The Issue of Mental Health Treatment from a Social Worker

The following is a guest post from my mother. She recently retired from her job as a social worker, a role she has had in various forms going back to the Johnson administration. She’s a gun owner, but you won’t find her on the range often because she’s too busy with her grandchildren. She’s hardly a raging libertarian, but also saw the many weaknesses of government programs to address many problems. These are simply some of her quick thoughts after watching the news today and reflecting on her personal experiences with the mental health programs over the last few decades.

It is heartbreaking to see what has happened today, as well as what has happened in other similar incidents. In these situations, it has been established that the majority of the individuals involved have had major mental health issues. After having just retired from more than 40 years in social services, I have seen many, many changes in handling those who are mentally ill.

Back in the early 80’s, we started mainstreaming mentally ill folks back into society, even those who clearly were not capable of functioning without some sort of structure. I agree that we need to understand mental health issues and must learn to distinguish those from those who are treatable and are capable of following treatment from those who, without structured guidance and possible mandated medication and treatment, are not able to function in mainstream.

We closed many hospitals, which I agree many needed to be updated and made more humane, but by not improving those facilities, we turned many people out on the streets without any form of support. Those people were left to become homeless, unable to manage medication, unable to take care of their personal needs, etc., and many of those turned to crime not because they were a bad person. They had no conception of right or wrong, they weren’t on medication, and they often have no family to assist them. Or, perhaps they had family that cared or had family who become emotionally burned out and/or financially strapped and unable to function themselves. It is a sad state we are in and, while I don’t have answers, I do know we need to look at what needs to happen in our mental health programs.

It seems it’s easier for the government to give them a check, food stamps, than deal with real treatment programs. My sister currently works as a case manager for mental health and her caseload is off the charts with no way to require her clients to comply with treatment or take medication correctly. The result is that some end up in jail for some type of crime or homeless because they couldn’t function enough to properly take care of their lives.

My heart breaks for the families and children, I just pray that the wrong “cause” isn’t made the issue instead of looking at the “real” issues of what’s happening here.

19 thoughts on “The Issue of Mental Health Treatment from a Social Worker”

  1. You know ‘we’ are to blame, nothing about the backstory on this person… I cannot fathom what would allow him to harm a child, much less 19 of them…

  2. News accounts indicate that he had “mental problems.” Well, duh. The vast majority of these mass murders involve someone with a mental illness history.

  3. But at some point, ‘we’ as a society failed. The more precise description of his schism with reality will be made apparent in the coming days and weeks, but in the end, it is up to the broader, collective ‘we’ composed of every citizen of any political stripe who walks the soil contained within our borders to come up with solutions for mental health care in America. It is that ‘we’ who aren’t demanding better. Again and again, it’s a paperwork problem that keeps one out of NICS, or the parent who fears of stigmatizing their child, or the neighbors who don’t want to get involved, something falls through and another of these occurs.

    Sebastian made a post years ago pondering that this sorta thing happened rarely in the ages before GCA 68 and other regulations because the local hardware store clerk at the gun counter actually knew his neighbors in the town, knew who was responsible enough, knew who might be off kilter and could simply refuse to serve. Those inherent safeties in a small town society are now gone. It’s time to develop new ones.

    I don’t know what the final answer is, or even the current make-do. I’m an engineer who likes to read and ponder, but I’m no doctor or social scientist. I do know that we, the shooting community and it’s lobby arms, need to be proposing solutions, ideas, or know that a ‘solution’ may be thrust upon us.

    1. These sort of event happened rarely before 1968, and they happen rarely now. Although Andrew Kehoe’s suicide-bombing of an elementary school in Bath, Michigan, in 1927 is evidence that “rare” does not mean “never.”

      There are millions of Americans with “mental health” problems. This monster in Connecticut did not do this because he was ill, he did this becase he was evil.

      1. Sometimes people with severe hallucinations are seeing and hearing things that are not there. Watch A Beautiful Mind for an illustration of how hallucinations cause people to do very odd things.

