Introduction
This blog post was previously posted not long after the shooting occurred, but then withdrawn.
Original Blog Post
The killing of a six people and the attempted killing of a member of Congress as just happened in Tucson, Arizona is preventable. The mind is a terrible thing to waste. The current ongoing debate over a more civil discourse in society is a gigantic red herring.
First, I would like to recommend a great article that appeared on 1/12/2011 in the Wall Street Journal’s excellent Opinion section by E. Fuller Torrey titled “A Predictable Tragedy in Arizona”. If this author is right, then such a tragedy is also preventable. This article as well as others that were published these days list a dozen or more similar cases of a mentally ill person committing horrible acts (e.g. Virginia Tech University). Moreover, it appears that a significant percentage (perhaps as high as 10%) of all homicides in the US are committed by “individuals with seriously mental illnesses”. Thus, Dr. Torrey concludes if serious mental illnesses remain untreated “[i]t is not a question of if such tragedies will occur but rather when and how often.”
Key Issues Related To Mental Illness
In my opinion, following key issues need to be addressed:
1) The centuries old taboo about mental illness in our society
2) Mentally ill individuals ought not to be stigmatized
3) About 40 years ago, scientists, doctors, and society thought it was human progress to discharge mentally ill people in large numbers from mental institutions and to close down mental institutions.
4) It is possible that there is still a widespread perception among people that the treatment for seriously mental illness are crude/harsh/brutal and mind/personality altering.
5) Has psychiatry deteriorated into a pseudo science?
6) Does mental illness run in families?
Mental Illness - A Huge Taboo And Stigma In Our Society
Yes, we live in the 21st century with all its scientific, medical, and technological advances; equal rights and opportunities for women; the best care in the world for injured soldiers; ending of racial discrimination; the non-discrimination and acceptance of homosexuals; recognition of and assistance for physically and mentally disabled individuals etc. However, as far as mental illness is concerned we still hold rather medieval and superstitious beliefs or fears about it.
This taboo of mental illnesses in our society is pervasive, severe, and unhealthy. People feel ashamed or uneasy to talk about it. People try to deny or conceal any mental issues they may have for fear of repercussions. Why do we call a psychiatrist a ‘shrink’? A person known or perceived to have mental health symptoms is stigmatized and ostracized. What about parents with a mentally ill child? Do such parents readily admit to that or hide it? How do e.g. neighbors respond if they know of such a child?
I would also venture to guess at this point that because of this deep-rooted societal taboo funding for research into the causes and treatment of mental illness is probably disproportionately insufficient.
Failed Mental Health Policies
I remember well how it was almost celebrated in the 1970s or so when, e.g., mental institutions in Italy were closed and its patients were discharged to live among the population. Since the Dark Ages, mental institutions were seen as dungeons to permanently lock up people with mental issues. Yes, it was time that people with rather harmless, mild mental illnesses were integrated to live a normal life within our society. However, as it happens so often in human history, the proverbial pendulum swung too far and the cognizance and correction of the negative consequences takes far too long. Significant numbers of seriously mentally ill persons appear to be among the homeless and among the prison population and they are untreated.
In the case of the Arizona Shooter, it is reported that Arizona is among the worst states when it comes to public mental health services: Too few hospital beds and outpatient clinics to treat mentally ill people.
For now 40 years, it has been mistakenly ignored or neglected that a significant percentage of mentally ill people, if untreated or insufficiently treated, are potentially violent or dangerous to others or themselves. Of course, not every seriously mentally ill person is a potential killer and it is probably only a minority of seriously mental ill persons who eventually commit horrible acts.
Seriously mentally ill people, who deny, refuse or neglect treatment, may need to be monitored closely or need to be kept in a mental institution. Court-ordered mental evaluations or treatments may need to be issued more often.
Psychiatry A Pseudo Science
There are people who argue that. One of their arguments is, e.g., that the criteria for diagnosing mental illness as stated in the Diagnostic and Statistical Manual of Mental Disorders are overly broad and vague that almost anyone could be considered to be mentally ill to some degree.
It is a well-known tendency by doctors to expand the numbers of real and potential patients. This is good for business.
Mental Illnesses Run In Families
I suspect this could be a little known fact that there is an increased probability if a parent has a mental illness that an offspring might acquire one too. Why does the general public not learn more about this? How much do psychiatrists know about this?
There is, e.g., a suspicion that the father of the Tucson shooter is perhaps mentally ill as well.
One Flew Over The Cuckoo’s Nest Or Horrors Of Psychosurgery
The deterrence effect on the general public of radical medical methods used in the not so distant past to treat mentally ill should not be underestimated.
