GUNS FOR THE MENTALLY ILL–PRACTICE VS. THEORY

In my previous post, I speculated on the dangers of the GOP congress’s rollback of President Obama’s strictures on permitting the sale of firearms to serious mentally ill people. Here is an example of what can go wrong: A warning, a gun sale and tragic consequences

GUNS FOR THE MENTALLY ILL!

You may have missed it, given the uncapped pipeline of news raging out of Washington, but on Friday, February 28, President Trump signed into law a Republican-backed measure to restore gun-owning rights to people afflicted with serious mental illness, such as schizophrenia. The rollback would relieve some 75 thousand mentally ill people from accountability to background checks.

Photo by Mika Järvinen (originally posted to Flickr as M4gery) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
Trump’s action struck down a congressional regulation spurred by President Obama as a response to the notorious 2012 massacre of 20 young schoolchildren in Newton, Connecticut. That particular butchery was carried out, via a (legally purchased) semiautomatic Bushmaster XM 15-E2S assault rifle, by the 20-year-old Adam Lanza in Newton, Connecticut. Lanza had begun that morning by putting four bullets into the head of his mother at their home with a (legally purchased) .22-caliber Savage MK II-F bolt action rifle. Then, carrying the Bushmaster and two (legally purchased) handguns, a Glock 20SF and a 9 mm Sig Sauer P226Lanza climbed into the family car and drove off to the nearby Sandy Hook Elementary School. He used the Bushmaster to shoot his way through a locked front-entrance door, then stalked the corridors and classrooms, gunning down children and teachers in small random clusters. In addition to his tally of 6- and 7-year-olds, Lanza murdered the principal, the school psychologist, three teachers and a teacher’s aide, and wounded two teachers. At least two of the teachers had been shielding children with their bodies when the Bushmaster’s bullets struck them. The dead teachers included the school psychologist and a part-time behavioral therapist.

Lanza, who had methodically paused to reload in the course of his meandering spree, then withdrew the Glock and shot himself in the head as police closed in.

A search into voluminous police reports later revealed that the young man underwent consultation at the Yale Child Study Center as an adolescent, and had been prescribed an antidepressant. The files revealed no diagnosis of serious mental illness.

Obama’s measure had infuriated Republicans and the National Rifle Association from the outset. (Technically, the rule required the Social Security Administration to inform the FBI about disability insurance recipients with mental impairments—and who needed a third party to manage their benefits–effectively disqualifying them from buying guns.)

Sam Johnson image via Wikipedia Commons

It was the Republican congressman Sam Johnson of Texas who introduced legislation to block the bill. (Around this same time, in late 2016, Johnson, in his role as chairman of the House Ways and Means Committee’s Subcommittee on Social Security, also released a plan that would drastically reduce that program’s benefits.)

Johnson’s GOP colleagues (along, of course, with the National Rifle Association) had condemned the Obama order as unconstitutional. Senator Charles Grassley of Iowa, according to one report (https://www.usnews.com/news/business/articles/2017-02-14/senate-wants-to-block-rule-on-guns-and-mentally-ill), went so far as to predict that before you knew it, the order would be keeping folks with eating and sleeping disorders from buying guns! (This line of reasoning might qualify as a suitable Republican party motto in its Latin form, Reductio ad Absurdum.)

Sen. Grassley image By United States Senate [Public domain], via Wikimedia Commons
All of which is by way of saying—brace yourself—that yet another of the most morally fraught public crises of our time, the question of powerful firearms in the hands of the mentally ill, has been distilled into ideology.

Let me acknowledge the two most formidable arguments posed by those who agree with the congressional GOPs who voted to roll back the rule.

One argument involves the impossibility of determining who, among the mentally ill, is a threat to commit deadly violence, and who is not. Homicidal schizophrenia is not predictable. Mental illness itself is not predictable. Sandy Hook was not predictable. (See Adam Lanza.) Therefore, the Obama rule was prejudicial, to the disadvantage of nonviolent people with serious mental illnesses. Or so one may persuasively argue.

The other argument restates the familiar Second Amendment case held by gun-rights advocates: restricting firearms possession by anyone is unconstitutional. Period.

Is there a logically airtight counter-argument to these positions? If there is, you won’t find it here. I am not by temperament an absolutist—not on any topic. Dammit. I kind of envy those who are, though I don’t much care to be around them. Absolutism, like carpet-bombing, gets rid of a lot of thorny impediments. It just ain’t my style.

