It was the senseless wicked shooting at the Minneapolis church the other day that finally made me decide that mental illness had become such a malevolent and pernicious evil in American society that vast new unprecedented measures had to be taken at once to build up a mental health system as pervasive and powerful as the one for physical health.
Mental illness lies behind school shootings, domestic violence, opioid addictions, homeless camps, most suicides (especially among youths), Covid-triggered depression, and a host of other crimes and crises. Self-help books, heavily weighed to individual mental problems and solutions, are the largest selling books in America and one of them with a vulgar title has been on the list for 300 weeks and counting. The Mental Health Association estimates a quarter of all adults—that’s some 64 million people–experiences a mental illness episode each year and a fifth of all youths have an episode of major depression yearly. Those figures, however, represent only those instances reported to police or medical authorities and certainly undercount by thousands.
Given such an obvious crisis, one might imagine that a rational society would respond with serious medical assistance and treatment. In fact, however, American treatment of mental illness has decreased over the past half-century as mental hospitals have all but disappeared. Starting in the 1950’s, when a variety of psychotropic drugs first appeared, public policy began the movement away from institutional care, with its Snakepit sorts of mistreatments and repressions, and toward what was called “community” health centers, with local care-givers and a variety of drugs. This was made official with a Community Mental Health Act in 1963, and by the 1980s the U.S. had eliminated almost all mental hospitals and turned the mentally ill over to the hands of smaller clinics with voluntary participation by their charges.
The experiment has long proved itself a failure. The mentally troubled did not show up at the clinics, or showed but ignored psychiatric advice, or showed only for the drugs, often misused. Those who committed crimes might be sent to prisons where there was some psychiatric care, but the penal system readily admitted that it was not in a fit position to handle more than a handful of the ill and then only with hit-or-miss drugs. Reports of mental sickness increased every year, until by now it is a standard and regrettably common explanation for incidents on every newscast.
There are 6,146 hospitals for physical illness in the U.S. and 1.1 million doctors. There are 1,841 psychiatric hospitals for mental illness and just over 200,000 psychologists and psychiatrists. It’s high time as a society we got over all our doubts and suspicions about mental illness and admitted that we have a problem and ought to redress that imbalance.
I do not think psychiatry has distinguished itself much as a successful health profession, and I regard with disdain its heavy reliance on drugs to take care of mental disturbances. But it is a recognized profession and could certainly improve with additional attention and patronage, plus additional citizen involvement, and it is all we have as an immediate solution to our crisis. Given the support of well-funded institutions with supportive staffs—something like the asylums of the past, but avoiding their mistakes and excesses—it could expand its reach and effectiveness and make mental health treatment a common solution to our present crisis.
It is madness to do otherwise.