Older generations may remember this famous and remarkable 1975 movie starring Jack Nicholson titled “One Flew Over The Cuckoo’s Nest”. This movie was filmed at a real psychiatric hospital. This film featured first a horrible electroconvulsive therapy and then an even scarier lobotomy applied to Jack Nicholson, who in fact was not even mentally ill. Both therapies were common in the 1940s and 1950s. The inventor of lobotomy even received a Nobel Prize. Thus, this film illustrated both horrible medical therapies resulting in the actor becoming ultimately an unresponsive idiot and the danger of the wrong person receiving such an irreversible treatment. Such perverse therapies like lobotomy were also applied to a number of prominent people, e.g. the sister of John F. Kennedy and an older sister of Tennessee Williams.
Recent movies in which mental illness played a central role, i.e. Beautiful Mind (2001; starring Russel Crowe; 4 Academy Awards) and The Aviator (2004; starring Leonardo DiCaprio; 5 Academy Awards) depict an unfavorable outcome of what medicine can achieve. In Beautiful Mind the protagonist, a first rate mathematician and Nobel Prize winner in economics, on his own aided by his wife defeats his demons. In the Aviator, a biographical drama of the life of Howard Hughes, one of the wealthiest man at the time and a very intelligent man was not able to overcome his mental illness.
Even the treatment with current pharmaceuticals is not without controversy, because of its sometimes profound (side)effects on the patient. Refusal to take the medication is not uncommon, e.g. John Nash of Beautiful Mind fame is said not to have taken any medication for decades, because they interfered with his intellectual capacity and emotional life.
Thus, it is of paramount importance to have public campaigns to inform the general public that therapies for mentally ill have since then come a long way. It is also for this reason, why mentally ill individuals or parents may hesitate to seek help.
Public Campaigns To Increase Awareness Of Mental Illness Are Long Overdue
Acute awareness and education about mental illnesses need to be widespread among young and old. There are so many effective public campaigns out there about all kinds of non-mental illnesses, e.g. how to recognize stroke symptoms and that immediate medical attention can save the victim; drug abuse and much more. There are automated external defibrillator devices now installed almost everywhere in public spaces and people are encouraged to learn how to use them, because a life can be saved. Why are there no public campaigns for mental illnesses?
Public campaigns about mental illness would most likely also help mentally ill persons to become more aware of their condition and may persuade a mentally ill person to voluntarily seek help. Is there actually something like an Alcoholics Anonymous for mentally ill persons?
Maybe we need an AIDS or Green Peace like campaigns to heighten awareness. Is there any prominent Hollywood actor who would come out like the death of Rock Hudson helped in the AIDS awareness or the struggle and death of the Superman actor Christopher Reeve and so on?
Why do we not have 5 K runs for mental illness? Why is there no Susan G. Komen Foundation for mental illness (Susan, pardon me for singling you out)? The First Lady Michelle Obama campaigns against obesity, why not mental illness?
Mental Illness Is A Long Process
I would guess, as with other diseases, the earlier an individual with a mental illness can be helped or treated the better.
Mentally ill serial killers or other killers do not happen overnight. As we have learnt from many previous cases, seriously mental ill individuals show warning signs for others to notice often long preceding the commitment of horrible acts. Unfortunately, with mentally ill persons, I believe, they are sometimes not aware of their situation (Anosognosia), thus they are unable to seek help for themselves. If true, this would suggest it is the responsibility of anyone who encounters or who is close to a mentally ill person to try help in some way. Of course, there are the issues of denunciation of or vengeance against an innocent/healthy person in a free society. How to balance the respect for individual freedom and how to respond to a possibly mental ill person is difficult, but there is a need to debate the issue.
The Arizona shooter was a 22-year-old man who still lived with his parents. What did the parents know about the condition of their son? Did the parents not notice that something was wrong with their son? Were the parents too afraid to contact mental health services (perhaps they even felt threatened by their son)? Did the parents ever seek help for their son? Were the parents even aware of any available help like mental health services?
A college that the Arizona Shooter attended suspended him, but allowed him to return if he had received a mental health evaluation. Was this enough? Did the college notify mental health services or did the college offer any mental health service to the Shooter or parents.
Police officers need to be trained to recognize possible mental illness when they deal with a person. Perhaps, police officers also need to consider whether they bring in a trained mental health service professional if they sense mental health issues. Police officers are sometimes the first to encounter a person and to recognize a possible mental health issue.
Happy End
If we rid society of this huge taboo and stigma about mental illness, if we offer appropriate mental health services to mentally ill and their relatives, friends etc., then killings like the one occurred last weekend in Tucson, Arizona will become very rare or almost extinct.
I have full confidence in the acceleration of medical progress we are already seeing. Perhaps in a few years, we will have novel treatments of mental illnesses as our understanding of brain chemistry, genetics, neurology etc. rapidly advances.
I am convinced, we are on the verge to be able to cure mental illnesses.