And yet I believe that the new Trump law is wrong; an unnecessary risk to public safety, including the safety of people with eating and sleeping disorders; and an affront to those trying hard to invest the troubled American mental healthcare scene with clarity and moral purpose. I’ll explain, in my timorous, hanky-twisting way:

Schizophrenia is different. Guns are different. Each is different from its category on an order of magnitude that sets it apart from recourse to fixed ideas. Each poses a unique menace to safety, to the Self, to human life. When combined—when a firearm is made accessible to a schizophrenic person—these menaces increase in potency, even though any given afflicted gun-owner is statistically unlikely to commit violence.

Let’s take guns first. What is there left to say? Guns are instruments of killing. Increasingly, rationalizations aside, they are manufactured specifically to kill people. In this they are categorically different from (more intentionally lethal than) any other consumer product. The ideology of unconstrained firearms ownership has survived and hardened in the face of every interrogation of the Second Amendment’s ambiguities, every conceivable appeal to moral restraint, the safety of children in the household, common sense, self-evidently sensible safety measures. No argument I can make here will shift one grain of sand in that desolate desert. I might mention, for example, that my younger brother Jim, in the midst of a marital crisis in the 1970s, turned his hunting shotgun on himself and blew a hole in his head, leaving a widow and two young daughters. (Jim was untreated for any mental illness, and I do not take up his suicide in NO ONE CARES ABOUT CRAZY PEOPLE.) The responses to such tragedies from the gun-rights people are inscribed in the cosmos: Tough titty. These things happen. Shoulda seen a shrink. Law-abiding citizens’ rights. The only way to deter a suicidal man with a gun is with. . .

So let’s move on to schizophrenia.

Schizophrenia (along with its related afflictions such as bipolarity) is a brain disorder without parallel in human history. It is not a mood, reparable by therapy or good fortune. It is not an attitude, responsive to correction or coercion. It is not curable, though in many of the afflicted its symptoms may be controlled by antipsychotic medication. Such medication is resisted by a great many sufferers, whose judgment is crippled by the frequent companion scourge known as anosognosia, or the incapacity to understand that one is ill. The potential calamities enabled by anosognosia are self-evident. Thus, at least as it seems to me and thousands of others, schizophrenia victims require care and treatment that is different—more case-specific, more morally nuanced and always more undergirded with psychiatric insight—from treatment given to “normal” people in crises. This may mean, amidst hundreds of other considerations, keeping firearms out of the reach of certain mentally ill people—say, disability insurance recipients with mental impairments and who needed a third party to manage their benefits.

For understandable reasons—furthering fear and stigma, for instance—mental-illness advocates hesitate to emphasize or even admit the fact that psychosis and guns can combine to spread carnage. (This is one reason why the lessons of Sandy Hook have remained tragically muted.) Yet, as D.J. Jaffe, the outspoken director of the Mental Illness Policy Organization, has written: “. . .4 percent of those with mental illness are affected by serious ailments, such as schizophrenia or bipolar disorder, causing them to hallucinate or become delusional and psychotic. When these people go untreated they do have a higher incidence of violence than the general population. http://mentalillnesspolicy.org/consequences/violence-statistics.html It’s an unpleasant truth that the mental health industry has encouraged politicians to ignore. Without recognizing the problem, policymakers won’t take steps to fix it.”

 

And so here we are, preparing to cope with one more feckless and gratuitous disruption of the arduous project to make society safer—not only for potential victims of people in violent psychosis, but for the mentally ill themselves.

I will not pretend to vouch absolutely for the nosological claims I have advanced here. No one can. That is due to schizophrenia’s properties as different.

But enough disclaiming. I believe that mixing guns and serious mental illness is an abomination.

WORST NIGHTMARE

This article by Natasha Tracy in Huffington Post spells it out, folks: the menace that every parent and caretaker of a mentally ill victim has dreaded since Donald Trump (and Paul Ryan and others before him) gained power in national Republican politics. Our helpless, blameless charges are being pushed to the edge of a precipice.

So much of the money needed to combat serious mental illness and safeguard its victims is enfolded into the Affordable Care Act. Its repeal–perhaps not likely, but eminently possible–would be tantamount to a brutal eviction notice slapped on the millions of people who now live in some degree of humane circumstances thanks to mental hospitals, community care centers and other forms of supervision and medication. Back into the streets. Back into the mercies of predators. Back into deepening psychosis unchecked by medications and counseling. Back into their centuries-long prospects of incomprehension and early death.

