One thing about mental illness… it always pulls you back in.
You know what I am going to talk about, don’t you?
Oh, sure, I am seeing the Facebook posts that we shouldn’t talk about the reasons for the Connecticut Shooting (how interesting. Now it is capitalized. A proper noun), that now isn’t the time to make to make a political point, that now is not the time to talk about gun control or mental illness.
As far as I am concerned, that only applies to the families of the victims. The rest of us have no right to sit around crying “Why?” and throwing around words like “evil.”
We just did that a earlier in the week with Clackamas, Oregon. We did it six months ago with Aurora, Colorado. We did almost two years ago with Tucson, Arizona. We did it four and half years ago with Virginia Tech. We did it nearly thirteen years ago with Columbine.
I mean, seriously, how many more times are you going to act shocked? I would think by now you should be getting used to it.
What is it, exactly, that shocks you? Is the events themselves or the number of the dead? It’s a legitimate question. What is it that makes this harder every time, instead of easier?
Is it because it is getting harder to answer that “Why?” question?
“I just can’t make sense out of this,” you say.
I am afraid CNN is not going to make sense of it for you. And it is rather inconvenient to our need to understand when these killers keep killing themselves afterward.
You are right, though. It doesn’t make sense. Which should tell you something right there.
The average number of homicides in the United States is approximately 20,000 per year, of which best estimates suggest those under 18 make up approximately 2000.
20,000 homicides per year. Not bad when you consider there are over 300 million of us living in this country.
You see them every night on your local news. A gang shooting that left six people dead, including one baby. A hit-and-run that killed a six year old girl. A man arrested for murdering his wife because he believed she was cheating on him.
You don’t ask “why?” with those. Why?
Because, in a twisted way, those murders make sense to you. You can understand why six people were killed in a gang shootout. It was probably a drug deal gone bad or two gangs fighting over drug dealing turf. The driver who hit the six year old and drove off? Probably a guy who was drunk and already has several DUIs. He runs because in most states, like California, killing someone under the influence is automatically a murder charge. The guy who murdered his wife? She was cheating on him and he shot her and her lover. Okay, so it’s probably not what you or I would do in that situation but you get it. You understand it. It makes “sense” to you.
You even understand serial killers, even if you claim not to. They killed because of some sick pathological desire, rooted either in deviant sexuality or “rush” from killing.
But those killers all have one thing in common: they try to conceal their crimes and they try to run. They kill and hope to resume living their lives as if nothing happened.
It gets a little bit harder to fathom when a guy walks into a movie theater and opens fire at random people and then calmly walks out to wait by his car for the police. It doesn’t make sense when another guy walks into an elementary school classroom and kills 20 kids he doesn’t know and then blows his own head off.
Mass killings, where there is no relationship between the killer and the victims, make no sense to you because you can’t find a motive. But you still try, don’t you?
Half the country is screaming for gun control. That’s fine, but it would be helpful if you articulated what kind of gun control you are looking for.
Ban on assault weapons?
None were used. Yes, a Bushmaster .223 semi-automatic rifle was found. In the car in the parking lot. All the victims were shot with two semi-automatic handguns. UPDATE: This was later determined to be incorrect. The Bushmaster was the weapon used. It was a shotgun found in the car.
Ban high capacity magazines?
Sure. I mean, after all, do you really need 30 rounds to kill a deer?
But that only reduces the death toll to between 8 and 15, depending on the capacity of the standard magazine. And they can always reload.
Ban semi-automatic weapons in general?
Okay. That reduces the death toll to six, or the number of rounds in a standard revolver. Unless the shooter brings more than one gun.
Ban all guns?
Fine with me. But then these killers can do as the Chinese do…. A machete to the neck.
A friend of ours was just attacked by a schizophrenic man with a knife (after he was done stabbing himself repeatedly). Should we ban knives?
However will we cut our prime rib then?
Canada has more guns, including assault rifles, per capita than we do but they have far fewer mass shootings.
No, I am not a member of the NRA and I don’t own a gun. I have two mentally ill kids. Why on God’s now bloodied earth would I own a gun? Frankly, people I know who own guns scare the shit out of me, even if they aren’t mentally ill.
Unfortunately, the NRA is right on their famous line: “Guns don’t kill people. People kill people.”
Okay, so “evil” then? What, exactly, is “evil?”
“Ah…. It’s doing bad things.” Oh, you mean like eating a grape in the produce section and not paying for it? “No, you idiot! Really bad things. Ten Commandments stuff!”
