A Terrifying Picture

Read (beg, borrow or steal) the Opinion piece in yesterdays [4-23-07] Wall Street Journal (my favorite newspaper) by Jonathan Kellerman called Bedlam revisited. (subscription) It's dynamite. And it has an absolutely terrifying illustration by David Klein.

I was moved to write a letter to the editor about it. Of course the odds of getting a letter published in the WSJ are pretty skinny. The nice thing about having a blog, is that I can publish my letter!

So here 'tis...

Letter to The Editor

The biggest question raised by Jonathan Kellerman’s powerful “Bedlam Revisited” is this: Can our country reverse a truly monumental mistake?

When “institutionalization” morphed into “community psychology” in a few short years, and we quickly developed the witches brew of mass homelessness as Kellerman notes, and prisons full of psychotics, there was not so much as a “woops” from the political class. Huge mistake? What mistake?

We had several recent instances here in Albuquerque in which schizophrenics who wouldn’t take their medications went on shooting sprees, one killing a state transportation worker, two young motorcycle shop employees and two Albuquerque police officers, another seriously wounding a female police officer. But it takes a full-scale catastrophe like the Virginia Tech shootings and the insights of someone like Kellerman to put the mental health care issue back on the table.

Re-institutionalization? The two practical questions are: a. Would it really work? b. Can we afford it? The larger question is about individual freedom and personal rights, but unless it is a practical solution to the problems brought about by closing all those mental hospitals, why even discuss it?

Since the mid-seventies there have been many advances in treatment techniques and pharmaceuticals for the mentally ill. Keeping psychotics in controlled environments under state-of-the-art treatment has a far better chance of succeeding now than ever.

Just taking the mentally ill out of the prison systems and redirecting the money spent on them there would pay a meaningful portion of the costs. Since U.S. citizens are coming to the position that we must take better care of our wounded veterans – and since so many of our mentally ill homeless are vets – there is another potential revenue stream.

We can afford it – we can’t afford not to do it. And it would work, at least a whole lot better than what we have now. Surely our public officials have their personal liberties instincts honed by current challenges enough to write effective safeguards.

Now all we have to do is convince those “conservative scrooges” Kellerman mentioned.

P.S. The WSJ did publish it on May 1st - at least the edited version below. Everything is improved by editing. sd

Should we, as a society, attempt re-institutionalization of the mentally ill? The two practical considerations are: 1.) Would it really work? 2.) Can we afford it? A larger question is about individual freedom and personal rights, but unless it is a practical solution to the problems brought about by closing all those mental hospitals, why even discuss it?

Since the mid-1970s there have been many advances in treatment techniques and pharmaceuticals for the mentally ill. Keeping psychotics in controlled environments under state-of-the-art treatment has a far better chance of succeeding now than ever.

Just taking the mentally ill out of the prison systems and redirecting the money spent on them there would pay a meaningful portion of the costs. We must reverse this "de-institutional" mistake. We can afford it. And it would work at least a whole lot better than what we have now. Surely our public officials have their personal liberty instincts honed by current challenges enough to write effective safeguards.