Crazy thinking.

In my high school health class — which, I must add, was an excellent health class taught by one of the world’s great straight talkers — we had units in, let me think: quack medicine, sex and reproduction, birth control, STDs, drugs and alcohol and basic self-preservation. Probably some more stuff too, but those were the biggies.

I’m sure AIDS has been added to the curriculum by now, as well as homosexuality. What else? Take your pick. Hep B? The perils of piercing? Our health seems to be in such peril.

It was a one-semester class. I have a suggestion: Make health a full-year deal and devote at least a month to studying, discussing and drilling on mental illness. Make sure every kid who makes it through the tenth grade understands depression, bipolar illness, obsessive compulsion and schizophrenia. Among other perils of the chemically unbalanced.

Why? Oh, just reading the accounts of the carnage in my hometown earlier this week, the guy who climbed onstage at a crummy rock club and killed four people. Immediately afterward, I thought what probably most of the nation thought: What a loser. Then I read the third-day stories, and the facts became all too familiar. The Dispatch won’t let you in without paid registration, so let me quote a few passages:

Initially, Gale was friendly and well-liked within their circle of friends, Johnson said. … “But after a while something happened,” he said. “He just kind of snapped. He went from being a cool guy to being a guy you didn�t want to be around.” … He and friend Jeramie Brey said they distanced themselves from Gale six years ago because his behavior drastically changed and he began to scare them. … Once, Gale showed up at Brey�s house and said he wanted to share some songs he had written. The pages of lyrics he wanted to sing, Brey recalled, were copied from Pantera. Gale argued that they were his. “He was off his rocker,” Brey said. “He said they were his songs, that Pantera stole them from him and that he was going to sue them.”

The shooter, Nathan Gale, was 25, which means his abrupt behavior change came at 19, the bullseye age for the onset of psychotic mental illness. Let’s check off the symptoms — social dysfunction, obsession, paranoia, all apparently left untreated for several years. This is just Nance here, diagnosing from the comfort of her armchair on the basis of a few newspaper articles, but I’d be willing to bet Nathan was at least a borderline paranoid schizophrenic, or may have been what they call schizotypal, more or less the same thing.

We had a case not too different here a few years ago. Guy walks into his sister’s living room and opens fire, killing all four people in the room. Why? “I thought they were talking about me.” In this case, in the Gale case, in a million other cases, I thought the same thing: Didn’t anyone figure out this guy needed to see a psychiatrist? The guy in Fort Wayne installed an electronic lock on his bedroom door and changed the combination daily, so paranoid was he about his room being entered. No one thought this was anything more alarming than an eccentricity.

The Columbus sniper of a few months back? Another lost soul, a paranoid schizophrenic who stumbled through the gaping holes in the mental-health safety net: Jen Frisby said she dated Mc-Coy for several years. The relationship ended more than two years ago because of his erratic behavior, she said, including his stated fear of the FBI.

I’m reminded of something a health ethicist told me once: “If a kid falls into a well, we’ll spare no expense or effort to get him out. But buy him glasses so he can see the well and not fall in? Forget it.” That’s the way it is with crazy people, the worst impulses of civil libertarians and conservatives dovetailing to turn them back out into the world untreated or badly treated or refusing treatment, until one climbs onstage at a rock club and kills four people because his favorite metal band broke up. Also, they were stealing his lyrics. I ask you.

Of course, even the people who know better don’t help. The prosecutor in Columbus wants to give the sniper the hot shot. The public demands it, I’m sure. It’s so much better to make a problem go away than deal with it.

Posted at 6:40 pm in Uncategorized |
 

17 responses to “Crazy thinking.”

  1. Carmella said on December 10, 2004 at 7:30 pm

    …yeah, that guy in FW had shot and killed his parents when he was in high school, then walked to the bus stop. THEN his sister let him move in with her and her kid(s), THEN he shot the people in her living room. When was the red flag going to get bright enough for her?!?!?

