What to Do with Our Mentally Ill?

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January 16, 2011 by Daniel Stack

The horrific shootings in Tuscon, Arizona by alleged gunman Jared Lee Loughner has triggered a number of debates here in the United States. Nothing can bring back our dead nor make that event good. But most of us need to find some meaning, try to make some good out of this awful event. So I think that some of the soul-searching many, myself included,  find themselves going through is a good thing, though I’d not attempt to say it is worth the lives of those we have lost. Not one of them.

In my last blog entry I talked about the state of our civic debate. Here I’d like to talk about mental health in the United States. Examining the public statements of Jared Lee Loughner presents us with what certainly appears to be a deeply disturbed individual. Most obviously, that leads to the classic debate about the insanity defense. At what point does an individual have control over his or her actions? If you were driving and were to out of the blue have a stoke or seizure that caused you to lose control of your car, it would be difficult to find you responsible for what happened after you lost consciouses, assuming you were unaware of your condition.

The case of Loughner isn’t so simple and is one that will be decided in our court system.From my own experience I believe with every fiber of my being that it is absolutely possible to be mentally ill to the point where horrific thoughts make perfect sense. Someone with an anxiety disorder often knows they are worrying over nothing. But they can’t help themselves. They have to check that the door is locked for the 14th time, that the stove has been turned off. Someone with depression knows they have a good life, they shouldn’t feel this down, that life is worth living. But knowing that does not change all of the input going into your brain that life isn’t worth living, that there is no point getting out of bed.

My own personal experience does not thankfully go to the point of schizophrenia or psychosis. But my readings of those who have as well as those of professional psychiatrists indicate much the same. You may know there are voices in your head, but which are real and which aren’t.

To be honest, the knowledge that something is wrong is a difficult one to reach. It took months, probably years, of my wife’s depression getting worse and worse until we realized just how bad it had become. Thankfully, I have excellent mental health insurance. (Not perfect, we are involved in a dispute with our carrier over part of her treatment.) With major treatment she has gotten much better. I don’t know if she’ll ever be “cured”.

You might be reading this and thinking you’d be able to ignore these voices. To ignore the input of hopelessness. To ignore the worry, the panic.  And to be honest, you might on some days. The mentally ill have good days and bad days. But day after day, it is like the ocean wearing away at the rock. As strong as the rock is, the ocean will win in the end.


I’m not making a judgement on Loughner’s mental state or if he knew his actions were wrong. Again, the courts will decide that. But as I’ve testified in this blog many times, mental illness is quite real. And I firmly believe that it must be treated with the same seriousness as physical illnesses. I also happen to think of health care as a right. No one should have to be unable to dismiss the voices in his head due to financial status. There’s many unfortunate people for him treatment does not help. Mental health is in infancy compared to other areas of medicine. At my wife’s day program one of the doctors explained that to diagnose a tumor or a heart condition we can use tumors, x-rays, etc. to get an exact picture of what is going on. But our tools for diagnosing mental health conditions are akin to our abilities to diagnose a tumor a century ago. The tools for precision just aren’t there yet. Even so, there are people who can be treated, whose lives can be made better.


This brings us to a second problem. Often the illness interferes with the seeking of treatment. If Loughner was and is mentally ill, even if he were to have access to the proper medical care (which I do not know if this were to be the case), it is very difficult to force someone to receive treatment. However, mental illnesses are often more apparent to people around the person who is suffering than the person him or herself. As I said, it took months or years for my wife and I to realize just how bad her depression had gotten, though those close to us nearly universally said they sensed something was wrong, they just weren’t sure what. But when you live with it day in and day out, it grows to seem normal.

In the case of Loughner it is clear there were signs of mental illness. His college was frightened of his behavior. He was unable to join the military. He mad a series of nonsensical postings on youtube. But with all of this if a person has committed no actual act or threat to himself or others it is nearly impossible to force him to seek treatment.

I don’t have a magic answer for this. Like many things, I believe it to involve a difficult balancing act. On one hand, it is to the benefit of both society and the individual for people who are mentally ill to be treated. On the other hand, people have a right to their own live their own lives so long as they do not hurt others. The side-effects of medication for mental illnesses are often unpleasant. They don’t always work and when they do work they don’t always keep working. But at the very least we as a society need to realize these are real issues to consider.


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