My excuse was youth. What’s theirs?

Barbara Amiel on why mental illness can’t be treated with legalities

My excuse was Youth. What's theirs?

Doral Chenoweth III/Columbus Dispatch/AP

Back in the 1960s I had “Charlie.” Charlie was a derelict living in Toronto flophouses. I was a CBC researcher living in a highrise studio apartment. My assignment was a documentary on skid row lives, and Charlie was one of the three winos I had selected. All of them had mental disorders of varying degrees. They heard voices or suffered from paranoia. The day before shooting, Charlie went AWOL, ending up in the drunk tank. I bailed him out on CBC expense money.

Charlie didn’t have a golden voice, but he heard lots of voices and had conversations with them all. He wanted a regular job, he told me. After filming, I bought him a clean T-shirt and took him to a centre hiring hourly labourers. When I came home, an inebriated Charlie was waiting. He preferred working on camera and thought that was his true calling. I took him into my apartment for coffee and a talking-to. Afterwards he left—taking some small sterling silver items of mine.

My excuse was plain stupidity and youth. I’m not sure what excuses the enthusiasts behind the golden-voiced, down-and-out Ted Williams who, in a predictable arc after discovery by a journalist, gained worldwide fame, was arrested for an altercation, took part in an intervention on television’s Dr. Phil show, and disappeared into rehab. His sob story was watched by millions, when they weren’t watching people with utterly no connection to victims of the Tucson killings (except nearby zip codes) sobbing their eyes out. Heaven knows, Americans can go on “healing” and “counselling” and “intervening” until every last person is in therapy. But the problem when a popular culture goes barking mad is that complicated problems get reduced to cartoons.

The Tucson murders raise issues that can’t be cured by a “walk for peace,” calls for healing—or gun control. Jared Loughner was demonstrably mentally disturbed. He used a gun to kill six people and wound 14, though he could as easily have driven a truck into that crowd, or a snowplow like the Toronto chap who allegedly went on a 90-minute rampage last week and killed a policeman. Because Loughner had previously given signs of an unquiet mind, demands surfaced for a central registry (in cloudland perhaps) noting symptoms so he could have been prevented from purchasing weapons. Since blame must be assigned, we have the college who didn’t report him to authorities, the police who let him off earlier when he ran a red light, and the man in the moon who must have heard his nightly wailing.

I’d be all for gun control if it would help rather than aggravate the situation—if you could remove guns from criminals or insane people alone rather than those on the side of the angels. But it makes no sense. After all, a life or two might have been saved if someone in that crowd at Safeway’s had had a gun in their handbag.

The passengers on the Greyhound bus travelling along the TransCanada Highway ran like hell as one of them stabbed and decapitated his seatmate, but I doubt if a passenger with a gun would have run, let alone the bus driver if armed. Here in Florida, where I am staying, a bill is proposed to allow the unconcealed carrying of weapons. The thought of encountering visibly armed fellow shoppers at the 7-Eleven store is unnerving at first, but on consideration I suppose it should be reassuring.

How do you deal in advance with people who have mental disorders that may turn violent—short of an Orwellian society? Loughner had no criminal convictions, no hospitalization. There are loads of websites with feedback 10 times more violent and bizarre than his ramblings. In a litigious society, what American doctor would risk certifying anyone incapable of violence and fit to own a gun? What university would risk being sued for reporting a student because they said inappropriate things in class? Was it political correctness, liability worries or both that, according to National Public Radio, suppressed the discussions at Walter Reed Medical Center about perceived paranoid behaviour in Maj. Nidal Hasan, who allegedly went on to kill 13 Army personnel at Fort Hood? Tort reform in America that reduces liability and jury awards would be more help in reducing violence than gun control.

Starting in the 1960s, a deinstitutionalizing movement ended most forcible medicating and confinement of mentally ill patients in Canada and the U.S. The result were Charlies: people unfit to live in the outside world sleeping on streets, wandering about muttering to themselves, or in prisons. Families were wrecked by members who would not take their antipsychotic medication and could not be forced to, except for short periods of time. A reasonable guesstimate was that 98 per cent of people with mental illnesses did not commit violent acts. Should they all be locked up, declared incompetent or rigorously monitored for the two per cent that might? For how long? If the voices tell a person to paint himself blue, what harm to society or himself? How can we know in advance if the same voices will order something violent?