  2. brian stouder said on December 11, 2004 at 12:23 am

    “That’s the way it is with crazy people, the worst impulses of civil libertarians and conservatives dovetailing to turn them back out into the world untreated or badly treated…”

    BZZZZZT!!

    I realize that the word “conservative” on this blog is defined as synonymous with “nincompoop” or “block head”, always and forever….

    but I think that the “deinstitutionalization” thing back in the ’60’s and ’70’s was a liberal/left thing, along with the libertarians.

    But be that as it may – agreed – one doesn’t have to go far to see people who need lots of help and structured living, and indeed I agree that society ought to provide it.

    The implementation of any such plan would certainly entail lots of difficult decisions and indeed – unpleasant realities. Take any of these souls who ended up violenty imploding; if you could turn the clock back and institutionalize them BEFORE they snap and kill, then the uneasy notion will be – we are ‘punishing’ eccentricity, and not really “treating” anyone.

    Afterall, one person’s treatment and care is another’s imprisonment

  3. Nance said on December 11, 2004 at 6:34 am

    In this case, Brian, I was being a strict constructionist with the c-word. Deinstitutionalization had legitimate science behind it — newer and better psychotropic drugs meant you didn’t have to sedate the psychotic into dozing-and-drooling lumps at some regional hospital and pay a few nurses and orderlies to clean up and maintain security. The better meds meant you could actually clarify a person’s thinking, keep them from seeing bats dive-bombing their car on the interstate and hold out the promise of a better life outside the hospital. As long as they took their meds.

    (The fact these drugs had their own awful side effects were a footnote, usually filed under “nothing’s perfect” by people who didn’t have to endure them. This is sane thinking; it’s difficult to imagine how hard this is for a psychotic.)

    So science offers a cure-of-sorts, and liberals and civil libertarians appalled by the idea of holding people against their will and the conditions in these hulking Gothic hospitals on the hill (see “One Flew Over the Cuckoo’s Nest,” a signal text of the time), pushed hard for deinstitutionalization and replacing the old nuthouses with community mental health centers, essentially big outpatient clinics where people could be evaluated once every six months or so, resubscribed to their meds, given a little “support” and otherwise treated like a well-made car.

    Here’s where the conservative lawmakers step in, who were in their ascendancy with the election of Ronald Reagan. They only have one line in this tragedy: “Fewer people on the public tit? One more line out of the budget? Tax relief? Sounds good to me!”

    The liberals/libertarians — many of the former possessed of the romantic notion of the time, that craziness is the only logical response to an insane world, and many of the latter new to this public-policy game, and anyway used to dealing mostly with theories on paper rather than people in the flesh — were wrong in dozens of little ways. They didn’t envision just how crazy crazy people could be, how they didn’t necessarily want to be cured, hated their new meds as much as the old ones, were as likely to go off them as stay on. Prison-like conditions in some of the old hospitals were still fresh in memory, and so we saw the rise of the truly insane idea that life in a cardboard box over a subway grate was no worse than life in a locked ward under Big Nurse.

    (I realize I’m oversimplifying. But this is the comments, after all.)

    Again, the conservatives just make a short appearance on stage: “So you don’t need so many community mental-health centers? Sounds good to me!”

    The first approach — deinstitutionalization — was a good idea that required an enormous publicly funded defense that never came to pass. Much of this is only something you can see in hindsight, I have to add. If you boiled it all down to one line, it would be “It seemed like a good idea at the time.”

    I favor deinstitutionalization, and if we’re not going to have the backup we need, then we certainly need to educate people so they can self-police. When Joe puts an expensive lock on his door and changes the combination daily, it might be a harmless eccentricity, but it’s probably paranoia. (And yes, Carmella, you hit on the key event in the family history: “Hmm, he killed our parents 10 years ago. Maybe this is a sign that something’s…wrong.”)

