Guest Opinions

Adequate mental health services? It’s a matter of priorities

I agree with Clayton E. Cramer (Oct. 18 Guest Opinion) on how a variety of social, political and legal barriers stand in the way of providing desperately needed mental health services that might help reduce the incidents of mass murders.

Cramer’s last sentence — a question: “Why is this so difficult?” — caught my eye. I have found that trying to answer that simple question leads to finding still more barriers to reducing the frequency of mass murders, which makes the resolution of the problem as difficult to come by as attempting to predict who will be the next mass shooter.

Experts agree that with the present knowledge and psychological skills we have, it is impossible to predict who will commit murders, no matter the type or degree of mental illness. Further, as a moral and ethical issue, the idea of legally identifying and permanently isolating human beings based on our fear of them or fear of what their future behavior might be goes against basic democratic values and laws.

But for argument’s sake, let’s say two assigned experts agree that “X” is seriously mentally ill, threatened to kill people, and has recently shown erratic, impulsive and extremely aggressive behavior to the point of being at high risk of harming himself/herself or others. To treat X, they must next convince a judge to authorize committing him or her to a treatment institution (if available) for a specific amount of time. At the treatment’s end, will X’s doctors know if he/she is truly “cured” and will they be able to guarantee he/she will not harm others or himself/herself in the future? To the public’s and lawmakers’ dismay, they cannot.

Another influencing factor: Are appropriate local resources always available to treat X? Too frequently, no. Why? Preventing mentally ill individuals from harming others is the financial and legal responsibility of states, counties and cities, and historically their governing bodies do not give high priority to funding mental health services. (Ongoing federal mental health programs exist but only for U.S. military personnel, eligible war veterans and those in federal prisons.)

In the future, will local taxpayers approve additional many millions of dollars to foot the bill to expand treatment programs? I strongly doubt that will happen, primarily for two reasons: 1. There is a pervasive and historical deep prejudice against mental illness and those afflicted by it. The public mostly does not understand it or its causes and often judge it as simply craziness or a weakness of character. 2. The mentally ill and their advocates do not have the political influence or money to successfully lobby for their benefit.

Case in point: In a prosperous city where I once lived, the city council repeatedly rejected funding of programs for the homeless (most all of whom were mentally ill). But during the same time period, more than a million dollars were allocated for improving a hikers and bikers trail, and the building of a children’s park and a new dog park. One council member explained the council’s votes as a matter of priorities.

Robert Brownbridge had a 40-year career as a mental health researcher, administrator, community organizer and clinician. He is currently living and doing volunteer work in Boise.