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The mental health system fails again

Last week, Randel Richardson allegedly drowned his 6-month-old son. Last month, Jonas Grice was charged in the killing of Anthony Hartman, apparently a total stranger, at a carwash. I remember that in 2005, Stephen R. Miles decapitated his stepmother in Burnsville; in 2003, Naomi Gaines tossed her infant twins off the High Bridge (one survived) before jumping herself; and in 2000, Lawrence Dame killed five relatives in Lino Lakes. These grisly killings were all local (and the real list is surely much longer); nationally, it must run into the thousands per decade.

Is there a pattern here? Darn right, there is. Here are some things these five killings have in common:

• The accused perpetrator was actively psychotic at the time.

• The accused had shown clear signs of psychosis prior to the killing — this was not an out-of-the-blue episode.

• The accused, or the accused person’s family, had sought mental-health treatment prior to the killing.

• Our mental-health system failed to provide the treatment that could have prevented these incidents.

• Afterward, authorities rushed forward to explain that it wasn’t their fault — no one could have known this would happen, and close monitoring of people such as  Grice is “hard” and/or “prohibitively expensive.”

This last point is complete and total nonsense. It wasn’t the fault of the authorities that Richardson, Grice, Miles, Gaines and Dame had mental illness in the first place, but failure to provide adequate treatment demonstrates the on-going failure of our mental-health system.

According to published reports, Grice had a history of violence and had been diagnosed with schizophrenia, resulting in a six-month commitment, which was then not renewed. Does this make sense given that schizophrenia is a life-long illness? With Grice’s history, it was obvious that, without invasive treatment, he would be disturbed and potentially violent for at least 30 years. Six months of treatment is the equivalent of applying leaches to a patient with cancer.

The public, unfortunately, is left with the impression that mental illnesses are mysterious and untreatable – which is not the case. Schizophrenia is not curable, but it is treatable. Many organizations around the country, including Tasks Unlimited here in the Twin Cities, have demonstrated success in converting people exactly like Richardson, Grice, Miles, Gaines and Dame into productive, tax-paying citizens.

“Expensive” is a relative term. Providing aggressive treatment for every American with schizophrenia would cost less than trying to find Bin Laden, and would save more lives. And by the way, social workers are cheaper than cops; and treatment for mental illness is cheaper than prison.

We also hear the excuse that involuntary treatment would violate people’s rights. This is a concern, but it is important to remember that schizophrenia impairs judgment. Tasks Unlimited’s 200 tax-paying citizens all participate voluntarily, but this wasn’t necessarily true of their first encounter with the mental-health system. It makes no more sense to base the treatment of a potentially violent perpetrator on his or her acceptance than to seek the permission of a 2-year-old getting a vaccination.

While examining the pattern of these events, it is probably also worth looking at the dissimilarities: Four of the five accused were male (about what one would expect), four of the five were white (consistent with Twin City demographics), some were affluent, and some were poor. In other words, mental illness is not a sociological problem; it is a health-care issue and one that strikes across social boundaries.

Murder is a crime. But these people are not, fundamentally, criminals; they suffer from a treatable illness, which our criminal justice system is ill-equipped to treat. [Gaines and Dame were convicted and sent to prison, and my guess is that Richardson and Grice will be as well. Miles was found not guilty of murder by reason of mental illness. He was ordered to remain at the Minnesota Security Hospital in St. Peter, where he was committed in 2006.]

The victims’ family and friends are outraged, as well they should be. Unfortunately, their anger is often directed at the perpetrator, who, really, is a victim also. Their anger should be directed at the folks running our mental-health system. Maybe we are holding the wrong people accountable.

John Trepp recently retired after 30 years as the executive director of Tasks Unlimited, which provides recovery services for people with severe and persistent mental illnesses.

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Comments (3)

  1. Submitted by Greg Kapphahn on 08/06/2010 - 01:04 pm.

    Once again, we’ve been had.

    Closing the state hospitals and moving the mentally ill and mentally handicapped into small, family-like, community-based group homes and other, similar facilities was touted as a more humane alternative, which it was.

    But it also rendered that population largely invisible. Since the initial move, funding has not kept up with needs, especially for the mentally ill, to the point where it now falls far short.

    If these folks were still in the state hospitals, we’d be able to see the “snake pit”-like conditions under which they are living, but, now that they are dispersed throughout the population, we only see these people, many of whom are NOT capable of holding down jobs, caring for themselves, or taking their medications reliably, mostly as homeless people.

    Even where their families keep them from falling into homelessness and struggle to find them the help they need (and get them to accept it) such help is often not available or it is beyond the family’s abilities to pay for it or to convince those in need to accept help.

    The system is BROKEN because it is seriously underfunded and gives too much leeway to those incapable of making rational decisions.

    But Hey! who cares as long as we don’t have to pay taxes! (Unless, of course, it’s your son or daughter in danger from someone who’s violent and mentally ill or who’s mentally ill themselves).

  2. Submitted by Nancy Hokkanen on 08/06/2010 - 04:15 pm.

    Treating mental illness all too often involves pharmacological roulette — presumptive prescribing until some psychotropic medication masks a symptom. Why are so few physicians investigating causality by measuring patients’ body burden of toxins?

    China has seen an increase in outbursts of mass murder. China simultaneously has seen an increase in mercury deposition from coal-fired power plant emissions. It’s theorized that rice rhizomes pick up mercury. “Mad as a hatter” — from breathing mercury, from eating mercury, from drinking mercury.

    Carl C. Pfeiffer, MD, PhD studied prison inmates and found that many suffered from nutritional deficiencies, mineral-metabolism disorders, and food allergies. Currently Dr. William J. Walsh, PhD, founder of the Pfeiffer Treatment Center in Illinois, also noted biochemical predisposition to behavior disorders in prisoners.

    As long as the environmental and dietary conditions that contribute to mental illness in susceptible populations remain unchecked, public health response will continue to be reactive — and often tragically too late.

  3. Submitted by Ross Newlund on 08/11/2010 - 01:53 pm.

    As a Mental Health Professional I wish I were s knowledgeable a Joe Trepp. He says “Grice had a history of violence and had been diagnosed with schizophrenia, resulting in a six-month commitment, which was then not renewed. Does this make sense given that schizophrenia is a life-long illness? With Grice’s history, it was obvious that, without invasive treatment, he would be disturbed and potentially violent.” Mr. Trepp knows, as I that the last majority of the mentally ill are not violent–they are scared, keep to themselves much of the time, and are less likely than most to commit a violent crime. Trepp wants us to believe schizophrenics are the boogy-man of 1920’s movies. Nothing could be further from the truth. Even in the Grice case, where there apparently was some history of violence, does Trepp know what sort of violence? How long ago? When he was ill? Again most mentally ill people can be treated and do not need to be under commitment. For Trepp to second guess the decision to let the commitment expire is without knowledge and justification. There are many gaps in the mental health system and many areas that it fails to provide good care, but Trepp has not provided evidence that this is one of them.
    Ross Newlund, LICSW

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