    Perhaps this is something beyond the capacity of the human heart. Perhaps, if you’re a mother, you don’t want to face the fact your boy is schizophrenic and so you deny, deny, deny. That’s why I get pissed at the people who should know better, who could turn these tragedies into the so-called “teachable moment” to help people understand what’s going on here. But it’s only a handful of mental-health advocates, the random judge and, of course, the vast resources of NN.C. Grrrr.

  4. James said on December 11, 2004 at 6:50 am

    “… but I think that the “deinstitutionalization” thing back in the ’60’s and ’70’s was a liberal/left thing, along with the libertarians.”

    It’s my vivid recollection that this happened in the Reagan years, which would be the 80’s, which would place it squarely on the watch of conservatives.

    Aren’t you conservatives supposed to be all for personal responsibility? Than take responsibility for this one…

  5. humblereader said on December 11, 2004 at 7:26 am

    In Indianapolis this past summer, a man walked down the street of a residential area armed with assault weapons. When the dust settled, he, his mother and a police officer lost their lives. Four other police officers were seriously injured. Had he been on the street at an earlier hour, the results could have been more tragic.

    A few weeks later, a campus police officer lost his life when a man diagnosed as mentally ill shot him.

    Treatment and resources for these and other individuals suffering from severe mental illnesses offered in the past are no longer available. It’s a clear-cut example of public policy gone awry. The initial savings are offset by the expense of not taking care of the problem before it gets out of hand.

    Let’s remember that this is the 21st century. Dorothea Dix, the Quakers and like minded reformists in the 19th century knew that society had to treat it’s weakest with compassion. They found the best treatment medicine and science could provide. It’s the least we can do for the ill and for ourselves.

  6. humblereader said on December 11, 2004 at 7:27 am

    In Indianapolis this past summer, a man walked down the street of a residential area armed with assault weapons. When the dust settled, he, his mother and a police officer lost their lives. Four other police officers were seriously injured. Had he been on the street at an earlier hour, the results could have been more tragic.

    A few weeks later, a campus police officer lost his life when a man diagnosed as mentally ill shot him.

    Treatment and resources for these and other individuals suffering from severe mental illnesses offered in the past are no longer available. It’s a clear-cut example of public policy gone awry. The initial savings are offset by the expense of not taking care of the problem before it gets out of hand.

    Let’s remember that this is the 21st century. Dorothea Dix, the Quakers and like minded reformists in the 19th century knew that society had to treat it’s weakest with compassion. They found the best treatment medicine and science could provide. It’s the least we can do for the ill and for ourselves.

  7. Dave Reilly said on December 11, 2004 at 8:43 am

    I think Nance describes the development of the situation exactly right. Progressives in the field started down a path. Conservatives running the government during the Reagan years looked at what was happening and jumped on the point that conservatives in government always jump on—a way to cut taxes.

    But I think when mental illness enters the legal system—that is when a mentally ill person does something that hurts or threatens other people—then the word “conservative” means “just about everybody, Republicans or Democrats.”

    Most people are extremely conservative. They don’t want anything to change. They may want their personal situation to change for the better, but they want it to happen with nothing else around them changing. This is why people are content to spend thousands of dollars a year buying lottery tickets instead of accepting an increase in taxes to pay for socialized medicine.

    Accepting an enlightened and civilized attitude toward mental illness means abandoning the idea that we are in control. It means giving up on the idea of free will. It means accepting the idea that most of the good behavior we love to pat ourselves on the back for is really a result of luck. Punishing the crazy person who gets out of line is a way of scapegoating—it’s human sacrifice. Juries sacrifice them as way of preserving their own comforting self-image.

    But there’s one more thing. Prosecutorial vanity. DA’s love to come down hard on people they know are out of their minds because the cases are high profile slam dunks. Horrible crime, creepy and easily demonized suspect, lots of headlines and stories on the evening news, a sure win—what’s not not to love for a DA with an election to win?