It is clear that Donald Trump has not paid a seconds’ worth of attention to the realities of serious mental illness, and this fact increases the likelihood of a reign of terror upon these victims. In this, he is hardly alone among politicians. Recall that only a few weeks ago, Chris Christie was blithely opining that solitary confinement was just fine with him as a means of punishment–or emergency shelter. (The consensus among psychiatrists is that solitary confinement, even for brief periods, is the most catastrophic of all remedies in the criminal-justice system; it not only degrades the mental stability of “normal” prisoners, but drives those in psychosis deeper into irrecoverable madness.

I urge you to sign every petition, join every march, telephone every congressperson, take part in any coalition that has a voice in preserving Affordable Care. The alternative is a new Bedlam.

Read the full article here: http://www.huffingtonpost.com/entry/mental-health-care-in-a-trump-administration-devastates_us_58b5944ee4b0658fc20f9a25

ANOTHER MENTALLY ILL INMATE DIES IN JAIL

In NO ONE CARES ABOUT CRAZY PEOPLE, I write, “Too many of the mentally ill in our country live under conditions of atrocity.”

Here is one more among the unending examples of what I mean: Inmate, 23, who died in Orleans Parish jail Wednesday identified.

THE FIRST REVIEW OF NO ONE CARES ABOUT CRAZY PEOPLE

Book Review

Review: No One Cares About Crazy People

No One Cares about Crazy People: The Chaos and Heartbreak of Mental Health in Americaby Ron Powers (Hachette, $28 hardcover, 384p., 9780316341172, March 21, 2017)

From Shelf Awareness

In the opening line of No One Cares about Crazy People: The Chaos and Heartbreak of Mental Health in America, Ron Powers, Pulitzer Prize-winning journalist, author and co-author of nonfiction such as Mark Twain: A Life and Flags of Our Fathers, writes: “This is the book I promised myself I would never write.” It is a hybrid, a nontraditional history of mental health care fused to an incredibly personal story about his two sons’ struggles with schizophrenia. For his son Kevin, that struggle ended in suicide, and the heartbreak of that experience (among others) permeates every impersonal date and statistic in the book with sorrow and rage.

Powers doesn’t attempt an encyclopedic history of mental illness and care in the United States, instead focusing on specific factors–trends, innovations, individuals, etc.–that played a role in creating a status quo wherein “too many of the mentally ill in our country live under conditions of atrocity.” Powers finds one of his chief culprits in deinstitutionalization, a program whose name “carried the lilting harmony of silverware spilling from a cleanup tray.” The well-intentioned experiment was designed to move prisoners from “the malingering scourge of decrepit mental asylums” to “community centers for treatment of the mentally ill.” Instead, budget cuts left hundreds of thousands of patients stranded and desperate, fueling the rise of homelessness as well as mass incarceration.

Clueless politicians are hardly the only ones to blame for the current crisis, however. Powers’s story is one of repeated moral failings, from the doctors performing transorbital lobotomies to the greed-fueled depredations of Big Pharma–“to open the dossier on the behavior of American and European pharmaceutical giants over the past quarter-century is to confront a fortified casino of riches and debauchery.” The title of the book is a quote from leaked government e-mails, repurposed into a damning allegation.

For the families of the mentally ill, of course, caring about “crazy people” is a necessity. In roughly alternating chapters, Powers allows us to watch his sons grow up, dealing with the challenges of incipient schizophrenia as well as tragic events that shape their young minds. All the while, Powers movingly relates the joys of raising creatively gifted children. Kevin proves to be something of a musical savant, while his older brother, Dean, shows talents for music and writing. A typically sweet anecdote recalls Kevin’s introduction to music as a young child serendipitously brought up on stage at a concert: “His poker face held, but inside him, volcanoes were erupting and winds were blowing one life out and a new one in.”

Unfortunately, the reader is also witness to schizophrenia sweeping through the loving family as Kevin and Dean experience hallucinations, paranoia and psychotic breaks. The boys’ interactions with the mental health care system give Powers a first-hand look into its failings, and in turn he shows the reader the devastating human consequences of society’s indifference toward the mentally ill. —Hank Stephenson, bookseller, Flyleaf Books

Shelf Talker: No One Cares About Crazy People pairs a history of mental health care with the deeply personal story of the author’s two sons and their struggles with schizophrenia.