I have no difficulty with a society that makes it hard to lock people up for a meaningful period of time, though I have some difficulty with making it virtually impossible. Getting the right balance is difficult in the best of circumstances. But mental illness is now defined and treated in a defensive legal setting rather than an aggressive clinical one. If this is to continue, there is no point our going beserk when a lone individual does. We must submit to the rule of trial lawyers and legislators and quietly bury our dead.




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My excuse was youth. What’s theirs?

  1. "Legalities" come from the enforcement arm of government, and governments are supposedly organized for the welfare of citizens…of all ranges of mental function. Deinstitutionalization was a "cost-saving measure" undertaken at the cost of the personal safety and well-being of people with mental dysfunction and any other citizens who may be adversely affected by these dysfunctions.

    Mental illness is treatable, but more than that, it is largely preventable. On average, environmental/social influences are estimated to be responsible for over half the cases of schizophrenia, the disorder most often pointed to as being purely of "genetic" origin. Other mental disorders such as antisocial personality disorder (which causes a huge amount of crime and suffering to all citizens) also is primarily a result of adverse social environment.

    Ignoring people who develop problems later in life is not the answer. Treating these people to help them improve their level of function is a money-saver (as compared to repeated offending/incarceration), but the real savings of lives, human suffering, and money comes in prevention, education, and early intervention — all of which can be enacted via "legalities" from governments responsible for the welfare of their citizens.

  2. "Legalities" come from the enforcement arm of government, and governments are supposedly organized for the welfare of citizens…of all ranges of mental function. Deinstitutionalization was a "cost-saving measure" undertaken at the cost of the personal safety and well-being of people with mental dysfunction and any other citizens who may be adversely affected by these dysfunctions.

    Mental illness is treatable, but more than that, it is largely preventable. On average, environmental/social influences are estimated to be responsible for over half the cases of schizophrenia, the disorder most often pointed to as being purely of "genetic" origin. Other mental disorders such as antisocial personality disorder (which causes a huge amount of crime and suffering to all citizens) also is primarily a result of adverse social environment.

    Ignoring people who develop problems later in life is not the answer. Treating these people to help them improve their level of function is a money-saver (as compared to repeated offending/incarceration), but the real savings of lives, human suffering, and money comes in prevention, education, and early intervention — all of which can be enacted via "legalities" from governments responsible for the welfare of their citizens.

    • Mental illness is treatable…

      …and if that were actually true, if treatment was effective with minimal side effects, like, say, for appendicitis, we wouldn't be having this conversation.

      In fact, mental illness is NOT all that treatable. There is stigma aplenty associated with it, so people do not seek help when they need it, refuse the help when it's offered, and stop getting the help once it's underway. Many of the medicines make people feel like crap, even if they are strong enough to see past the ridiculously unfair stigma, so staying on a treatment plan is a major challenge.

      The truth is, most people would rather be in a room with twenty horribly disfigured burn victims and amputees than sit on a bus with three schizophrenics off their meds. Notwithstanding the well-intentioned deinstitutionalization that freed those afflicted to be out in the community among the rest of us, the community is not all that disposed towards being anywhere near them. And here we are.

      • Absolutely right. With a stroke of a pen they were all cured of their problems and set free with, for some, their last dose of meds to get them through the day. The next day was a problem but small as some were responding to the meds they recieved and it took a week before the calamity began.
        Where did they sleep the first night away? What food did they eat? What friends did they make? What did their Drs do? What is the first line from the Hypocritic Oath. First do now harm.
        What happened to them??????

    • Most mental illness is not treatable. Most medicines treat the symptoms, not the problems.

      And your claims about schizophrenia are wrong, the causes are largely unknown. What you attempt to cite as fact is simple speculation, nothing more.

      • Hey Joe. Simple speculation is the first step to determining the truth.

    • Mental illness is treatable, it's just rarely curable.

  3. Mental illness is treatable…

    …and if that were actually true, if treatment was effective with minimal side effects, like, say, for appendicitis, we wouldn't be having this conversation.

