In the Arena

Fear-Mongering?

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I must disagree with Massimo’s attempt to respond to my column below. He accuses me of “fear-mongering” about the mentally ill, which is a bit over the top. I was simply raising an issue that needs to be addressed. All too often political correctness is used as an excuse for us not to deal with a problem that is staring us in the face. I won’t abide by that: We have lost our way when it comes to protecting ourselves from  the violent mentally ill in this country, and protecting them from themselves–not just violent schizophrenics, but also some who are depressed and bipolar. But let me deal with the specifics:

–Massimo says that 7% of schizophrenics have a tendency toward violence. He compares that to 10% of young males who are violent. This is like comparing apples to freight trains. Yes, there is testosterone poisoning at large among young males in the society–and much of it is expressed in unacceptable, if time-honored, ways: brawls at sporting events, gang wars, minor crime sprees. As loathsome as each of these are, they exist within a context of comprehensible behavior. The violence perpetrated by the mentally ill is quite different: it is often unpredictable, existing outside of any rational context. Thus we have Andrew Goldstein, a schizophrenic off his meds, pushing Kendra Webdale into the path of an oncoming subway train in New York, which resulted in the passage of Kendra’s Law, a mild step toward redressing the imbalance between the rights of the potentially dangerous mentally ill and the protection of the rest of society.

–And yes, I know, that the vast majority of schizophrenics are not homeless. I have several friends who are dealing, lovingly and courageously, with schizophrenic children with varying degrees of affliction. One of these children is voluntarily institutionalized and his parents live in constant fear that he’ll decide that he wants to get out, or go off his meds (as has happened in the past), and get into real trouble. An argument can be made that the law doesn’t give the parents of the severely mentally unstable enough protective control over their adult children.

–And as for the homeless: these tend to be the most severely mentally ill, those whose parents won’t or can’t take care of them. I’d imagine that they represent a disproportionate number of the violently mentally ill (especially since so many of them are also drug abusers). Is Massimo suggesting that the their sudden appearance on the streets of our cities in the 1960s was a good thing? For a time, it was politically incorrect to describe the homeless as anything but severely poverty-stricken (as a minority of them are) or as counter-cultural free spirits; by the 1970s, it was clear that this was delusional. By the late 1980’s, in the midst of the crack epidemic, fully 70% of those who found their way to New York City’s homeless shelters were testing positive for cocaine. A significant number of these also were mentally ill. As Daniel Patrick Moynihan bravely–yet again– pointed out at the time: this represented a significant moral failure in our treatment of our mentally ill and a significant threat to society.

–And what does Massimo propose to do about this? Nothing, so far as I can tell. In the column, I suggested nothing more than a rebalancing toward legislation like Kendra’s law. Obviously, this does not mean the forcible commitment of all schizophrenics to mental hospitals. That would be unwise, immoral and impossible. It does, however, mean the following: that if someone starts acting like Jared Lee Loughner did at Pima Community College, we should have the right, as a society, to demand that he be submitted for a mental evaluation. If he is found to be potentially violent, he should be monitored and a course of treatment suggested. If he refuses to abide by this course of treatment, it should be made mandatory. One would hope that we’d finally find a way to overcome the crippling NIMBY objections and local some community treatment facilities in accessible places (to do this, by the way, would cost money–and higher taxes, no doubt–but if we want to consider ourselves a civilized society, we have no choice). In doing this, we should build in as many checks as possible–multiple evaluations, at the very least–to be sure that we’re not acting peremptorily or vindictively.

Will this sort of redress prevent slaughters perpetrated by the violent mentally ill? Of course not. But it will reduce the threat–and it will benefit the vast majority of potentially dangerous people who are untreated now–although there’s no way of knowing just how many slaughters we’ll prevent. But it does seem to me that calling for a rebalance between the rights of the violent mentally ill and the safety of the society is not fear-mongering at all. It’s an attempt to evaluate a difficult problem and find a solution that is more humane than the one we currently have.