VIRGINA TECH – PART II

So, yesterday’s rant is now obsolete. From the news reports I heard this morning, our killer has now been deemed as “crazy”, in the psychiatric sort of way. I haven’t gotten to the details yet but it appears school officials and other students were aware of his bizarre behaviors and tendencies to scare/terrorize other students. However, my contentions around responsibilities still stand. For whatever reason, he failed to seek help for his internal terrors and the people immediately around him failed to help also for I am sure he didn’t just wake up one day and start acting like this. I will only tweak things a little.
About 30 years or so ago a movement began in the U.S. to close psychiatric hospitals around the country. Medications to help control or manage mental illness were coming on the market and showing some promise and the goal was to bring these individuals back to their communities and closer to their families. Unfortunately, the needed number and type of group homes and community support systems never got built, the medications did not give the level of “cure” or even manageability hoped for (and sometimes promised to families), and the money used initially to run the psychiatric hospitals but was then earmarked for the community-based care got eaten up by other priorities. Now, the money is gone, this generation of medications don’t always work (despite the fact they have fewer side effects), families and communities are worn out from trying to care for these individuals on their own, and the mentally ill fill the back alleys of our cities or the psychiatric wings of our prisons. Add to things those cultural matters surrounding mental illness-still people have a very poor understanding of mental illness and as a result wish it would just go away (“Why can’t Johnny just act right?”) or figure if they will ignore it, the person will just go away, as in the case of the VT shooter.
Professors, and more likely friends, family, and acquaintances, just kept their distance, hoping this guy would either “get it and straighten out” or would at least leave them alone. No one bother to step up to the plate and get him help. Why? You’d have to ask them but even if someone wanted to get him help, where could he go?
If you come to the emergency room with a broken leg or having a stroke, you are immediately surrounded by doctors, nurses, and techs administering some sort of care. Enter your local emergency room, particularly after 6pm, claiming that you are a divine being and it could take hours for some beleaguered, over worked psychiatric social worker to start an evaluation. After trying extract the most basic information, he/she has to contact the on-call psychiatrist and, if she believes your are an immediate harm to self or others, convince the doctor to admit you. Then, she/he must search the area for an open psychiatric bed and if found , find transport for you to that facility. Once there, every heavy duty psychiatric horse pill on the planet will be stuffed down you throat until you acquiesce, and accept the fact that you have no power over the voices and will stop bothering people. By the way, you’d better have done all that by the end of no more than 7 to 14 days, otherwise you’re getting discharged anyway. You will be discharged with a list of community-based psychiatric clinics and maybe enough coin change to get there but not to get back home, if you have one. Oh, I forgot, if you don’t have insurance or your Medicaid has lapsed, probably half of this won’t happen and who knows what half that will be. So if you weren’t crazy before this started, you sure are now.
The state of mental health care in this country is horrific – even more so than during the times of the snake pits. We know more now about the causes and treatment but still do so little, either for the patients or the family. Even those of us with insurance can only, at best, count on 30 days per year of inpatient care while most reputable treatment providers will tell you that many people may need up to four months to find out which medication (and at what dosage) or medication combinations will be effective in managing the disease. And these folks have no lobbyists and they aren’t attractive, so they are easily ignored when we pass them begging on the streets, huddling in doorways, or swept inside our prisons.
Mental health care is health care and should be treated with parity along with diabetes and high blood pressure treatment. People went screaming in the streets and political leaders became apoplectic when Terri Schivo’s food tube was removed. I hardly see that happen when some mentally ill person is turned out onto the streets after receiving substandard care from some money hungry ER.
So next time you are bitching about how Virginia Tech school officials did little to help or prevent the VT shooter from rampaging through the campus, be ready to explain to them the last time you voted for universal health care and increased funding for psychiatric care. Or better yet, you may want to vote first.