  8. Lex said on December 11, 2004 at 9:00 am

    So what Dave’s saying is some of society’s most vulnerable get sacrificed on the altar of political vanity.

    (thinks a bit)

    Yeah, sounds about right.

  9. brian stouder said on December 11, 2004 at 10:58 am

    Lex – agreed.

    And when a D gets elected president, as was the case from 1992-2000, these issues tend to go beyond the focus of what used to be called the “mainstream media”

    One would think the reality of homelessness and all the associated issues of mental illness and substance abuse that many of these people suffer under only sprang into being upon the 1981 inauguration of RWR –

    and that it all somehow went away again once GHWB got fired in 1992.

    I think we agree that this issue is rightly addressed by government (or “Big Guvment”).

    So, if you had a magic wand and upon waving it, YOUR solution would be fully implemented – what the hell would you conjure up, specifically?

    Raise taxes? Done!

    Build buildings? Done!

    Hire staff? Done!

    and then….round up people to fill the buildings and busy the staff? On what basis do people fall into the net?

    I bet that some large percent of the people who need to be institutionalized are easy enough to identify and take in; but as Nance notes, what of the ones that families keep closeted?

    We might well pause before granting ourselves the power to swoop in and take these people into the system, yes?

    Just by way of saying – the issue is large enough that the political process will continue to debate and revisit it, and the impulse to demonize the other side strikes me as essentially useless. The impulse to try and “cure” something (as with the old sanitariums) that cannot be cured (or at least which doesn’t measureably improve), ends up looking like (possibly rightly) simply warehousing people. The impulse to mitigate things with meds and deinstitutionalize people ends up looking like (possibly rightly) throwing them into the streets and trusting to luck.

    This is not an argument that anything we do is futile, and therefore we should do nothing.

    I guess what I’m REALLY commenting on is the abstract nature of “the national agenda” – and how the direct impact on that agenda Big, Consolidated Media of previous decades – the one that could show people sleeping on grates and get many people thinking that it was somehow Reagan’s fault(!) – has disintegrated into a much soupier entity.

  10. Linda said on December 11, 2004 at 12:13 pm

    I wholeheartedly agree about educating our young about mental illness and the fact that it truly exists.

    We have a family friend from back when I was a kid who has been diagnosed with Schizophrenia and Manic Depression, and from what I have witnessed over the years, I believe she also suffers from Multiple Personality Disorder ( number one lesson for the aforementioned psychology class: Schizophrenia and MPD are NOT the same thing). I’ve seen her move from apartment complex to apartment complex because every place she has lived, “someone was breaking in”. She changes the locks frequently and covers the windows with a combo of blinds, curtains, and bedsheets. Her t.v. was found to be vandalized, yet there was no actually sign of a break-in. Her wedding ring was found destroyed and hidden in her bathroom; again, no sign of entry. I’ve seen her convince my mother to climb up into a dusty attic to see if someone was breaching that way.

    My father has never believed she was “crazy”. He always refers to her as that “selfish bitch”, and chastises my mother for helping her and befriending her by saying, “I wish you would quit letting that spoiled bitch manipulate you. She’s just pulling your leg because she knows she can get you to do her running around.”

    Now, to be fair to my dad, he grew up in the Depression era south, so he is ultimately a victim of his upbringing, but I get so frustrated when I hear those remarks. And I sometimes think my mother doesn’t quite get it, either. I just can’t convince her that no one else broke in and destroyed the t.v. and the wedding ring, our friend HERSELF did it while in some psychotic incident or multiple personality change that she simply doesn’t remember.

    I know I’m rambling, but my point is that I agree that if we had better education of mental illness, some tragedies could be avoided.

  11. ashley said on December 11, 2004 at 12:33 pm

    When I think about how Reagan dumped all of the mentally ill out of the institutions, I think of Philip Bury. Of course, you may know him better as Buck Naked, if you know him at all.

