News Dec 17, 2012 at 10:39 am

Comments

1
I'm not sure I follow this argument, but I think it goes something like this: gun lovers have decided to jump on a mental health bandwagon, in the belief that providing comprehensive mental health care is a useful canard to deflect attention away from gun control. "The problem is not guns, the problem is crazy people on the loose."

They're right in that practically everybody who supports cleaning up our dysfunctional gun laws is also going to be enthusiastic about access to mental health care. All kinds of health care. Hence agitating for a national health care system for decades. Hence Obamacare.

So if the NRA wants to throw its weight behind Obamacare and expand the mental health components, I can't imagine much opposition. Win win for us all.

But will that deflate the gun control movement? Well, let's find out. Pass comprehensive mental health care.

And then we'll all get to see if there is any interst in obvious questions like: Now that we have a system in place to diagnose and treat mentally ill citizens, should we really do nothing if one of them wants to buy a gun at a gun show with no restrictions? Now that we have diagnosed mentally ill people identified, are we going to lock all of them up, or ask gun owners to lock up their guns? And so on.

Let's do it and see what happens. Everyone agrees, right?
2
I posted a comment in support in the page. I'm so impressed with her bravery and honesty, and I can't believe this is the response. Where has empathy gone to in this country? It's just shocking.
4
People are saying that it's so weird Liza Long didn't mention any of her son's violent behavior on her blog before now, only her frustrated reactions to him.

But that doesn't seem weird at all to me. Your kid being a violent crazy person seems like a pretty rational detail to withhold from the vast internet. Until you can't take it anymore and admit it and cry out for help. I mean.... all of that makes perfect sense to me. Where's the disconnect?
5
You could sign this petition in support of improving mental health care: https://petitions.whitehouse.gov/petitio… because it needs more signatures? Or not.

Take care.
6
There is another side to this story. Another mom was upset about the violation of the privacy of the 13-year-old in the blog post. They have since posted a joint statement that they agree on the end (access to affordable mental health care) but not on the means used in this case.
7
Wait, what? There's a BACKLASH against the author of that heartbreaking piece? Good God. And I'm supposed to be the one who sucks? That's the worst thing I've read today.
8
I'm sure you all love your children, but it's times like this that make me know I made the right decision to remain childless. When everything goes right, I'm sure it's very rewarding. But when everything goes wrong...well, it's just too heartbreaking. I have a close friend who's child destroyed her life. She's been left a shell of a person.
9
As someone with a schizophrenic family member—who was never a physical threat but turned our lives upside down in many other ways—I am deeply sympathetic to Liza Long and Rebecca Schoenkopf. I've been reading Rebecca for a long time, since her days at OCWeekly, and didn't know that about her family.

I like the way @1 thinks. It hadn't occurred to me that the gun nuts would be, or had been, pushing the "gotta do something about the crazies!" thing as a distraction from strengthening gun laws, because I'm not a devious little shit, but let's let them put their shoulders to the wheel in the effort to improve mental-health care in this country (even as we press for more sensible gun policies).

It won't be easy, though. All the same issues that came up around the "de-institutionalization" of mental patients in the 70's and 80's are still there. Do we test everybody for mental illness/sociopathic behavior periodically, or only when specific incidents occur? What if someone doesn't want to be tested? Under what circumstances are we willing to re-institute long-term commitment, and the forced-medication issues that go with it? How do we create an atmosphere of beauty, kindness, and caring in mental institutions that was so often absent even in our recent memory, and prevent physical and sexual abuse of residents? (The "green nursing home" movement offers some clues.) How do we honor the fact that bipolar and schizoaffective disorders are more prevalent among artists, many of whom have enriched our lives through their art?

These questions are perhaps even more difficult to deal with than the issues around guns and bullets, but I think we're up to the challenge.
10
What do you guys all mean when you talk about improving mental health? I've seen the blogs and social media flooded with nebulous calls for improvements or better access to mental health services. While I agree with the overall concept, I think what you all are asking for in reaction to the mass shooting is to decrease the barrier to involuntary hospitalization and forced medication. You want to lock up the crazies, so be honest about that. And what do you think is going to happen when people are put in hospitals against their will and medicated into submission? There is no healing in that. You want asylums and the ability to lock people away and speaking as one of the crazy people who's been hospitalized...you are threatening me with a horrible existence.
11
@10, exactly so. That's why the "it's all about mental illness" argument is so ridiculous. The people making it presume that (a) it's easy and obvious to tell when a person is mentally ill, and how severe that illness is and (b) the treatment for mental illness is also easy and obvious. Line 'em up, put your hand on the glass, and if the bulb turns red, give 'em a pill, and you're done.