    In fact, mental illness is NOT all that treatable. There is stigma aplenty associated with it, so people do not seek help when they need it, refuse the help when it's offered, and stop getting the help once it's underway. Many of the medicines make people feel like crap, even if they are strong enough to see past the ridiculously unfair stigma, so staying on a treatment plan is a major challenge.

    The truth is, most people would rather be in a room with twenty horribly disfigured burn victims and amputees than sit on a bus with three schizophrenics off their meds. Notwithstanding the well-intentioned deinstitutionalization that freed those afflicted to be out in the community among the rest of us, the community is not all that disposed towards being anywhere near them. And here we are.

  4. Most mental illness is not treatable. Most medicines treat the symptoms, not the problems.

    And your claims about schizophrenia are wrong, the causes are largely unknown. What you attempt to cite as fact is simple speculation, nothing more.

  5. Meanwhile, Andy Rooney has a moment of that "someone walking over my grave" feeling.

  6. That part about armed bystanders who could've saved lives during the Arizona shooting isn't worth the pixels it's written on. There WAS one, Joe Zamudio, and he came close to shooting at someone who was trying to disarm the killer. He was stopped just in time by other people attending the scene. (he was trying to help, just so it be clear) Anyways, most gun carriers don't have the training to react in "combat" situations, never mind take down hostiles quickly.

    And besides, can anyone tell me how a civilian could ever need a 33-bullet clip? If you're on a shooting range, you can just reload. If you're not on a shooting range, you'll likely not be carrying your weapon with such a clip, because its sheer size makes it simply unpractical to carry. In short, the only reason you'd "need" it is to be able to engage multiple targets, something that doesn't happen so frequently outside of videogames.

  7. That part about armed bystanders who could've saved lives during the Arizona shooting isn't worth the pixels it's written on. There WAS one, Joe Zamudio, and he came close to shooting at someone who was trying to disarm the killer. He was stopped just in time by other people attending the scene. (he was trying to help, just so it be clear) Anyways, most gun carriers don't have the training to react in "combat" situations, never mind take down hostiles quickly.

    And besides, can anyone tell me how a civilian could ever need a 33-bullet clip? If you're on a shooting range, you can just reload. If you're not on a shooting range, you'll likely not be carrying your weapon with such a clip, because its sheer size makes it simply unpractical to carry. In short, the only reason you'd "need" it is to be able to engage multiple targets, something that doesn't happen so frequently outside of videogames.

    • Not to mention she's trotting out the old argument about how "we can't stop sick people and criminals from getting guns, so we shouldn't try," which, as soon as you replace "getting guns" with "committing murder" you see how lunatic the argument is.

      I wish the gun-rights advocates would acknowledge that so we can move on past that stupid talking point to debating just how much control is suitable given the reduction it will provide

    • The idea that if individuals armed themselves personal and public safety would be advanced seems to me to be a kind of Mitty type of fantasy. For every instance of a shopping file clerk pulling out her Glock and shooting dead a maniac who's executing people in the vegetable aisle of Safeway, I think there would be exponentially more cases of irate people in Walmart parking lots shooting some poor sod in the head after an argument over a parking spot; or of toddlers shooting themselves with carelessly stored firearms. Guns would tend to replace fists in the spontaneous resolution of disputes. I tend to believe that the armed and prepared hero only resolves acts of supermarket slaughter in Stallone movies.

  8. Not to mention she's trotting out the old argument about how "we can't stop sick people and criminals from getting guns, so we shouldn't try," which, as soon as you replace "getting guns" with "committing murder" you see how lunatic the argument is.

    I wish the gun-rights advocates would acknowledge that so we can move on past that stupid talking point to debating just how much control is suitable given the reduction it will provide

  9. Ms. Amiel makes some very good points as to how is society going to determine who is mentally ill and dangerous and others who simply want to "paint themselves blue". It's a wonder more tragedies don't happen , as there is truly little help in the Health care System to treat anyone, never mind the mentally ill who can barely function. I once brought a friend who was suicidal to the hospital for treatment. The doctor who saw her said "unless she hurts herself , there is nothing we can do". My friend said "so I should go home and do something harmful to myself, and then come back"? A year later she did, and there was no more returning for any help.
    Why can't we have places for people to stay when they truly need it, that are comfortable, staffed with caring knowledgeable people who will provide the help needed. I know that's just a dream.

