Citizen Jeff

Politics and insanity are a dangerous combination. One might argue that politics is insanity, but certainly insanity is political.

Was the violent rampage of Jared Loughner in Tucson politics or insanity? To argue that Mr. Loughner’s actions in Tucson were politically motivated is to obscure the influence of mental illness on his shooting spree. Mr. Loughner’s politics may have grown from his insanity, but the deeper issue is that 50 years of politics has left us with a mental health system that leaves the insane unprotected, and fails to protect society from the insane.They are left to run the streets under the influence of their internal voices and political extremists.

Jared Loughner provides the latest opportunity to illuminate how politics has facilitated insanity. Let start with Jared’s parents. Didn’t they know he was unstable? Didn’t they care? Why didn’t they do something about it?

Since, symptoms of mental illness typically emerge in the teens or early twenties and are often brought on by stress, Jared’s parents may have seen his behavior becoming increasingly odd. Assuming they were educated and astute enough to recognize the severity of his illness, they may have sought private psychotherapy if they had been able to afford it (or had insurance that covered it) and if Jared had been willing to participate. While psychiatrists have a panoply of theoretical practices and anti-psychotics drugs at their disposal, they can’t force patients to show up for sessions or take the drugs. But, what if the family couldn’t afford therapy? Community mental health services are scant, underfunded, and operate as out-patient services to provide talk therapy and prescriptions for drugs that patients, acting as a free agents, may or may not choose to take.

Mental health patients as free agents is an important part of the politics. Until the early 1970’s, our society kept the insane locked up away from the daunting complexities of everyday life (not to mention radical ideas and guns). In the early 1970’s the deinstitutionalization movement began state by state, with California leading the way under Governor Reagan. Deinstitutionalization was a perfect storm of converging events: First, patients rights groups were joining the chorus of civil rights activists who were exercising the Fourteenth amendment to remedy the ills perpetrated on groups long marginalized by society—Blacks, women, disabled, gays, and….in this case the insane. Second, states were struggling with budget problems (as happens periodically!), at the same time anti-psychotic drugs were hitting the market for the first time. State politicians eagerly reacted to the obvious: distributing drugs through community mental health centers would be cheaper than maintaining institutions to house, feed, treat, and monitor mental patients. The solution was simple, shut down the institutions and rent the facilities to private companies to provide out-patient community mental health services. States pay less for the services and recuperate part of the cost back in rent on the facilities, and, as a bonus, they comply with the U.S. Supreme Court ruling that involuntary hospitalization and/or treatment violates an individual’s civil rights.

This model might have worked if 1) there had been adequate community mental health centers, ever, 2) if mental patients were capable of taking care of themselves and willing to show up for regular appointments and take their drugs every day, and 3) if the federal government (a little later on) under President Reagan hadn’t reduced federal subsidies for community mental health centers and anti-psychotic drugs.

While the mental health system was falling to pieces, states codified deinstitutionalization. Today, in most states, a person over 14 years old cannot be involuntarily committed to any mental health treatment facility unless they pose a clear (documented) danger to themselves or others. And even if the danger can be documented, hospitalization is limited to 72 hours unless a psychiatrist deems otherwise. Then the patient can be held for a maximum of six months, after which they are assumed cured and released.

Back to Jared Loughner: After the events in Tucson (witnessed by many, recorded on film, and documented by coroner’s records), Jared now can be committed (even if he doesn’t agree) for 72 hours of observation. Of course, murder tosses him into a different legal category, so we can rest assured that he is probably off the streets for more than six months regardless of what the psychiatrists determine. Even if Jared’s parents had been concerned about his “odd” behavior, their hands were tied without Jared’s consent. In most cases that’s a deal breaker. The insane often don’t recognize their own insanity. In addition, the other people and institutions in Jared’s life, that also noticed that his behavior was “odd” or threatening or downright scary, had less recourse than his parents. The community college that threw him out did so at the risk of being sued by Jared, had he been inclined to sue rather than to kill.