Adventures in Audioland

ron powersBack in the Friendly Confines (credit to Ernie Banks) of Castleton after completing work on the audiobook version of NO ONE CARES ABOUT CRAZY PEOPLE. The project was accomplished at a beautiful, hilltop, state-of-the-art recording sound studio, Guilford Sound, in the woodsy Green Mountains of Southern Vermont. http://guilfordsound.com/ The owner is the innovative former rock drummer Dave Snyder.

ron powersFar from an easy job (imagine filibustering a bill for four and a half days, or being Chris Matthews), yet worth the throat-tearing effort on a number of levels.

The process put me back in touch with the book in a far more concentrated, analytical way even than the process of writing it, which was strung out over more than two years.

Also, it amounted to a good prep (I hope) for any interviews that might come my way.

Finally—a bit of inside baseball here—no more foolproof method exists for detecting flaws in one’s work than reading it aloud. And yes, dammit, I came across some passages that cried out for further attention–including matters of repetition, which is one of my bad habits. Including matters of repetition, which is one of my bad habits. Ha-ha! a little writerly humor there!!
The process is highly physical. Reading aloud involves the entire body, even when one is sitting down. (I was often distracted by the vigorous circling motions of my own right hand as I read; and my creaking chair caused an unseemly number of re-takes.) The strain of it makes you aware of certain muscles in the throat that you seldom use to the point of stress. You become aware in part because, late in each day, you find that you cannot count on these flabby muscles to form the sounds you expect them to; they’re tired of it. Your mouth might be forming an “O,” but what comes out is a measly little “eeeee.” So you pause to go back and do it again, hoping to get there before the producer blares in your headphones, for about the eight hundred nineteenth time, “COULD YOU GO BACK AND DO THAT AGAIN?!”

A sip of water helps, but the price of sippage is seepage. Audible seepage. You must sit still for several seconds while the sip makes its way through your digestive system, every drip and gurgle of the journey dutifully recorded by the CIA surveillance-grade mic in front of your face, put there to ensure that no sound gets lost in the telephone-sized booth in which you are being held without bail.

You realize—horrors!—that the process does not stop when the workday ends. When at last you are ensconced in a booth in a local diner, reading the newspaper while spooning up the chili con carne, you come to a Twilight-Zone kind of realization: as you silently read the words on the page, you can hear yourself narrating them through your mind’s ear, in the same annoying singsong voice you have been spewing forth all day, as you involuntarily calibrate which syllables just ahead need theatrical stressing.

And here you thought showbiz was pretty.

What I liked best about the experience was the collaboration: with the very cool young sound engineer Matt Hall across the window in the Vermont studio (see photograph), and with an amazing blithe spirit and gifted producer named Bob Walter, who directed everything through our earphones from his own studio in Los Angeles. Bob immersed himself fully in the nuances of the book, and coaxed me gently into more fitting intonations at several points. The three of us were Very Professional and Serious in the early going, until we (inevitably) stumbled upon the realization that we were all born world-class wiseasses; at which point every “COULD YOU GO BACK AND—” break in the narration was filled by an interlude of wacky voices, improvised shtick, name-dropping and outrageous insults. Our antics kept the inevitable tension at a minimum and made the hard work go easier.

All of this in the service of an audiobook that I hope will convey my full measure of love for my beautiful sons, Dean and the late Kevin, and my passion for illuminating the great human tragedy of schizophrenia, the affliction that took over their lives yet did not manage to extinguish their soaring human spirits.

The audiobook is in post-production as I write. Plans are to integrate excerpts from the boys’ guitar performances as they coincide with elements of the narration.

ANNIE DON’T WAKE THE DAY

Dean and Kevin recorded this rollicking ballad in 2004. It is among the best of several pieces the two of them produced over that summer, a happy time for both of them, when Kevin visited his older brother in Dean’s Colorado Springs apartment. Kev’s schizophrenia had forced him to suspend his music education at the Berklee’s Music School in Boston, and the ensuing year would be his last. But this summer was filled with creative effort and close loving friendship between the two brothers.

Dean wrote and sings lead on “Annie Don’t Wake the Day.” He also created the visual montage that accompanies this song on YouTube. At about the 1:45 mark, the boys launch into blazing alternating guitar solos: Dean/Kevin/Dean/Kevin.

THE RIVER EAST OF HOME

Of all the music Dean and Kevin wrote and recorded together, this ballad is far and away my favorite. It is a quietly transfixing anthem of wayward drift and redemption. Dean composed it not long after his recovery from an addiction to alcohol that had taken hold of him after a terrifying car accident when he was 16, with him at the wheel. The boys recorded it at Dean’s apartment in Fort Collins, Colorado, where he’d invited his brother, by then afflicted with schizophrenia, to spend several months with him. Dean sings lead; Kev sings harmony and contributes the majestic solo midway through, which I describe below.