The whole point of Liza Long's story is that there is often no known treatment. Nobody has an answer for cases like that, or like Adam Lanza, or many of the 60-odd million people with mental issues in this country. What treatments are available sometimes work, sometimes don't.

The alternative, as you point out, is to lock 'em up. But what's the threshold? If I'm suffering from depression, do I get locked up? What if it's my third time? What are the precise symptoms that get a padded cell instead of outpatient therapy? Who's going to make that call? How can you be so sure?

What works every time, however, is seeing to it that the mentally ill can't get their hands on readily-available firearms -- and not just through purchase.
12
@11 I once took a gun off my schizophrenic friend when she was in a psychotic state and dropped it off at the police. Her mom told me I shouldn't do it because my friend would be upset and she was indeed pretty mad at me once she got out of the hospital. I was willing to lose that friendship if it meant keeping a gun away from my psychotic friend. If she'd used it, she would have been devastated at hurting someone else.

FWIW - She got the gun because of the gun show loop hole.
13
Huge fan of stronger gun laws here, first and foremost. But Fnarf, though family members can and should make sure guns are not accessible to mentally ill family members, and they don't have to satisfy some third-party ethical guidelines to do so, you gloss over the purchase side. How do we go about identifying people too mentally disturbed to buy guns/ammo?

To the extent that @10, 11 were responding to me @9 (maybe not at all), I'm all for generous insurance benefits (outpatient therapy, medication, hospitalization) for mental illness. Just as with the poor being forced to the E.R. for treatment of physical ailments, the costs to society of untreated mental illness in terms of productivity loss, family disruption, and sheer human misery are staggeringly high and almost completely ignored by those whose lives are not immediately impacted.
14
@8 You are missing the best part of life.
15
@13 - I missed your @9 post. It took me a while to compose my thoughts into something semi-coherent and did not refresh the page before posting. You are talking about all the right questions when we talk about mental illness hospitalization in this country. There's also the issue of how to treat mental illness or behavior problems in children and teens. How much is developmental or environmental vs biology? Most psychiatric medications have not been tested for use in children and can cause horrible side effects. And we put less value on intensive talk therapy because we believe it doesn't have the same benefit as medication or CBT/DBT which can be tested (sorta).
16
@9, 10 and 11:
I have some of the same concerns you have, seeing the comments in several places. However I also think it is possible to have decent care for people with mental health problems, and that prompt diagnosis and person-centered support can make all the difference in the world. There isn't always a cure, or even an always-effective treatment. But sometimes there can be enough daily help and support that a person who might otherwise go over the edge, does not.

People who are over-sensitive or have sensory issues can have working/learning environments that are tailored for their needs, instead of being lumped in with everybody else and expected to cope with it day after day, just for a start. A child who is noise-sensitive, to whom loud noises feel like a physical blow, should not be expected to cope with school bells, intercom announcements or shouting people on a regular basis, because s/he will end the day feeling beaten and battered: anyone would become aggressive if expected to deal with that day after day! Similarly, some autistic people feel a burning pain when people look them directly in the eye, and yet we insist on it (well, I don't!) because otherwise we think the person is not paying attention. If I burned a person's eyes several times a day, every day, and yelled at them whenever they tried to avoid the eye-burning, I would expect that they might eventually get pretty aggressive.

We can't put children through this kind of daily torture and expect them to be friendly and well-behaved at the end of the day. Especially if they are actually smarter than most of the adults who are in control of their lives, and they know it.

If a child grows up in an environment where there are constant insults and pain that they are just expected to put up with every day, 5 days a week for hours and not fuss, it's hard to see how they can develop into a well-adjusted, calm adult. Similarly, if sensitive adults are in a highly unsuitable work environment that causes them constant pain and stress, then it's not unlikely that some, at least, of these adults will be unable to take the strain and may do violence to themselves or become aggressive.

Sometimes - maybe most of the time - it's about getting the help before anything goes so far wrong that hospitalisation or medication is necessary. Sometimes, it's about recognising that we may have to suit the environment to the person, rather than the person to the environment. Would we expect a paralysed person to manage stairs, just because they are what everyone else uses? Of course not. In the same way, we have to accept that sometimes we need to change the environment of a person who is not neurotypical to accommodate their specific needs, whether that means completely sound-proofing the room they work in, making sure they are only interrupted at pre-agreed intervals, or just providing a lava lamp. Hospitalisation should be an absolutely last resort.