  10. Ms. Amiel makes some very good points as to how is society going to determine who is mentally ill and dangerous and others who simply want to "paint themselves blue". It's a wonder more tragedies don't happen , as there is truly little help in the Health care System to treat anyone, never mind the mentally ill who can barely function. I once brought a friend who was suicidal to the hospital for treatment. The doctor who saw her said "unless she hurts herself , there is nothing we can do". My friend said "so I should go home and do something harmful to myself, and then come back"? A year later she did, and there was no more returning for any help.
    Why can't we have places for people to stay when they truly need it, that are comfortable, staffed with caring knowledgeable people who will provide the help needed. I know that's just a dream.

    • You make some good points about the health care system. It is certainly challenged in the mental health field as it can't really claim to have any definitive explanations for anything, much less cure them. Much of what they claim to know is simply speculation on their part. I once called a psychiatrist because her patient had attempted suicide. I thought it the logical thing to do, but when I told her why I was calling, she said, "What do you want me to do about it?" I was left speechless.

  11. You make some good points about the health care system. It is certainly challenged in the mental health field as it can't really claim to have any definitive explanations for anything, much less cure them. Much of what they claim to know is simply speculation on their part. I once called a psychiatrist because her patient had attempted suicide. I thought it the logical thing to do, but when I told her why I was calling, she said, "What do you want me to do about it?" I was left speechless.

  12. The idea that if individuals armed themselves personal and public safety would be advanced seems to me to be a kind of Mitty type of fantasy. For every instance of a shopping file clerk pulling out her Glock and shooting dead a maniac who's executing people in the vegetable aisle of Safeway, I think there would be exponentially more cases of irate people in Walmart parking lots shooting some poor sod in the head after an argument over a parking spot; or of toddlers shooting themselves with carelessly stored firearms. Guns would tend to replace fists in the spontaneous resolution of disputes. I tend to believe that the armed and prepared hero only resolves acts of supermarket slaughter in Stallone movies.

  13. The person afflicted with a physical illness knows that they have an illnes, the person with a mental illness may not or does not know they have an illness. I am not a professional but what I have learned is that mental illness is a physical problem(s) with the brain and can be simple as certain deficiencies in the body like "Niacin" .__Problem is how do you treat someone that doesn't think there is anything wrong with them, but believes the wrong is with the world around them and often the people around them. Our laws tie our hands to help loved ones with mental illness, where to turn, what to do, how to get help for them as well for families affected is a maze of dead ends. Our laws shut us out, praticioners cannot & do not disclose any information or diagnosis of patients with mental illness to their families so how can we take care of our loved ones. The stress, anxiety & frustration of not being able help, not knowing what is the right thing to do breaks up familial relationships. If 1 in 5 people are affected by mental illness, where is our society going, who will or can take responsibility?

  14. The person afflicted with a physical illness knows that they have an illnes, the person with a mental illness may not or does not know they have an illness. I am not a professional but what I have learned is that mental illness is a physical problem(s) with the brain and can be simple as certain deficiencies in the body like "Niacin" .__Problem is how do you treat someone that doesn't think there is anything wrong with them, but believes the wrong is with the world around them and often the people around them. Our laws tie our hands to help loved ones with mental illness, where to turn, what to do, how to get help for them as well for families affected is a maze of dead ends. Our laws shut us out, praticioners cannot & do not disclose any information or diagnosis of patients with mental illness to their families so how can we take care of our loved ones. The stress, anxiety & frustration of not being able help, not knowing what is the right thing to do breaks up familial relationships. If 1 in 5 people are affected by mental illness, where is our society going, who will or can take responsibility?

    • Just another thought on mental illness. I have to wonder about some people playing the insane card in court, welfare offices, on the street and in your face. As it isn't hard to "act" mentaly ill, proving wether or not is almost impossible.

  15. Ummm…wasn't the good doctor who shot up the place on a military base supposedly surrounded by armed people? Didn't seem to help much there. Or the four cops shot in Alberta, all armed. Rarely does the Dirty Harry fantasy work out. If the answer was having the populous armed to the teeth America would be the safest place on Earth. Sadly over a million people have been killed by guns since 1967. To put that in perspective America lost 55,000 in Vietnam.

