All family members of loved ones with severe mental illness are cringing today. From the beginning of the news tsunami about the Tucson tragedy, we have suspected what is now emerging as the true story. After the posting everywhere of Jared Loughner’s menacing mug shot, we have known for sure. To invoke the title from Dr. E. Fuller Torrey’s recent book, Jared Loughner (allegedly) committed a heinous insanity offense.
Thirteen people were wantonly assaulted in Tucson. Among the dead are a respected Federal judge and a darling 9 year old girl. Most prominent among the wounded is an attractive and admired Congresswoman. These victims are—were—beautiful people, functioning at the highest levels, full of promise for great futures. Who could not be moved by their unspeakable tragedy?
And the perpetrator? The contrast could not be sharper. His menacing mug shot starkly shows a transfixed, tortuous face, eyes wide with madness, lips smirking in sick self-satisfaction, head bald and unnaturally shiny. Let’s face it. He looks exactly like what many suspect he is: deranged.
In this tragedy’s wake, partisans have been screeching political calumnies against unrelated third parties, ascribing direct or indirect responsibility for this violence for which no responsibility can truthfully be attributed to any other than the shooter and his sadly troubled mind. As a matter of civics, the carpings have been a disgrace. But more to what really matters here, they have been, for family members with loved ones battling serious mental illness, particularly difficult to bear. They do nothing to clarify the truth of this matter, but only to distract, obfuscate, polarize, and stigmatize. After the screaming is over, the partisans will have their victors and vanquished. But those with severe mental illness will not so easily overcome the society’s renewed hysteria about “wacks”, “schizos”, “nut jobs”, and “psycho” killers. Stigma will be stoked again. Those who suffer it now may, alas, suffer it more.
Contrary to the recent pontifications of officials and commentators who should know better, this case is not about extremism, hate speech, incendiary public rhetoric, political ideology, Arizona’s social climate, or gun control. As Dr. Jeffrey Lieberman of Columbia University’s Psychiatry Department said last night on The Charlie Rose Show, such talk is “a red herring”. Rather, it is about America’s sorry state of mental health care. Jared Loughner is a young man clearly with a severe mental illness, a mind tormented probably with schizophrenia which was insufficiently identified, screened, diagnosed, or treated. With proper care Loughner would not have come to this. Before he killed so many victims, he seems himself to have been a victim—a victim of a mental illness beyond his control and even self-awareness, compounded by insufficient care in a stigmatizing society that did not, could not, or would not get him help when he needed it most.
For his crimes a case can be made that the assailant should pay the ultimate penalty. And yet, hard as it may be at this awful moment of angst, grief and anger, can we spare a thought for this disturbed man and his devastated family? Yes, Jared Loughner has committed an insanity offense. But well before this week’s tragedy in Tucson, is it possible that America’s mental health care system–indifferent, insufficient, inadequate–first committed one against him?
“Mental care for the most needy is a social disaster. So says compulsory treatment advocate Dr. E. Fuller Torrey, who calls it “among the greatest calamities” (Torrey, 2008, p. 1). Why? Torrey says that violent crimes by untreated deinstitutionalized individuals are increasing. Four million Americans have severe psychiatric disorders. Ten percent of these (400,000) are the most problematic who, if not treated, tend to be homeless, jailed, or victimized. One percent (40,000) are “overtly dangerous” (Torrey, 2008, p. 5-6). Torrey’s controversial book, The Insanity Offense, grimly cites multiple “preventable tragedies” caused by this 1% cohort.”
–Excerpt from “Outpatient Commitment: A Philosophical Dilemma for Families”, by T.H. Pyle (2010). To read the entire paper, click here.