Following the shootings at Sandy Hook Elementary School in Newtown, Conn., more than a year ago, while President Obama and congressional Democrats were blaming the violence on guns, Republicans sought out and asked the only clinical psychologist in the House to look into the connection between the sorts of mass shootings that have plagued the country in recent years and the state of the nation’s mental health care system.
Rep. Tim Murphy, Pennsylvania Republican, was elected to Congress in 2002 after a stint in the Pennsylvania state Senate but was a practicing clinical psychologist for 30 years and authored two books on the child psychology. He was the obvious choice for the assignment and took it very seriously, spending a full year researching and interviewing experts on how the current system is failing and developing reforms to improve the way the nation deals with the mentally ill.
The resulting Helping Families in Mental Health Crisis Act would overhaul a failing and incredibly expensive mental health care system that focuses on making folks who’ve had a bad day happy while ignoring the severely and potentially dangerous mentally ill.
What Mr. Murphy discovered is that while we spend $203 billion annually, including $125 billion in federal money, on what he found can only loosely be described as mental health care, much of what we are doing is wasteful, misdirected or even counterproductive. The perhaps 11 million men and women with truly severe mental problems who too often lead to violence, arrest, prison and suicide are often ignored in favor of minor mental health issues.
Therefore, some 300,000 of those diagnosed as severely mentally ill aren’t in treatment facilities, but in our jails and prisons. In fact, in every single state there are more people diagnosed as severely mentally ill in penal institutions than in all the state’s public and private treatment centers. An additional 250,000 live on the streets, and about 38,000 of them a year commit suicide.
These are the paranoid schizophrenics, the seriously bipolar and others who often can’t cope with life in the real world and who too often become a real threat to themselves and to others. Our country provides them little help or treatment until it is too late.
Many would have been hospitalized before the “reforms” instituted beginning in the 1960s closed down many of the nation’s treatment centers and refocused mental health care spending on problems that seemed more tractable.
Jails and prisons aren’t set up to deal with mental health issues and many unfortunates come out in even worse shape than they were when they were sentenced. Take 62-year-old William Spengler, who had spent 17 years in prison for murdering his grandmother. He found life on the outside difficult and couldn’t stand his sister. On Christmas Eve 2012, Spengler ambushed and fatally shot two firefighters called to a burning house, where police later found the charred remains of his murdered sister. Cornered by police, Spengler killed himself, but left a letter in which he wrote, “I still have to get ready to see how much of the neighborhood I can burn down, and do what I like doing best, killing people.”
Spengler had spent a good deal of time in prison, but he was not a criminal in the standard sense of the term. Rather, like Adam Lanza in Connecticut; James Holmes, charged in the killing of 12 theatergoers in Aurora, Colo.; and Aaron Alexis, who killed 12 at the Washington Navy Yard, Spengler was very, very sick, but was wandering free without treatment.
Mr. Murphy’s reforms include much more, but would essentially refocus mental health care spending on those who truly need intervention, allow the institutionalization of the severely mentally ill, and encourage assisted outpatient treatment, which would require the severely mentally ill who can nevertheless cope if they take prescribed medications to take them or face institutionalization.
Assisted outpatient treatment works. The severely mentally ill receiving treatment in states with such programs in place fare very well, with a 55 percent drop in suicides, a 47 percent decrease in attacks on others, a 74 percent reduction in homelessness, 83 percent fewer arrests and an 87 percent decline in incarceration.
In spite of the evidence, patients rights advocates are opposed to such programs, and many continue to insist that there is no such thing as a mental illness anyway. After Sandy Hook, a major mental health organization called the National Rifle Association to protest calling Lanza “crazy” in describing his killing of 26 people. Mr. Murphy even discovered that the federal government is using taxpayer money to subsidize these groups. His bill would cut that funding off.
Mental health laws can be abused and have been in the past, but that is not a reason to deny treatment to those who need it, especially when they might pose a threat to themselves and others. We shouldn’t demonize the mentally ill, but as 38,000 suicides a year demonstrate and the fact that tens of thousands end up as victims rather than perpetrators of violence, denying them treatment or arguing that they aren’t really ill does little to either help them or protect the rest of society. Mr. Murphy’s bill is designed to fix a system that has failed them, as well as society as a whole.
Mr. Murphy wants to fix the problem, and in Congress these days, anyone who actually examines a problem and tries to solve it is someone worth some attention. His Helping Families in Mental Health Crisis Act may not be perfect, but it’s more than just a step in the right direction, and deserves serious consideration.
David A. Keene is opinion editor of The Washington Times.