Using Tragedy to Justify Mental Health Services in DelawareIn a letter that could’ve been written in virtually any state by any National Alliance on Mental Illness (NAMI) representative, NAMI Delaware executive director Matthew Stehl and president Mary Berger recently wrote an op-ed for Delaware’s leading newspaper, The News Journal.

In the opinion piece, Stehl and Berger decry the lack of adequate funding for mental illness treatment in the state. In a period of economic recession, state-funded health and human services are usually the first to undergo cuts. But it’s an especially relevant issue in Delaware, because the U.S. Department of Justice struck an agreement with the state to ensure it improves its mental health services for its indigent and poor residents who need mental health services.

All of which is good. I’m all for states and their legislatures to stop looking at the short-term costs of things like mental health treatment and start looking at the longer-term costs of failing to fund adequate mental health care in their state (in terms of increased burdens on the courts, police, emergency rooms, etc.).

What I object to is trotting out a straw man in the form of tragic and violent shootings, and suggest that the lack of access to mental health care was the reason for the shootings at Virginia Tech and Tucson, Arizona. How ashamed I am, as a native Delawarean, when mental health advocates make such irrational appeals to emotion.

Regular readers know this is a sore point for me — connecting people with mental illness and violence. As I wrote 4 years ago, the relationship between violence and mental illness is very complex. It is ridiculous to make a simplistic claim that people with mental illness are more prone to violence (that’s not what the research data show). It is even more ridiculous to use data outliers — such as the Virginia Tech shooting — to advocate for broad, sweeping general policy changes.

I quoted Paul S. Appelbaum back then, and his words are especially true today:

No single approach to reducing the risk is likely to be completely effective. And given the relatively modest contribution to the overall risk of violence by persons with mental disorders, the likelihood and magnitude of adverse effects from any intervention must be carefully considered before it is embodied in law.

But that didn’t stop NAMI Delaware from making the opposite claim in their op-ed:

Although statistics verify that people with mental illness are far more often the victims of crime rather than the perpetrators, we cannot dismiss the result of untreated mental illness that occasionally manifests itself in horrifying events such as those at Virginia Tech and in Tucson, Ariz. These men were known to have a history of mental illness. Had they been receiving effective treatment, these events would most probably never have occurred.

So on one hand, the authors suggest that people with mental health concerns are more often the victims of violence, than the perpetrators of it. Then on the other hand, they go ahead and say, well, yeah, but we still need to watch out for the mentally ill, because look what they can do!

It’s like saying, “Hey, it’s true that flying is about 26 times more safe than driving around in your car. But still, what about those 251 passengers that died when American Airlines Flight 587 crashed into a Queens neighborhood on November 12, 2001?”

We don’t know what caused Jared Lee Loughner to allegedly open fire on January 8, 2011 at a political demonstration, killing six people and seriously injuring many others (including U.S. Representative Gabrielle Giffords). While he has been so far found incompetent to stand trial on these charges, we don’t have enough information to conclude that Mr. Loughner shot others because of his alleged mental illness (or in the argument NAMI Delaware is suggestively making, because of his lack of ability to attain timely and affordable care to treat his mental illness — whether voluntary or not isn’t clear, since we don’t know Mr. Loughner’s specific treatment or mental health history [contrary to NAMI Delaware's claims]).

In the case of Virginia Tech, Seung-Hui Cho killed 32 people and wounded 25 others. In the Virginia Tech Review Panel report about the shooting, it noted that failures by Virginia Tech’s counseling center, flaws in Virginia’s mental health laws, and inadequate state mental health services contributed to the problem. But the report concluded that “Cho himself was the biggest impediment to stabilizing his mental health” in college. Cho was also the apparent recipient of a fair amount of psychotherapy and counseling before he entered college. All of it was apparently for naught in terms of helping him with his demons, however, as he still carried out his attack on his fellow students.

Can we really play Monday morning quarterback and try and say that a fully-funded mental health system would’ve prevented these kinds of tragedies?

Of course not. It’s an unreasonable and fairly ridiculous argument to make. Violence will always occur in any society, and all you can do is to make reasonable efforts to reduce the likelihood of it occurring. There’s no research (that I’m aware of) to indicate that getting better access to mental health services in mainstream society is associated with a reduction in the crime rate in one’s community. While it’s the right thing for a society to do, it’s not justified by promoting fear and ignorance about the likelihood of violence by people with a mental illness.

So while I commend NAMI Delaware for speaking out on behalf of people in Delaware who have a mental health concern, I’m ashamed they used two violent tragedies to try and make their case. It turns my stomach when I read things like this, similar to the disrespectful and dishonorable strategies of the Treatment Advocacy Center.

Let’s stand up and advocate for better care and funding of people with mental disorders. But let’s not do so on the backs of tragedies that represent significant outliers — ones that can never be adequately or wholly explained by a lack of services. All the treatment in the world may not have made a damned bit of difference in those two cases. Appealing to emotion is a common tactical ploy in op-eds such as these, but it doesn’t make it a good strategy for others to use. Instead, it turns me off of their cause.

Read the full article: State’s flawed mental health system desperate for overhaul

 


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    Last reviewed: By John M. Grohol, Psy.D. on 25 Aug 2011
    Published on PsychCentral.com. All rights reserved.

APA Reference
Grohol, J. (2011). Using Tragedy to Justify Mental Health Services in Delaware. Psych Central. Retrieved on October 1, 2014, from http://psychcentral.com/blog/archives/2011/08/25/using-tragedy-to-justify-mental-health-services-in-delaware/

 

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