Violence and illness: Treating the mentally ill

When violence breaks out and murder occurs, we want an explanation, a reason, and preferably someone to blame. After Buford Furrow shot children at a Jewish day-care center and then a Filipino-American postal worker in Los Angeles, the media trained its sights on the Idaho-based Aryan Nations, to which Furrow belonged. Full-page stories with color pictures took us into the lair and the mind of Aryan Nations founder Richard Butler. After Larry Gene Ashbrook opened fire at Wedgewood Baptist Church in Fort Worth, reports surfaced about his link with an Aryan Nations-like group known as the Phineas Priesthood.

I think we need to monitor such groups. I am glad that the Southern Poverty Law Center and similar watchdog agencies report on the activities of organized hate groups. Yet I worry about laying blame at their doorstep. Such organizations can be more easily stigmatized than understood. And it is not difficult to come to the conclusion that such groups are a social malignancy, candidates for surgical removal. The catastrophe at Waco with the Branch Davidians ought to caution us against simply stigmatizing offensive groups. Sometimes we can get so scared of something that we end up doing things we ought not to do, things that we regret.

Explaining the Buford Furrows and Larry Gene Ashbrooks of the world by pointing to hate groups can also obscure the role that mental illness plays in these terrible incidents. Before Furrow made his fateful trip to Los Angeles his family had sought help, even hospitalization, for him. They did not get it. For anyone with even a rudimentary knowledge of mental illness and its symptoms, Ashbrook's story was full of warning signals. Neighbors described a man given to sudden mood swings and outbursts of anger, a man who had just sustained the loss of his father. Ashbrook's letters to newspapers and radio stations in Fort Worth were replete with paranoid fantasies and accounts of hearing voices. Yet the media reports did not emphasize mental illness. Instead we heard about the Phineas priests. We heard professors from Southwestern Baptist Theological Seminary speaking of the battle with Satan. And we heard Governor George W. Bush say that what we're up against here is "evil."

We are by and large terribly ignorant about mental illness. It scares us. We have done a poor job not only in educating people about mental illness but in treating those who suffer from it and in supporting their families.

This is not to suggest that those who suffer mental illness are inherently more prone to violence than others, or that the solution is to criminalize and imprison them. There is already entirely too much recourse to that, often by default, since people with a mental illness often go untreated. Eventually some of them commit a crime and end up in jail—where they remain untreated. A significant percentage of our swollen prison population is made up of people with untreated mental illness.

Mental illness and those who suffer from it are often shrouded in ignorance, fear, shame and isolation. Those suffering from schizophrenia, bipolar disorder or major depression are often not receiving either medical treatment or social support.

For several decades we have been fashioning a social ethic that says, "You're on your own." One is reminded of the passage in the Letter of James: "If a brother or sister is ill-clad and in lack of daily food, and one of you says to them, 'Go in peace, be warmed and filled,' without giving them the things needed for the body, what does it profit?"

In his 1995 study, Surviving Schizophrenia—A Family Manual, E. Fuller Torrey estimates that 90 percent of those who would have been in psychiatric hospitals 40 years ago, before deinstitutionalization really got under way, are not hospitalized today. A significant number live with their families, families which themselves are often isolated and drained by the task of caring for them. Many of those who suffer mental illnesses live alone. And many, far too many, live on the streets and in homeless shelters. By most estimates the mentally ill make up 40 to 50 percent of the homeless population. It does not, as they say, take a rocket scientist to see that a significant number of the people haunting street corners and alleys are our brothers and sisters who are ill. Imagine deciding that we would put 90 percent of all cancer patients out on the street!

I speak not only as a minister who has worked with persons experiencing mental illness and with their families, but as one who has gone through a severe depression and who has mental illness in his family. Mental illness is a complex matter; I am not a mental health professional. But I have learned a few basic lessons about the illness and its treatment:

First, the brain is an organ of the body. Like the kidney or the heart, the brain can get sick. The brain may be traumatized by loss or violence. Or there can be too many or too few of certain chemicals necessary for proper functioning. The result is a disorder in thinking, mood and behavior.

Such disorders do not reflect a character defect or a moral failure; they reflect an illness. Those suffering from a mental illness are not bad people. Indeed, part of the heartache for their families is that they are often quite extraordinary and gifted people.

Second, mental illnesses are treatable. Medication, in concert with social support, can help many people regain normal functioning, much the way insulin and diet can allow a diabetic to manage that illness.

Third, despite variations in law and treatment from state to state, people suffering from mental illness are usually able to refuse treatment until it can be shown that they constitute a threat to themselves or to others. If they climb to the top of a bridge or have a knife in their hand, then something can be done, but not until then.

This means that much of the time treatment comes too late. And often treatment is of such short duration that the cycle of illness repeats itself. There has to be a humane middle ground between locking people up and the looking the other way or walking faster past them.