But all that means paying enough attention that we are aware of what each individual needs in the first place, and the school or workplace having the will and the funding to put it into place. And it would really help if we could dismantle the social stigma that goes with mental health issues and just regard them as a medical issue like any other.
17
@16 I agree very much about creating an environment where a child can thrive. I don't know where I was reading the story about Adam Lanza in high school, but all the descriptions very much match a teen with sensory issues. However, I would disagree that our current model of mental health allows for "prompt diagnosis and person-centered support".
18
@11

It's easy to say "don't let the mentally ill get their hands on guns" but that means you must first identify who the mentally ill are, and that means you must have mental health services they can access. One of the major points of the original post was that the only way to get her son any real help now was go get him charged with a crime -- to "get him in the system". Because the current system is all about the criminal justice.

Closing the gun show loophole doesn't mean much if a normal background check won't turn up mental illness because it's never been diagnosed because they can't get themselves to a doctor.

Even just locking up all the crazies presupposes a system to diagnose them. And hopefully cost alone, let alone common sense, would preclude paying to warehouse all of them. It's cheaper and more effective to simply treat them.

The flaw in most of this rhetoric is "it's ALL about..." It's not ALL about anything. Mental illness is one piece of a big picture. The mental illness piece has a lot of moving parts. Addressing the problem means putting together many different solutions, hopefully not as a patchwork, but rather integrated.
19
@8: Yay! It's all about YOU! How nice for you.
20
@fnarf: presume that it's easy and obvious to tell when a person is mentally ill, and how severe that illness is

Actually, given a complete intake, it is easy to tell if someone suffers from severe and potentially dangerous mental illness. In fact, it's fucking obvious. Frequent bouts of violent rage accompanied by threats of suicide and murder? Paranoid and psychotic hallucinations? How much more obvious does it have to get?

The alternative, as you point out, is to lock 'em up. But what's the threshold? If I'm suffering from depression, do I get locked up?

No, obviously. But if it's your 3rd attempt at suicide? Or the 3rd time you've picked up a knife and threatened to butcher the family? Or the 3rd time you disappeared for 2 days and were found by the police wandering naked on the street? Then yes.

Psychosis isn't nearly as fuzzy as you seem to think. Sure, we've all see One Flew Over the Cuckoo's nest, and we recognize the potential for abuse. But the field of mental health has come a long way since that book was written.

The reason we aren't locking up psychotics - e.g., the asshole who burned up his aunt in her house and then raped/murdered the lesbian couple in South Park, the guy who axed a man to death on Union St in Capitol Hill, the lunatic who stabbed that young woman on Capitol Hill on New Year's Eve - has nothing to do with our inability to identify them as psychotic. In fact, they'd already been identified as such. The only reason they were roaming the streets is because locking them costs money.
21
Agreed sendr. And what happens when the mentally ill person won't admit they have a problem? How can you get them help when they insist they don't need it?

I've watched my mother destroy herself for years, she has a counselor but the counseling doesn't help her because she won't admit that something's wrong and she'll lie and twist the truth to suit her needs.

Hell she's still angry at us for calling 911 when she attempted suicide because in her twisted view it meant we plotting against her and trying to get her 'locked up'.
22
I read one backlash article, the Hanna Rosin one, and did not in any way think that it was saying we shouldn't care about mental health issues. I don't get this article if it's a response to that article. I felt sorry for Liza Long when I read HER piece, but did also agree with everything Hanna Rosin said -- http://www.slate.com/blogs/xx_factor/201…

-- which was a pretty narrow argument about the judgment of equating your son with a mass murderer in the manner that she did, along with some fairly nitpicky but still justifiable criticisms of the way she dealt with her kid, according to her own testimony. We all make mistakes, blah blah, but we should own up to them as well.

This article to which you point us has nothing to do with that at all, unless it's to say, essentially, "Long's situation is sad -- just like mine! Here's mine, and please feel the undeniable sadness now as I tell it -- and because of sadness (and my sadness = her sadness, so let my sad story persuade you on this issue) you can't say anything unflattering about this woman." But I would like to give the author more credit than that and assume she is responding to a different backlash article.



23
Just a note on health care for mentally ill patients--one improvement I would like to see is earlier availability of generic drugs. Quetiapine, an atypical antipsychotic commonly used for the treatment of several conditions (including schizophrenia and bipolar disorder), is sold as Seroquel by AstraZeneca. In my experience, Seroquel was extremely expensive, even with solid insurance, and although the US patent was set to expire in 2011, AstraZeneca received a pediatric extension that pushed its expiration to March 2012. While many psych meds are generic and affordable, others are not, and these drugs are NOT interchangeable. Some people will not tolerate or respond to any drug but the one that happens to be unaffordable. Aripiprazole, brand name Abilify, will be under patent until 2015. Abilify is also prohibitively expensive, from what I recall. If someone isn't enthusiastic about med compliance, I can't imagine them wanting to pay for these drugs, or even the copays if their insurance only chips in (say) 85%.

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