    2. There is another reason as well. It was not just small-town society. Many people were hospitalized, sometimes for months or even years, when it became apparent that they had suffered a break from reality. Past 1975, deinstitutionalization as public policy made it difficult to commit a person and tell they had killed someone or darn close to it. If you are interested in solutions, my book My Brother Ron: A Personal And Social History of the Deinstitutionalization of the Mentally Ill (2012) will provide a number of strategies, as well as a history of how we got where we are.

      1. Actually, Clayton, I always look for your replies here, and your book is absolutely on my To Read list. I know that must not have been an easy book to write. Thanks for the reminder to vault it up the priority list.

    3. The current “make-do” is covert manipulation and coercion from government spooks and their collaborators. Enjoy.

    4. “the local hardware store clerk at the gun counter actually knew his neighbors in the town, knew who was responsible enough, knew who might be off kilter and could simply refuse to serve.”

      Sounds good, and maybe on broader balance actually was. But, the owner of my favorite gun shop where I used to hang out in my late teens, back in the ’60s civil rights era, had a policy of not serving any blacks, at all. His personal definition of “responsible enough” was, being white. Even after the federal public accommodation laws relative to civil rights were passed, he continued his policy, opining that a gun dealer was probably the last business in the U.S. that could get away with discrimination, and be applauded for it. And that was in Pennsylvania, not the Deep South.

      Just sayin’.

  4. One of the saddest things I ever saw was the homeless people in Middletown, NY., after the big hospital there closed in the ’70s. My church did what it could, feeding anywhere up to a dozen every day. But we could do little more. They needed full-time care, which they had received until the State threw them out in the streets with nothing. Another do-good social experiment that has had unintended consequences.

    1. No one wanted to pay to keep people institutionalized. Throwing them out in the street was passed off as a cost-cutting measure.

      1. Well, I’d say it actually was an (economic) cost-cutting measure; there’s nothing we love more than the illusion that we can have our cake and not be paying for it.

        Philosophically I lean toward the belief that “All Taxes are Theft.” But given that we haven’t made any moves toward any alternative ways of obtaining what we regard as “public services,” we have shown, democratically, that we will reward those who “hold the line on taxes” by things like, not doing maintenance on infrastructure, cessation or minimization of funding for mandated public pensions, etc., etc.

        Surely it is cheaper to throw the mentally ill on the street and hand them a fistful of food stamps (a metaphor for what is a credit card system, now) than to provide housing and treatment for them at a cost of perhaps $60K – $100K a head per year. And the people in government who did that were rewarded for it, and those who would reverse it will be castigated as Marxists, socialists, or at minimum lefties.

        1. Errr, per Clayton, the process of deinstitutionalization was finished circa ’75, and as I recall that was not long after the end of the “you can have your cake and eat it” political attitude (perhaps date that to Nixon’s closing of the gold window and wage and price controls??? Then there’s Proposition 13 in ’78), e.g. the “guns and butter” of LBJ. Importantly this started in that period.

          Hmmm, Clayton, did it get traction when transfer payments became really big? Just reviewing Wikipedia it seems the start was due to effective antipsychotics in the ’50s, which were true miracle drugs (my mother reports being astonished to see a “hopeless” case she’d tended to while in the psych ward 3 month period of her RN residency working at her hospital sometime later in a janitorial? sort of role).

          On the other hand, the relatively conservative (although a dedicated gun-grabber until he very recently got religion) Democratic Governor of Missouri is shutting down a long term care facility for the mentally disabled just north of my home town. They’ll be handled by the usual community services, cheaper and all that. Wikipedia reports that wave started 15 years after the first mentioned above.

          Not pleased, nor am I aware of any conservatives in my circle who are. This has long been considered a duty of the state, it long predates the concept of the welfare state that is what’s really bankrupting us. In fact, neglect of the traditional duties of the state in favor of buying votes with transfer payments is one of the things we’re most upset about.

          (Of course, I’m not a libertarian except when it comes to economics, whereas I gather you’re a lot more libertarian.)

          1. “Not pleased, nor am I aware of any conservatives in my circle who are. . .”

            Just for clarity regarding what I was talking about, the “have your cake” attitude is independent of ideology, though not necessarily on an issue-by-issue basis. But, liberal district or conservative district, no one has ever lost an election for not raising taxes, and it is rare that voters ever question too deeply how that was accomplished.