  16. Ummm…wasn't the good doctor who shot up the place on a military base supposedly surrounded by armed people? Didn't seem to help much there. Or the four cops shot in Alberta, all armed. Rarely does the Dirty Harry fantasy work out. If the answer was having the populous armed to the teeth America would be the safest place on Earth. Sadly over a million people have been killed by guns since 1967. To put that in perspective America lost 55,000 in Vietnam.

    • The people on the base were, in the main, unarmed. By order.

  17. Ms. Amiel has spent far too long in America. The idea that more guns in public hands would prevent unnecessary deaths is short sighted and disappointing. As was mention by another, the typical citizen is not trained to combat a gunman. In Arizona, even more people could have been killed if multiple people pulled guns and tried to stop the madness. And what of the next argument in a lineup that escalates to someone pulling their gun to end it. Less guns not more…very disappointing Barbara.

    • If you lived in a different neighborhood, you might get a different opinion.I don't think there is anything short-sighted about the opinion of an intelligent lady.

  18. Ms. Amiel has spent far too long in America. The idea that more guns in public hands would prevent unnecessary deaths is short sighted and disappointing. As was mention by another, the typical citizen is not trained to combat a gunman. In Arizona, even more people could have been killed if multiple people pulled guns and tried to stop the madness. And what of the next argument in a lineup that escalates to someone pulling their gun to end it. Less guns not more…very disappointing Barbara.

  19. I tend to agree with most of the comments of readers here, rather than Barbara's. Less guns has to mean a few less problems regardless of all the rest of the picture, which is difficult to solve. I do agree with her less therapy idea though.

    • Fewer guns in the hands of police and the military: good idea. Fewer guns in the hands of private individuals: a tyrant's dream.

      • Dream on.

  20. I tend to agree with most of the comments of readers here, rather than Barbara's. Less guns has to mean a few less problems regardless of all the rest of the picture, which is difficult to solve. I do agree with her less therapy idea though.

  21. Mental illness is treatable, it's just rarely curable.

  22. The people on the base were, in the main, unarmed. By order.

  23. Fewer guns in the hands of police and the military: good idea. Fewer guns in the hands of private individuals: a tyrant's dream.

  24. Just another thought on mental illness. I have to wonder about some people playing the insane card in court, welfare offices, on the street and in your face. As it isn't hard to "act" mentaly ill, proving wether or not is almost impossible.

  25. Dream on.

  26. Lawyers and legisators are one and the same and that is why they both don't work.

    Ms. Amiel hath not a clue what she speaks of. Dance lessons. That's the only cure
    for mental illness.

    http://ahabit.com/axiom.htm

    One more thing. I am a certified psychotic, I know exactly what I speak of.

    Second Point: If I was Conrad Black's Trial Lawyer, he would be a free man today.

    All in good fun…Barbara !

  27. Lawyers and legisators are one and the same and that is why they both don't work.

    Ms. Amiel hath not a clue what she speaks of. Dance lessons. That's the only cure
    for mental illness.

    http://ahabit.com/axiom.htm

    One more thing. I am a certified psychotic, I know exactly what I speak of.

    Second Point: If I was Conrad Black's Trial Lawyer, he would be a free man today.

    All in good fun…Barbara !

  28. When freedom is a facade, we are a society that arbitrarily imprisons, not everybody who is dangerous or who violates the law, but one or two "examples" to make ourselves feel superior. It's "us" against those wretched prisoners, when the truth is, the most wretched criminals are roaming the streets, to give the police the opportunity to mop up the latest, dead body.

    That's my short summary of Ms. Amiel's classy column.

  29. When freedom is a facade, we are a society that arbitrarily imprisons, not everybody who is dangerous or who violates the law, but one or two "examples" to make ourselves feel superior. It's "us" against those wretched prisoners, when the truth is, the most wretched criminals are roaming the streets, to give the police the opportunity to mop up the latest, dead body.

    That's my short summary of Ms. Amiel's classy column.

  30. If you lived in a different neighborhood, you might get a different opinion.I don't think there is anything short-sighted about the opinion of an intelligent lady.

  31. Hey Joe. Simple speculation is the first step to determining the truth.

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