Changes in Mental Health Care Contribute to Shootings

I grew up watching the Chicago Cubs. Almost half a century later, I can still rattle off their 1969 infield (“SantoKessingerBeckertandBanks: the infield, third to first”) the same way broadcaster Jack Brickhouse did at the start of every game. Wrigley Field offered such intimacy that those seated in the outfield had to be instructed not to ask for autographs during the game.

Occasionally, exuberance got the better of a fan, who would hop down the wall and run onto the field, stopping play until they could be removed. It happened so often that WGN-TV and Brickhouse developed a policy of refusing to show the trespass, using the delay instead to remind viewers that this path to infamy was now closed. That, plus a bit more fencing, slowed the frequency.

And so, I admired Douglas County Sheriff John Hanlin’s refusal to name the gunman last week in Roseburg. It is certainly too late to unring that bell, but his attempt to deny the young man any infamy may have altered what slant the press coverage took. This newspaper published photos of the nine victims who hadn’t done any killing that day on Page One, larger and ahead of the one who had.

The next day, I sat on an airplane beside a TV cameraman sent from Los Angeles to cover the story. No motive for the shooting had been revealed, but he was only too happy to share his thoughts. “I have my own theory, for what it’s worth.” He paused, in case I wanted to calculate it. “I think the guy was batsh@t crazy. End of story.”

Meanwhile, the commentariat was gearing up, as it always does, around the central question that comes up each time. “What are we going to do?” The political left wants more gun control. The political right wants — for wont of a better name — better profiling.

New York Times columnist David Brooks echoed on PBS Newshour what so many others have said: “… the profile of these guys who do it is very similar, and it is in this case, alienated young guy with loneliness issues and self-worth issues. If we looked around for young men like that in our society, maybe we could do something there.”

Brooks seemed to be identifying a very large group of people. Brooks was being careful in the way that my flightmate wasn’t. The profile being proffered includes — or at least implies — mental illness.

I don’t know many twenty-somethings who don’t attach themselves to some sort of magical thinking, whether it’s winning the lottery or dating Taylor Swift or getting a socialist into the White House. Learning to separate idealism from delusion is part of growing up. Worrying about that distinction is what parents do every day.

Only a person beholden to crazy notions would relish notoriety they won’t live to enjoy. In this way, America has built a cult of young men devoting themselves to some eternal prize — our own version of 70 virgins awaiting them in paradise. But don’t stop there. What rational need do any of us have to see the killer’s face, much less know his name? There’s enough irrationality for everyone here.

Crazy is always among and within us. But when does it become dangerous and who decides? This is the unanswered question embedded in the profiling solution being offered.

President Jimmy Carter on May 15, 1979 wrote this, introducing his Mental Health Systems Act: “It seeks to assure that the chronically mentally ill no longer face the cruel alternative of unnecessary institutionalization or inadequate care in the community. It provides local communities with more flexible federal support for mental health services and places a new emphasis on the prevention of mental illness.”

In 1979, between 1.5 and 1.9 million Americans were institutionalized because of chronic mental illness. Our own Ken Kesey illustrated the inhumane treatment best in “One Flew Over The Cuckoo’s Nest.” Carter sought to fix it, but the funding never followed.

Carter signed the bill into law on October 7, 1980. A month later, Ronald Reagan won the White House by a landslide. He repealed the act 10 months later, cutting mental health care funding by 30 percent and giving states block grants instead. This sequence of events removed “unnecessary institutionalization” but failed to replace it with “adequate care in the community.”

They contributed to where we are today.

If you’ve ever cared about anyone with severe mental illness, you know how difficult it is to hew a balance between autonomy and safety. They want their freedom, as we all do. Sometimes they “forget” to attend therapy, or to take their medication, or to not mix it with alcohol, or to lock their door at night, or to not walk through others’ unlocked doors.

Involuntary commitment to care that sacrifices a person’s autonomy is used now only when the danger to themselves or others is deemed “imminent.” Too many communities, including our own, have learned “imminent” often has a heartachingly different working definition: “too late.”

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Don Kahle (fridays@dksez.com) writes a column each Friday for The Register-Guard and blogs at www.dksez.com.