            My reference to, “people will be called Marxists” meant that people may demand that the bothersome mentally ill be taken off the street, but will then nit-pick the cost of doing that; probably insisting that the costs are high only because bleeding hearts won’t settle for Bedlam-style living conditions for the patients.

  5. Too many parents facilitate the kind of useless, shiftless, meaningless lives that these young people wind up living before they finally crack and hurt other people or wind up killing themselves. Parents let these kids get away with being difficult in school, not doing well academically due to sheer laziness, and having no post-high-school career, job, plan, ambition, etc. The more money and resources that the parents have, the less likely they are to demand that the kid get his or her act together. Look at the Eagles coach and his two sons. You think a smart guy like that has offspring who do not have the genetic make up to be successful adults? No. but they apparently did not have the motivation to become successful adults because Daddy kept paying the bills, buying the food, buying the cars, buying the toys. And the guns. My parents were middle class, and they did not give us a lot of the things that other kids got. We never had Atari 2600 or 5200 game systems, but then again we only had one TV in the whole house (7 kids). We did not get the cool stuff that was popular. We got what we needed and most importantly we got the motivation to grow up and be able to become successful on our own. I’ve got friends who let their adult children freeload off them while they “find themselves”.

    Another thing is that parents let their kids have, hold, possess, control firearms way before the law allows it. I am all for teaching your kids about guns, taking them shooting every chance you’ve got, demystifying the gun culture for the kids, making guns so commonplace in their lives that the guns never have the function of being enticing forbidden fruit, etc. But at the end of the day, the guns go back to the safe, and the child does not have the key or the combination. Too many parents let the kids “own” the guns for all practical purposes. The guns are in the kids’ rooms, under the kids’ control at all times, etc. Geez, look up any topic about AR-15’s on YouTube and you will find whole bunches of videos done by kids who can not be more than 15 years old, discussing various tacticool features of their $1,000+ weapons systems. Do you really think that when the video is done, the kid hands that AR back to Dad who then dutifully locks it up in the safe out of little Throckmorten, Jr’s control? Give me a break.

    Parents who are failures are the reason we have these problems.

    1. I’d say that’s a judgement call. My family never did the safe thing (as far as I know, to this day I’m the only one with one), yet my parents were entirely responsible in letting us have unrestrained access to all their guns.

      And if you lock up your children’s safety, statistically this will get some killed, as we’ve seen in e.g. California. And counterwise, look at all the cases where kids less than 15 years old defended themselves and their’s. Ayoob wrote an article in Combat Handguns with a bunch of cases going all the way down to toddler (seriously, he listened to his mom when she said to never touch her Raven .25 ACP … until someone was brutally raping her, and the thug got the surprise of his life when the child put the gun against his temple and killed him).

      Ayoob of course had one of more of his children shooting competitive pistol at age 7 plus or minus, although he’s a special case…. I don’t have his Gunproof Your Children handy, but I’m sure he doesn’t recommend entirely betting on a safe, especially since kids will come into contact with guns at other people’s places. Then again, if a gunowner in my home town had rigorously observed Clayton’s advice, he’d not have lost a 14 year old daughter one evening when she brought over several “friends” for a sleepover as I’ve mentioned before.

      Note that the traditional age of young adulthood was around 13 or so. E.g. that’s the age for the Bar Mitzvah, when “According to Jewish law, when Jewish boys become 13, they become accountable for their actions….” (Wikipedia) It’s 12 for girls, they do mature faster than boys.

    2. “Another thing is that parents let their kids have, hold, possess, control firearms way before the law allows it.”

      As someone who was wandering the fields of Bucks County, PA, unsupervised with my .22 at the age of seven, I don’t know what to say to that.

      Yes, I am aware of “different world,” and I didn’t let my kids do that (the world surely would have harmed them and me, more than they harmed the world, but. . .) nor would I let my grandkids do it today. But part of that is, that I sense both the kids and the world are different; the world makes the kids different, arguably less mature almost form birth. (Read stories of the late 19th century, when often 12-years olds were doing responsible adult jobs.)

      But, the idea that “the law” should be a factor in such private decisions? Well, as I reflected, I guess the world has changed.

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