Steve Forbes: Why The Treatment Of Our Nation's Mentally Ill Is An American Disgrace

When I first read this article by Steve Forbes I liked it.  I am thankful for the open discussion on helping the mentally ill. However, there are a few problems with his views on helping the mentally ill in the United States.

1.  He has a far too simple view of why America should not have shut down many of its psychiatric hospitals. He fails to mention how the discovery of Lithium by John Cade in Australia (it was first strongly resisted by the psychiatric community in the United States) eventually helped empty out the large state hospitals.

2. He actually minimizes the abuse and degradation that occurred in those hospitals. He states it was a deplorable if not barbaric movement to shut down psychiatric hospitals.  I have been in a number of psychiatric hospitals both as a mental health professional and a patient. It is a traumatic and painful place to be a patient. Abuses in these hospitals occur all the time.  There are many abuses that still occur especially as it relates to lack of coverage and managed care.

3. He fails to discern that the term "mentally ill" is for a group of persons who have many different types of illnesses that affect the mind, mood and the body.  Severe cases of those with schizophrenia (the people you usually see on the streets) need more time in the hospital. However as part of a third revolution of psychiatry, a highly skilled psycho-pharmacolgist with newer medications can accomplish much. Many with the above treatment and a recovery model can still play a part in society. Schizophrenic persons and those with bipolar disorder should not be locked up for five, ten or twenty years.  The equating of  schizophrenia to Alzheimer's is not an accurate one.  Those who suffer from Alzheimer's gradually lose all touch with reality and there is no cure in sight. Schizophrenia has an average onset of early to mid twenties; these people have a whole life ahead of them and years to deal with this illness.  The more money spent the better you can make their quality of life.

4. And last, but not least, the man in Connecticut suffered from a mild form of Autism called Asperger's Syndrome. Most experts believe that he did not shoot those precious children because he was psychotic. These massacres did not come about because the shooter should have been in long term psychiatric care; the shootings came about  because this young man was evil.

If you would like to read more about the subject of the mistreatment of mental illness, please see our book, Broken Minds Hope for Healing When You Feel Like You're Losing It Kregel Publications, Grand Rapids, MI, especially chapter 15, A History of (Mis) treatment.
http://www.heartfeltmin.org/#!events/c15sx or http://www.amazon.com/Broken-Minds-Healing-Youre-Losing/dp/0825421187

Forbes' article begins here:

What happened in New Town, Connecticut is igniting discussion and debate about one of the most deplorable, if not barbaric, moves the U.S. has made in the past half-century–the shutting down of most of our institutions that treat people with severe mental illnesses.
The so-called deinstitutionalizing of mental patients was a result of a reaction to abuses some people suffered in those places and a perverse interpretation of individual rights. Instead of dealing with the particular problems and accepting the common sense notion that people with serious mental problems can’t rationally decide what is best for themselves, we have largely emptied our public psychiatric hospitals. Even though our population has increased by some 140 million since this movement began, the number of public psychiatric beds in the U.S. has declined by 90%. An estimated 3.5 million people with very serious mental diseases are receiving no treatment. We see many of them wandering around our city streets. As Rich Lowry, editor of the National Review put it: “Imagine the national outrage if people with Alzheimer’s were permitted to wander around the streets uncared for. But, by some perverse logic, it’s considered okay for schizophrenics.”
It’s almost impossible now for families to commit someone involuntarily to an institution so he or she can receive sustained treatment. Connecticut, in fact, is one of the worst states in this regard. To our shame, the only way most of our very mentally ill citizens can get treatment is behind bars. Almost one-fifth of prisoners are mentally sick.

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There’s no federal solution here. Real reform has to be done on the state level. No one would assert that more proactive treatment of people with extremely serious mental ailments would prevent all mass killings. But the growth in the number of such massacres since the 1960s, when the deinstitutionalizing movement got under way, makes clear that these horrific occurrences could be sharply reduced. More to the point, hundreds of thousands of people leading tortured, miserable lives would get the treatment they so badly need.

http://www.forbes.com/sites/steveforbes/2013/01/02/an-american-disgrace/