No One [Knows Much] About Crazy People

Well, not “no one.” Still, the levels of ignorance, too often coupled with hostility or sheer meanness, remain unacceptably high in this country. We in what I’ve called “the sub-nation” must never assume that the people we encounter will have even a working knowledge of severe mental illness: not a relative, a next-door neighbor, a caregiver, a police officer, a stranger in the park or on the street–not even the President of the United States.

Below are three recent bits of evidence that prove my point. The first is the text of a Facebook post by Scott Carpenter, a leading reform advocate based in Iowa.

Scott and his wife Leslie, who have seen a family member stricken, are among the strongest voices in America for what needs to be done. Yet not even they are immune from incidents of unexpected and bewildering hatefulness:

“So we’re helping to set things up before a Moms Demand Action Rally in Iowa City.

An elderly man walks [up to me] and says that ‘the problem isn’t about guns. It’s about crazy people.’

Leslie (against my advice to not engage) indicates that we have a son who has a serious mental illness and that he should come listen to he comments in an hour or so. He declined.

Then he said, ‘your son and all of the crazy people should be taken out in a field and shot. That way they could be useful as fertilizer’.

Please don’t ever think that a day of activism is easy.

Scott J. Carpenter”

When you have caught your breath from that, please follow the two links below.

The first link is to some remarks that President Trump made to campaign workers before a political rally in New Hampshire, in which he continues his strange and uninformed characterization of the mentally ill as, collectively, a horde of depraved killers that must be rounded up and swept into asylums. This and other tirades show that Trump knows nothing about insanity and cares less: his real agenda is deflecting attention from the ongoing mass-shooting crisis: The article leaves no doubt about this:

“Trump said many other Republican leaders and the public don’t want ‘insane people, dangerous people, bad people’ owning guns.” 

CNBC.com: Trump says US should build more mental health institutions to combat gun violence: https://www.cnbc.com/2019/08/16/trump-suggests-more-mental-health-institutions-to-combat-gun-violence.html

The second link offers a rebuke to the president delivered by Angela Kimball, the acting CEO of the National Alliance on Mental Illness.

“Words matter, Mr. President. ‘These people’ are our friends, neighbors, children, spouses. They’re not ‘monsters,’ ‘the mentally ill’ or ‘crazy people’ – they’re us. Talking about reinstitutionalization only further marginalizes and isolates the one in five people with mental illness. Instead, we need to be talking about the power of early treatment and effective intervention to change lives.”

NAMI.org: NAMI’s Statement Regarding President Trump’s Comments On Reinstitutionalizing People With Mental Illness: https://www.nami.org/About-NAMI/NAMI-News/2019/NAMI-s-Statement-Regarding-President-Trump-s-Comments-on-Reinstitutionalizing-People-with-Mental-Ill

These are but a couple of examples of incidents and attitudes that repeat themselves daily in America. They underscore the urgency of the seminal five-part manifesto organized by advocate Dede Ranahan and made widely available online and to presidential candidates last week. (Ranahan’s mentally ill son Patrick died in an institution in 2014.) The lessons in Ranahan’s great document are many and vital.

What I have outlined above constitutes just one. It is at once tiresomely repetitive and freshly urgent: We can never assume that any given individual–not even our Chief Executive–knows much about crazy people. And we must work relentlessly to change that.

P.S. Mental healthcare advocates Scott and Leslie Carpenter discussed the challenges they experienced when seeking proper care for their son Patrick during an interview with The De Moines Register. What they share is both heartbreaking and informative. I encourage you to take a few moments to watch their interviews below to better understand how mental healthcare policies and procedures often fail to provide effective or compassionate care to the mentally ill.  If you would like to share your own experiences of mental healthcare for yourself or a loved one, I invite you to comment below.

Stories from the front lines of Iowa’s mental health crisis


“Mentally Ill Monsters”

In the aftermath of two traumatic mass shootings, the president re-invokes a horrid, distorted falsehood about the mentally ill.

