The other conversation: America’s decrepit mental health infrastructure

Administrative segregation prisoners take part in a group therapy session at San Quentin state prison in San Quentin, California, June 8, 2012.
Administrative segregation prisoners take part in a group therapy session at San Quentin state prison in San Quentin, California, June 8, 2012.
REUTERS/Lucy Nicholson

Human catastrophes rarely have a single cause; society and psychology are both far too complex to allow for simple, linear explanations. So while a mass shooting may bring our thoughts to America’s criminally negligent gun laws, we can’t allow ourselves to stop there. Violence has other roots beyond access to the tools of violence.

There’s too much that we don’t know about the alleged Newtown shooter to speculate about his mental state. But what we do know is that the perpetrators of other, similar shooting rampages have often been severely mentally ill. A 2000 New York Times study of 102 killers, in shootings which occurred between 1949 and the 1999 Columbine attack, found that “[a]t least half of the killers showed signs of serious mental health problems.” To that, Mother Jones adds, “the majority of mass shootings are murder-suicides.”

Mental illness isn’t just a criminal justice problem or a regulatory issue, and we can’t treat it like one. But for the past few decades, that’s exactly what we’ve done: Instead of treating people with serious mental illnesses, we’ve shoved them to the margins of society where they could be easily ignored. According to a 2006 report [PDF] from the federal Bureau of Justice Statistics, more than half of the country’s prison population suffers or has suffered from mental disorders. Only a fraction of that population receives treatment during their incarceration.

Mental illness is also endemic to homelessness. According to the statistics [PDF] from the Substance Abuse and Mental Health Services Administration, nearly two-thirds of the chronically homeless in America “have experienced lifetime mental health problems.”

The roots of America’s poverty-and-punishment solution to mental illness can be traced back to the mid-twentieth century and the once-promising trend of deinstitutionalization. This Kaiser Commission report [PDF] is a good primer on the history of the movement. In the late fifties and early sixties, civil libertarian activists challenged the involuntary commitment of hundreds of thousands of Americans in mental hospitals, saying that it violated civil liberties and that the hospitals themselves often subjected patients to horrible conditions.

At first, according to the report, the downsizing of mental hospitals was accompanied by a serious effort to create infrastructure for a national community health clinic. But a number of institutional, economic and political pressures gradually eroded the burgeoning program. The killing blow came in the Reagonomics area, when President Ronald Reagan dismantled much of the federal welfare state, leaving countless mentally ill Americans without access to income or housing. Federal funding for community mental health clinics dropped by 25%.

Trying to render the mentally ill invisible—or, worse, trying to funnel them through our increasingly corpulent and barbaric criminal justice system—won’t mitigate the problem. Nor will it do any good to stigmatize mental illness, or sensationalize the horrific actions of a small handful of individuals. What is needed here is real support and real treatment.

Tune into The Ed Show at 8 p.m. and 11 p.m. EST to see Ed Schultz talk about America’s mental health care crisis.