Twice in the past week, I’ve seen examples of how modern mental health has failed. What bugs me is that while folks will fuss on social media and fuss at reporters who cover examples of such failures, they rarely fuss at the ones responsible: the lawmakers.
Folks with mental problems were once kept in chains the attic or the basement. One of my own kinsmen was confined that way in the 1700s. Today he would be diagnosed with severe post traumatic stress disorder: his family was massacred during the French and Indian War, and he went on to avenge them. He even received a commendation from none other than George Washington for his service. He kept fighting during the American Revolution.
Sometime in his late 40s, when he no longer had enemies to fight, he continued fighting them in his mind. A teacher, a Bible scholar who entertained crowds with classical soliloquies, a man who knew which fork to use and which wine went with which dish – that man was mentally destroyed by the deaths of his family, and the deaths of others at his own hands.
His family chained him in the attic, where only one or two relatives were allowed to care for him. If he saw anyone other than those two, there was a 50/50 chance he would mistake them for a French-allied Indian or a Redcoat and try to kill them. They sometimes gave him rum to keep him from howling and screaming in the night.
Times were different then.
Another kinsman became one of the first residents of Staunton Asylum in Virginia; he “lost his mind” according to an anetbellum newspaper account, after his pregnant wife fell through a porch he hadn’t fixed. He rode back into town from a business trip and discovered everyone was at her funeral.
Contemporary accounts say he tore his clothes off and ran screaming into the woods, where he lived naked for several months, raiding gardens and trashpiles, eating raw chickens and crying in the night. One account said he would scream apologies to random women whom he called by his wife’s name. Eventually he was captured, and reportedly became a very friendly, sociable patient, one of those who was occasionally chained in the yard at Staunton to greet visitors and tourists “who came to see the lunatics.”
Yes. You read that correctly.
Again, times were different.
I was a little kid when I “accidentally” carried newspapers to the wrong floor of a local nursing home. It was terrifying; none of the patients on the “mental floor” were dangerous, but I understood immediately why I was not supposed to go to that floor. A male attendant escorted me to the nurse’s station with my newspapers, and a nurse had to unlock the elevator to let me out. That nurse called my mama, too, but that’s a column for another day.
Again, times were different.
Mental health care has always been treated about one step above animal control in rural and urban counties; it’s a necessary, distasteful, expensive inconvenience that nobody really wants to deal with. If you have ever tried getting help for a relative, you understand.
Years ago, the late State Sen. Tony Rand called me after another column on this subject. We rarely agreed on anything except our love of Southeastern North Carolina and our mamas, but that’s neither here nor there. He told me he’d read my column and wanted to let me know there was a move afoot to “reform” mental health in our state.
Listening to him, I could see some good points, but I told him flat out what he suspected: deinstitutionalization and gutting local mental health care agencies would fail.
It was already failing, and failing miserably, when COVID hit and people were diagnosed with mental problems almost as frequently as they were the China Virus. Before that, was the opioid epidemic, followed by the much-ballyhooed opioid settlement. Specialized companies happily took over addiction treatment and mental health for rural counties that were unable to attract or keep mental health staff. It made sense on paper, especially since addiction and mental health often crosspollinate, with one problem leading to the other.
But what has happened since then?
Nothing good.
This week in my crime blotter, a young man was arrested after allegedly attacking another man and trying to steal his vehicle. And another man was wandering around an intersection carrying a machete. Reports and individuals said that both men needed mental help.
Either one of them could easily have ended up in the same condition as a severely handicapped man I wrote about years ago. Only his mother could handle and understand him. He was a big man – more than 6’4”, strong as an ox, and almost non-verbal. He was only violent when he got frightened.
When his mom passed away, he ended up attacking two policemen out of fear. They shot him. It was justified, but one of the officers hung up his badge a short time later. The other was never the same.
Sadly, there are some folks who need to be in institutions for treatment of their mental health – not a local hospital, under police guard, while criminals run loose. It’s shameful that so many get so far down that law enforcement gets involved. It’s not fair to the patients or the cops.
But when there are no local mental health resources and no mental hospitals, and the solution is always to throw drugs at someone who is already in an altered mental state, then trusting them to take their drugs as scheduled.
Our state once led the nation in humane treatment of mental health. But asylums became passe’. Advances in medical science made re-entry into society possible for more people, and for some folks medication truly can make all the difference in the world.
But not for all.
Some folks need a safe place, where they don’t have to deal with the cruelty and insanity of the world while getting themselves straightened out. Some of them simply can’t deal with the real world with the best of drugs.
For the love of all that’s good and holy, lawmakers and the medical field need to realize that mental illness and drug addiction are two different mules, and should not be harnessed to the same cart.
Mental illness is always going to get the short end of the stick, since there’s no profit in it. It’s harder to treat than addiction.
That’s not to say addicts who truly want treatment don’t deserve a chance, but I’m of the opinion that increased penalties for drug dealers and treating inmates like convicted criminals might help reduce that problem, too.
There are treatment programs whose administrators who drive pickups and used cars with lower recidivism rates than those with multi-million-dollar buildings, professional PowerPoint programs and a handy list of local officials who don’t want the hassle of dealing with federally mandated addiction or mental health treatment.
We need folks who truly care about those who are addicted to drugs, and we need folks who truly care about those with mental illnesses. Both treatments sometimes must work hand in hand but throwing them all together doesn’t work.
Times have changed since the days of chaining crazy uncles in the attic or subjecting “hysterical” women to ice baths. No more do we lobotomize folks for mourning the loss of a loved one. Poorly-behaved young’uns don’t get electroshock treatments, although I know of a few politicians who might benefit from such.
Times have changed when it comes to mental health care – and they need to change again.