Is “Thou Shall Not Kill” the First Commandment?
- “I am the Lord thy God. Thou shall have no other gods.”
Huh. I guess not. God is apparently more concerned that we get who He is than whether we take another life. Well, it’s gotta be number two, right?
- “Thou shall make no graven images or likenesses.”
Okay, okay, God, we get it. You da man. Number 3?
- “Thou shall not take the Lord’s Name in vain.”
Jesus Christ! Ooh! Sorry. But when are going to get to the good stuff?
- “Remember the Sabbath and keep in Holy.”
Oh, come on! Really? The Almighty is more concerned that we don’t work on Sundays?
- “Honor thy Father and thy Mother.”
So taking the trash out when your parents tell you is more important than not killing?
“Thou shall not kill” is number six on the Ten Commandments countdown. Number six! Or slightly more important than not committing adultery but less important than listening to dad and mom. I guess these killers’ parents never sat their kids down and said, “Son, it’s important not to kill people.”
I don’t remember the episode of “The Brady Bunch” where Mike Brady sits Greg down to have a serious talk about not killing. Apparently, I missed that one.
If fear of damnation is the only thing that keeps us from killing, I guess I better watch my back around my atheist friends, those Godless heathens.
Let’s be honest here, okay? If “evil” makes people kill then why aren’t you in church right now, praying for God’s deliverance from your desires to murder? Because obviously you have then, right? The Devil is lurking around, waiting to tempt you into murder, and it is only the Grace of God that saves your immortal soul from pulling the trigger on a Glock 9mm into a classroom of kindergartners.
“I respect the law,” you say. Good for you (but make sure to come to a complete stop at a stop sign). But I guarantee that if there were no legal consequences for killing most of you would not be rushing out to do so. Why? BECAUSE YOU DON’T WANT TO!!!!!!!! Not because you are protected by God’s Grace, not because of the law, but because your brain is not telling you to do so!!!!!
And that scares you, doesn’t it? The idea that the only thing between you and twenty dead kids lying at your feet is a couple of functioning neural pathways. That all it takes is one break somewhere inside your brain and suddenly you are hearing voices and think everybody is out to get you. That in six months you can go from being a well-liked and reasonably happy individual to planning a mass murder.
No other human affliction can make you do that. Not asthma, not diabetes, not leukemia. There is nothing else that can destroy everything you were and remake you into Jared Loughner or James Holmes or Adam Lanza. All of them were once nice boys. But now their names will forever be linked to monstrosity. To senseless violence.
“You’re being too negative,” critics say to us.
I’m sorry. Is there anything positive about ebola? Anybody? No?
“That’s different,” you say. Really? Ebola can turn you into a killer as well. So can HIV. You could give it to someone else before you ever know you have it.
Do you know the history of the Black Death? Do you know about the rumors that swirled around Europe after it arrived in Italy in 1347? Some believed it was God’s vengeance. Many more believed the Jews had poisoned the wells and set about killing them on a scale to rival the Nazis nearly 600 years later.
Except it was caused by a bacteria carried in the fleas who lived on the rats who lived with the humans at the hole at the bottom of the sea. But nobody knew that until the 19th Century.
Today, we call it bubonic plague and it still exists. Every few years, there is an outbreak of it in the American Southwest, usually on Native American reservations.
Quick! Kill all the Indians! Actually, we better quarantine the states of Arizona and New Mexico, just to be safe.
Ah, but now we have penicillin. We can treat bubonic plague without issue.
We can treat mental illness as well.
So let’s stop crying “Why?” shall we? You know “why.” Are you aware that all these mass shooters were in their late teens or early twenties, which is the typical age of onset of schizophrenia in males?
You want to know how to stop the violence? I’ll tell you.
First, you must understand the nature of mental illness. It is a disease and like any other disease it cannot be stopped without treatment. You can’t beat it on your own, at least in its most severe forms (schizophrenia).
Second, it can strike anyone. And I don’t mean getting killed by someone with a severe mental illness. Honestly, that isn’t too likely to happen. No, I am talking about YOU. ME. US. Any of us can have our brain turn against us and the rest of the world. If it is going to happen, there isn’t a damn thing you can do to stop it. And the worst thing is you wont even know it’s happened to you. In the beginning, you will feel yourself starting to change but you won’t know why. You will seek help. And you won’t find it. And that will feed into your paranoia. Soon, who you were wouldn’t even recognize what you’ve become. The most insidious thing about psychosis is it becomes normal to you because it alters how you see the world and yourself. The voices or the hallucinations, the “bad” thoughts,” it all becomes as much a part of your life as breathing. Most do (we think) fight back. But eventually, without treatment, they lose the fight. The world of psychosis overwhelms the outside world and nothing matters anymore but the thoughts in your head.