And there it is: history’s defining damnation of sufferers of incurable damage to the brain, distilled into a three-word phrase of transcendent ugliness and stunted understanding.

The phrase was uttered on Monday. It was uttered to identify the provenance of the weekend’s massacres by shooters using legally purchased high-capacity semi-automatic weapons toward their collective harvest of 31 people dead and some 50 wounded. 

The phrase was uttered by the President of the United States. It left stains, stains which, in moral and intellectual terms, replicated the stains of blood shed by the shooters’ victims. 

Donald Trump | Image Credit Gage Skidmore via Flickr

Blaming “mentally ill monsters” (or “nut jobs,” or “wackos,” or “lunatics”) for such carnage is a morally repugnant, if time-tested device for shifting the public’s passion for safety away from gun control and toward the presumed demons in our midst. The president could not have been more transparent in exploiting the device. “Mental illness and hatred pulls [sic] the trigger, not the gun,” he instructed us, going on to label one of the shooters as “another twisted monster.” 

In fact, it is a settled truth in psychiatric research that victims of brain afflictions are no more prone to violence than the general population. The prominent advocate Dj Jaffe makes an important stipulation: that the untreated mentally ill—those not stabilized by antipsychotic medications—can be more likely to cause harm to themselves or others. Still, implying that mental illness itself equates to degenerate aggression serves only to further isolate and punish the most helpless members of our society; to herd them back toward the dark corners and confinements of “insane asylum” days.

And herein lies the “intellectual” stain that President Trump’s words help spread: most people—like the president himself—do not understand mental illness: what it means, how it occurs, how it differentiates, why its victims behave as they do, and how even its most abject sufferers can be aided, often stabilized, by medications and therapy. In this vacuum of understanding, people tend to substitute prejudice, false science, myth, and hostility toward “crazy people.” 

Briefly: 

“Serious” mental illness—the kind in question here—is rare and unique. And incurable. Unlike alcoholism or anger or depression, serious mental illness is rooted in genetic flaws of the brain. Its various names include schizophrenia, schizoaffective disorder, bipolar disorder—similar yet not interchangeable conditions. It results in a loss of reason and rational control; hallucinations and the hearing of voices; alienation from family and friends; and, yes, sometimes—rarely—violence. 

My wife and I have educated ourselves about serious mental illness because we’ve had to. It invaded our family several years ago, causing the suicide of a beloved son. Unfortunately, this is the painful route to understanding for most people: a loved one is stricken.

The costs of this cluelessness describe a cone of destruction that widens from the stricken individual through society.

The cone draws in and ravages parents and siblings of the stricken. It can cripple the finances of families without adequate insurance to cover treatment and medications. It drains human capital from the workforce, and thus economic revenue. It reduces the budgets of hospitals that can’t get reimbursement for their mentally ill patients. It overburdens police, whose lack of training and, sometimes, self-restraint, can result in death by gunshot of unarmed people in psychosis. It coarsens our criminal-justice system: think of schizophrenic adolescents hustled into jail by untrained or uncaring judges, where they await trial—often for weeks and months—while their unmedicated psychosis deepens. Think of solitary confinement. Think of a brain-afflicted child, perhaps your own (as countless parents must) ensorcelled in a cell, abused by fellow inmates and guards, with no end in sight, no comprehension. No hope.

Now think about “mentally ill monsters.”

Mentally ill monsters are not the source of our current crisis of public massacres. The monster is the gun: too many guns, with too little restraint and oversight regarding purchase. To his credit, President Trump gave lip service to keeping guns away from those “who pose a  grave risk to public safety,” and to strengthening gun laws generally. 

But leave the gun issue aside. Part of any president’s duty—a foundation of his “bully pulpit”—is to educate his fellow citizens on matters of complexity and urgent public import. The nature of serious mental illness, and the reclamation of its victims, comprise one such matter. The president could make a great, galvanizing contribution to ending the centuries-old oppression of “crazy people.” He could lead us in that direction. He could educate us. But first he must educate himself.