Remembering Kevin on his birthday. Dean wrote and sings lead on this luminous ballad, "The River East of Home," my favorite among all the work they did together. Kev sings harmony and comes in with a towering solo about halfway through.Be sure to push the sound button up.

Posted by Ron Powers on Thursday, July 21, 2016

 

FROM CHAPTER 15 OF NO ONE CARES ABOUT CRAZY PEOPLE, “. . .something unexplainable. . .”

Dean’s self-willed recovery—reprieve is probably the better word—held benefits for his younger brother. Kevin was able to make it through his spring semester [at the Berklee School of Music] without another setback.  Dean invited him to spend the summer in Fort Collins, passing up the chance to return to his beloved Front Range for road-building work. He had rented an apartment on the first floor of a modest brown wood-frame house in a residential neighborhood not far from the university campus. Kevin gratefully accepted, bringing with him his Martin and amp, and the prescription drugs that were now a part of his daily obligations.

The two of them had a fine old time, the best time of their lives together. They played coffeehouses and bars around Fort Collins and along the winding mountain roads above the city. Sometimes Kevin set aside his guitar and backed Dean up on a borrowed drum-set, playing as though it were the only instrument he had ever touched. Dean wrote a new flurry of ballads, including the two best pieces of his life, and the brothers captured them all on the TEAC recorder that Dean had used for his earlier songs. When Honoree and I arrived for a mid-summer visit, the two were as eager to let us hear them as Kevin had been to play the Booby pieces for me in the Burlington airport two years earlier. They tugged us into Kevin’s room almost before we had set our bags down, and flipped on the TEAC.

We listened first to “Annie Don’t Wake the Day,” Dean’s madcap romp about a night on the town with a frolicsome, laughing girl who skips and dances through the revels, sits in briefly with a bar band, then whirls on, “back out on the street with the bright lights shinin’ away.” Dean sings lead vocals and alternates with Kevin in a jubilant guitar bridge, two solos apiece, the brothers driving hard, a pair of young tigers bursting loose from their cages.

“It’s been a long, crazy night, but don’t wake the day!”

That was for starters. The anthem that followed, the cathedral of notes and lyrics that meditate on loss and journey and hope, on redemption-through-letting-go, stopped our breathing and cupped us in its guileless majesty.

Its title was—is—will always be—“The River East of Home.” Dean wrote it and sang lead; Kevin, harmony. A bridge in the midst of the verses brings up Kevin’s guitar in a cascade of notes that seem to fall from a high place and gather for a moment in a pool before overflowing and dropping again, until they find resolution in the flowing melody at the base.

The opening image is of a figure on horseback, forging along a western mountain path until horse and rider fetch up “at some forgotten fountain.” The rider tries to push his filly on through. “But though it wasn’t wide/She buckled and she balked/She couldn’t see the other side.” The rider tells us of his years of roving between the wilds and mountains. Sometimes he’s on an Arizona highway, right down that center line. Sometimes, crossing water, he falls, and stays down “until I’m good and ready. When I can’t fight the current no more/You’ll find me in the eddy.”

 

But always, the chorus tells us, the rider is searching. Just as Yeats’s wanderer searches for the silver apples of the moon, the golden apples of the sun, the rider is on a quest for the elusive River East of Home. It sounds as though his quest will be eternal. But then, “One chipped and faded chapel shines up out of the valley.” The rider ventures through the doorway, because a voice, long forgotten, calls him. “I said my life’s been driftin.’ He said that there’s an answer. And if I just believe, this slender reed becomes an anchor.

“I let the river go.”

PLANS FOR THE BLOG

On Friday (February 3), Honoree, Dean and I will leave for a week’s midwinter getaway.

On our return on February 13, I will resume preparing blog entries that will alternate between topical developments and commentaries regarding mental health, brief excerpts from NO ONE CARES ABOUT CRAZY PEOPLE (to be published on March 21) and videos/audios of Dean and Kevin performing their music.

I have asked my administrator to publish some of their songs in the coming week, to be refreshed every third or fourth day. I hope you enjoy them. In the meantime, I urge you to keep abreast of national political developments, particularly the ones that involve the future of mental healthcare policy. I welcome any suggestions you may have for coverage or commentary. You may leave them on this blog or on my personal Facebook page, at https://www.facebook.com/profile.php?id=100012275493034

My best to everyone in the coming week!