Third, you have to see past the rhetoric, both the external that will strive to provide another explanation (more gun control, despite the fact that Connecticut already has some the strongest gun control laws in the country), and internal to the mainstream mental health advocacy, are probably screaming at their computer screens right now, “Most mentally ill people are not violent! Michael, you are contributing to the stigma!” That’s our big catchphrase in mental health advocacy… “stigma.” We fight the “stigma.” I suppose because it’s more polite than the truth: MOST PEOPLE DON’T GIVE A SH*T. That probably doesn’t help with the donations, especially corporate sponsors, who want to sponsor “positive” things, “empowering” things. They want the big money donors to feel good about themselves while they toss back their champagne and slap each other on the back for the job they are doing to fight “stigma.”
They are right, however, about most mentally ill not being violent. That is true. But it is interesting that I only ever hear that from women, either women with mental illness who are on medication and are functional and fear being ostracized by the judgmental society they are trying to fit into (which is why they play “nice”) or mothers of mentally ill children who don’t want people looking at their son and seeing a future killer.
I understand both of these things.
But notice I said “sons.” And notice I made no mention of ever hearing complaints about my contributing to THE STIGMA from men with mental illness.
Most mentally ill are not violent. Most are likely to wind of dead simply because, like I said, society doesn’t give a damn. Those women can bristle at what I say because they themselves are not going to be mass shooters. Mass shooters tend to be male and young. So young mentally ill woman worry about the stigma because they have that luxury. But the mothers of mentally ill sons worry about it because they are terrified that, no matter how much of a longshot, it might actually come to pass.
Which brings me to my fourth point and the answer to your question of how to stop this violence.
Laura’s story and the law in California named after her. Laura Wilcox was a 19 year old college sophomore volunteering at the Nevada County (California) public mental health clinic when she and two others were shot to death by then 41 year old Scott Harlan Thorpe, who suffered from schizophrenia and was resisting his family’s attempts to get him treatment.
Laura’s Law, passed into law and signed by Gray Davis shortly before the citizens of California recalled him for the Terminator, created what is called “assisted outpatient treatment,” or, more bluntly, forced medication. If you are lucky enough to get into an inpatient psychiatric hospital, you will get meds but there is no system to forcing compliance out in the world (other than prison, and currently the California Department of Corrections is the largest provider of mental health care services in the world). Laura’s Law would change that.
Unfortunately, it was left up to each California county to decide whether to implement it (the Citizens Committee on Human Rights, which is a Scientology front group, has sued counties that have tried). So far it is only fully implemented in Nevada County, with a pilot program in Los Angeles County.
By the way, Mr. Thorpe had sought psychiatric help from the Nevada County Clinic in person several times before and been turned away every time, being told that there was “nothing we can do to help you.” By which I assume they meant they couldn’t get him inpatient.
So here is what we need to do if we want to stop the violence. Not everybody is going to like it. Tough.
- Part of the reason Laura Wilcox is dead is because there are not enough psychiatric hospitals, or “beds” as they are called. This is because building psychiatric hospitals is neither a political priority for funding, for donations, and because nobody wants one in their back yard. You see, even if you present to the ER with psychosis, if there are no beds available, you will be released. Attempts to build more are often blocked by local governments and community groups, who view patients as “inmates” (now there is a stigma we can fight). Nobody objects to the local hospital adding on a neo-natal unit or a stroke unit but they don’t want psych wards. The irony in this is that the mentally ill are already all around them. Do you want the bubonic plague spreading or do you want to treat it? Your choice.
- Even if you can find a bed, you won’t be there very long because there is no real parity between physical illness and mental illness. Insurance companies will pay for chemo as long as you need it (or until you die) but they still view mental illness as “behavioral,” which is a code word for “something you could really control if you just wanted it bad enough.” In 1980, the average stay at UCLA’s psychiatric unit was six months. Today, it is four days. You can’t treat cancer in four days. Why in the hell would they think you can treat severe mental illness in four days? Right now, doctors have to balance the need for treatment with how likely they are to get paid by the insurance company or Medicaid. Laws must be passed which force insurance companies and Medicaid to pay for inpatient care as long as doctors feel necessary to stabilize the patient (while at the same time forcing them to offer inpatient and outpatient mental health care, which most individual plans don’t). This is because mental illness is forever. With cancer, the insurance companies know you are either going to get better or die. Either way, they won’t be paying forever. With mental illness, they will. If we treat mental illness like we treat cancer, the number of these killings will drop dramatically.
