

    There is an opportunity for Democrats to show they can come up with answers. Let Bush veto a comprehensive bill for psychiatric care for seriously ill & potentially violent residents of this country.

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