    Long story short: guy named Michael Kagan was released from an institution when Reagan was emptying the looney bins (and increasing the prison population with draconian drug policies…anyway). Kagan was an obsessive pigeon feeder. Buck was walking his dog in golden gate park. Kagan thought that Buck and his dog were bothering the pigeons. So Kagan shot Buck to death.

    At least we didn’t infringe on Kagan’s second amendment rights.

  12. 4dbirds said on December 11, 2004 at 1:40 pm

    The media described Gale as a “Former Marine”. It seems when some unstable person commits mass murder the media likes to bring out the fact that the person used to be in the military. The Texas Tower shooter was a “Former Marine”, Ng in Northern CA was a “Former Marine”, etc. However if you read closely, one finds out that these murderers are almost always FAILED Marines/soldiers/sailors. None of them finish their enlistments, usually being drummed out for behavoral or adjustment problems. One more clue that Gale wasn’t normal and one more chance to help him lost.

  13. Nance said on December 11, 2004 at 2:43 pm

    Now, Ashley. Since the tone has remained remarkably decent and coherent up to now, let’s refrain from saying Reagan personally kicked all the mentally ill out of their hospitals. I stick to my contention this was a perfect storm of the dark side of everyone’s best intentions. But certainly it happened on his watch. I recall it going on almost overnight in Columbus — one day, everyone was upright on the sidewalk, the next you were stepping over people sleeping there.

    But people like the Columbus shooter(s) weren’t homeless. They had families who were in a good position to get them help, if help were available. Since Brian asked for a wish list, it would be this:

    * An public-education effort comparable to the one that taught us smoking is bad;

    * A real community m.h. infrastructure available on a crisis basis to handle emergencies;

    * More discretion for judges to hold people beyond the standard 72-hour period, until they’re stabilized;

    * Real follow-up with case managers — who aren’t staggering under preposterous workloads — to check on independent-living mentally ill people regularly, to make sure they’re staying on their medicines.

    A final note: The first group of people I’d bring in for re-education camp would be clergy, who still, STILL get away with telling families that Uncle Bob’s ravings are the result of demon spirits and/or a failure to meet God’s standards in one way or another. Not helpful.

  14. JoBu said on December 11, 2004 at 4:31 pm

    I love it. He was an ex-Marine. He was a loner. His neighbors thought he was a freak. Heck, even the people at a freaking tattoo parlor thought he was a whack job. Mental illness is laughed at in this country. Truly is Darwin’s survival of the fittest in action. If you can’t handle life, fuck you.

  15. juan said on December 13, 2004 at 11:24 am

    Either:

    A. Ronald Reagan was a competent budget cutter (a/k/a “Good President”) and Dubya is a reckless, spendthrift, vote-buyer, running up the deficit (a/k/a “Bad President”).

    Or….

    B. Ronald Reagan was a draconian, heartless, budget cutter (a/k/a “Bad President”) and Dubya is a compassionate overspender, doling out money we don’t have to immigrants and elder perscriptions (a/k/a “Good President”).

    Pick one. Not both. You are entitled to be an idealog, but not hypocracy.

  16. ashley said on December 13, 2004 at 4:28 pm

    Juan,

    Why do I have to pick either “good” or “bad”, and “not good” or “not bad”? Are there no shades of grey? (This, coming from a professor whose chief research has been in ‘fuzzy logic’)

    Kind of like, there are no blue or red states, but they’re all kind of purple.

  17. juan said on December 14, 2004 at 1:38 pm

    Of course you are entitled to your shades of grey continuum, Ashley.

    “If only there were evil people somewhere insidiously committing evil deeds and it were necessary only to separate them from the rest of us and destroy them. But the line dividing good and evil cuts through the heart of every human being. And who is willing to destroy a piece of his own heart?” – Alexander Solzhenitsyn

    I haven’t seen a lot of grey in your Dubya rhetoric, Ashley. I’m just seeing a lot of black. It seems the man can do no right in your eyes. But that’s just my opinion of your opinion.