- Make Laura’s Law mandatory across the United States. This is where our advocacy gets controversial. If you won’t take your medications, we must force it. It sounds ugly but if you had bubonic plague, we wouldn’t allow you to refuse treatment. Let me put it in everyday terms. Have you ever been flagged as possibly having tuberculosis? It’s pretty common if you develop pneumonia. What happens? They quarantine you until they are certain you don’t have tuberculosis. We do not allow the option to refuse treatment for tuberculosis because you are a risk to public health. It’s the same if you are severely mentally ill. You are risk to yourself and to public health. We have to treat you, whether you want us to or not. Human rights violation? Not if you have TB. Don’t like the way your meds make you feel? Talk to your doctor. But you are gonna take something.
Laura’s Law is based on New York ‘s “Kendra’s Law,” which has been around long enough that New York State Psychiatric Institute and Columbia University were able to conduct studies of efficacy (how well it works). This is what they found:
- 74 percent fewer experienced homelessness;
- 77 percent fewer experienced psychiatric hospitalization;
- 83 percent fewer experienced arrest; and
- 87 percent fewer experienced incarceration.
Comparing the experience of AOT (assisted outpatient therapy) recipients over the first six months of AOT to the same period immediately prior to AOT, the OMH study found:
- 55 percent fewer recipients engaged in suicide attempts or physical harm to self;
- 49 percent fewer abused alcohol;
- 48 percent fewer abused drugs;
- 47 percent fewer physically harmed others;
- 46 percent fewer damaged or destroyed property; and
- 43 percent fewer threatened physical harm to others.
As a component of the OMH study, researchers with the New York State Psychiatric Institute and Columbia University conducted face-to-face interviews with 76 AOT recipients to assess their opinions about the program and its impact on their quality of life. The interviews showed that after receiving treatment, AOT recipients generally endorsed the program, with 62% reporting that being court-ordered into treatment had been overall a good thing:
- 38 percent of them reported that AOT helped them gain control over their lives;
- 81 percent of them said that AOT helped them to get and stay well; and
- 90 percent of them consider themselves more probable to keep appointments and take medications because of AOT.
Pretty good numbers. All the major risks to severely mentally ill individuals dropped. And for your benefit, notice the 47% fewer physically harmed others.
That’s it. We make those three things happen and we significantly reduce not only the risk of violence but reduce the far more likely causes of death for patients with severe mental illness. It’s a win-win for our society.
But why do we (meaning me and Susan) do this? Why do we care when Jani is extremely unlikely to ever be the perpetrator of a mass killing? Why, on our Facebook page at www.facebook.com/janifoundation, keep bringing up all this “negative” stuff instead of focusing on the “positives?”
I’ll tell you.
When you have a Facebook “page” that people can “like,” it allows you to see how many people have “seen” each status or post. The other day I posted two photos of Jani at school with her hair done in braids by her therapist there, smiling into the camera.
Within a few hours, both pictures had been seen by more than 5,000 people. It had hundreds of “likes” and hundreds of positive comments on how well she looks.
I hate that.
You know why?
Because in another thirty years, I will, in all likelihood, be dead. Maybe forty years. And what will happen to Jani when Susan and I are gone? What will happen to her at 18 when we have no legal control over her anymore?
I hate the people who want to focus only on the positive because they will be the same ones who will walk past a disheveled dirty blonde bag lady in the street in forty years and not even recognize her as Jani, that cute girl from Facebook and the TV specials all those years ago. You like her now and you want to help now but if you don’t help me to change the mental health care in America before I die, you won’t remember her when she is on the street and dirty and disgusting. None of those five thousand people who “liked” those pictures will be there. I know you too well. You are not bad people. You are human, just like me. And you will forget. Because everyone eventually does. Right now Jani is a subject of fascination but eventually that will fade. But she will still have schizophrenia.
NAMI (the National Alliance on Mental Illness) has been around since 1979. That’s 33 years. In that time, they have helped push the biological model of mental illness and I am grateful for that. But I don’t have another 33 years to wait for mental health care in America to move at the glacial pace it has been moving. That is why I am not “positive.” I have to move you any way I can, even if that means screaming what you don’t want to hear.
Jani and thousands of kids like her don’t have the time left.