Seung-hui Cho clearly was mentally incapacitated. He clearly was a menace to society and to himself, but who could have predicted that he would respond to his situation in the way he did? Even Cho's roommate was shocked and surprised by what transpired. So how do we decide who to haul away in handcuffs? And who should make those decisions?
In view of the recent Virginia Tech massacre, it is easy to say that a mentally ill person should simply be locked up until his or her symptoms abate, but the fact is that treating mental illnesses rarely resolves a person's problems quickly. Instead, this is usually a long and time-consuming process that requires a fair amount of money and patience. Many people with a mental illness lack one or more of these resources, so they suffer, and their loved ones suffer along with them.
Speaking from experience, when faced with the draconian controls imposed by the mental health establishment, it is easy for a person to view it as something less than helpful. Worse, it is traumatic to be hauled away to a mental health hospital in handcuffs, as Cho was -- and is an event that often negatively colors a person's interactions with the mental health establishment for the remainder of their lives.
Additionally, even under the best of circumstances, finding the correct psychiatric medications is more of an art than a science, requiring many many months, sometimes years, of experimentation with a wide array of medications. Further, many psychiatric medications cause a wide variety of unpleasant side effects, such as physical illnesses and extreme weight gain, that make some patients unwilling to take them at all. Others refuse to take medications because of the tremendous expense involved, or the perception that the medications are not alleviating the symptoms of mental illness. Added to these factors is the social stigma of mental illness that results in the loss of jobs, or rejection by loved ones or family, and the resulting social isolation, and you can see a compelling argument for ignoring the symptoms of mental illness until it is too late.
I think the best way to deal with such situations is to teach the public the warning signs preceding an impending psychological collapse, and we need to enact laws that allow the public to protect themselves before such a collapse occurs. However, the public has a responsibility to treat mental health issues as medical problems, rather than as a legal problem, and to provide mental health treatment to those who cannot afford it themselves so the sufferer can receive treatment before a devastating psychological collapse occurs -- a breakdown that can result in that person being forcibly removed from their social and professional lives.
Unfortunately, far too often, a diagnosis of a mental illness is a weapon used by society to permanently shun the sufferer or to reduce that person to a mere shadow of what she or he once was, personally, socially, professionally. To be fair and just, society must ensure that once treated, a mentally ill person is allowed to make a full return to society, to their work and families, without suffering social stigma -- something that I think is sorely lacking in today's blame-the-victim society.
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This was a very well written, thoughtful and insightful post.
The difficulties of being mentally ill combine with the stigma to create a vicious cycle. If society is worried about what the mentally ill may do, they must make mental heath care more available and stop treating the mentally ill like the way they used to treat lepers.
I just watched Harvey, the Jimmy Stewart movie where he has an invisible 6 foot tall rabbit for a friend. Besides being a great movie it shows how we treat mentally ill people.
Texas in the early 90's had treatment for depression and anxiety for people who could not afford it. Now the Republicans are in charge and there is no more help from state government. I believe Cho was getting some help? From Who?
In addition, the overwhelming majority of 'psychological collapses' do not result in anything like the VATech murders - a sort of event which is extremely rare, and responsible for a relatively low number of deaths (by comparison, about 100 people per day die in vehicular accidents). Yet many sweeping policy changes are driven by these events.
They need to enact better mental health parity laws, as well. Most private insurers have limits on how much psychiatric treatment they will pay for, which is ridiculous. They don't say, "We're not going to pay for more than one cancer surgery," or, "You get ten days of physical therapy and that's it."
For all the advances we've made, there's still a long way to go. There are plenty of mental illnesses that defy everything medicine throws at them, and even defy the best intentions of the patient. When I worked in mental health, I worked with one person who went to two therapy sessions a week, day program five days a week, made frequent use of the crisis line, took a full complement of meds, had taken several extended stays both at local MHUs and specialized hospitals, did everything everyone suggested and had for years, and was still unable to live a normal life. This person often self-injured, suffered a lot of anxiety, and often requested that I hold the meds and give a week's supply at a time. It was very sad, especially since this person had a lot to offer society. I wonder how many more are living like this.
It seems to me that one of the basic measures of a society's worth is it's willingness and ability to help those who cannot help themselves. Mental illness, practically by definition, renders a person helpless to one degree or another, same as any number of other illnesses.
Gee, I really wouldn't call him mentally incapacitated or even mentally ill. The first term seems belied by the fact of his focus and planning skills. The second is for mental health professionals to determine, and often those diagnoses aren't worth too much either. Ditto the drugs. (IMO and experience.)
But what I wanted to say is that he was definitely socially and emotionally unhealthy. As a layman, I feel confident saying that, whereas more technical terminology may just throw up a cloud. The fact is the guy couldn't be open with anyone, from childhood.
He came from a culture, as many of us still do, where "mental" problems must be hidden and are considered a sign of weakness. Granted, he was also from a relatively uneducated working class family, which also fits with being unprepared to deal with someone who's emotionally different. He did get some professional help when he was classed as a risk or depressed, but without the basic trust and human connection, he would be unlikely to find a therapist/practitioner who could reach him and deal with all that hidden anger.
I think it's important to reach out to people who are different and try to include them, rather than isolating and ridiculing them. I used to teach ESL. Calling people stupid or isolating or ridiculing them were some of the very few things that were absolutely not allowed in my groups. I can see how it hurts people. I was one of those different people. Am. Society is often very painful for those of us outside the 66%. Can't we be smarter than poultry and give up the pecking order, already?
Bush's recent suggestion to be alert for people who are different (sorry, I can't find the quote) sounds like the beginning of a witch hunt, though.
ps I'm Canadian.