Mental Illness Among Us

Quote of the day:
“You question authority, eh?”
“No. I annoy authority. More effect, less effort.”
--Darby Conley in Get Fuzzy.

As a result of the Virginia Tech tragedy, we seem to have entered a debate about how to deal with mentally ill people.

The main issue with this kind of conversation is that “mental illness” is not a pure condition. Virtually all of those who have psychiatric problems do not have them 100% of the time. There are moments of clarity and lucidity mixed in.

And sometimes people with psychiatric problems have a charming, interesting, or at least somewhat normal side to their personalities.

When I was the program director of KPBS radio, we would often get letters from interesting people. One who was quite memorable was the correspondent we came to call “Dog Man.”

Dog Man would write to me once or twice a month, and his letters would always begin engagingly and thoughtfully, as he responded to a news or feature item we had aired. But somewhere midway through each letter he would change course, and begin talking about the problem of dogs defecating in local parks.

Every letter we received from him ultimately was about this issue. I would always write back, thanking him for his thoughtfulness, though it was clear there was something going on with Dog Man that needed some attention.

I have to confess that it became quite an event for us when a letter from Dog Man arrived. We became quite curious about exactly how he was going to tie together the subject of his letter and his real obsession--dog feces in local parks.

Unfortunately, one day Dog Man went too far. We received a letter that not only had his usual complaint but also threatened the mayor. We called the police. After that, we never heard from Dog Man again.

I sometimes wonder what happened to him.

Are We All Psychiatrists?

Quote of the day:
“Commuters run to their destinations and away from themselves.”
--Timothy “Speed” Levitch, New York tour guide

Quote of the day no. 2:
“It comes down to a balance between providing a platform to a madman and helping explain a riddle that has confounded many Americans.”
--Jon Klein, CNN president

Klein’s comment has become the standard response to those who have complained about the airing of videos, photos and writings of the man who killed 32 people last Monday at Virginia Tech. The way Klein frames it, I’m not sure it’s a true choice.

He says the good in airing it is “helping to explain a riddle.” To the extent the killer’s actions are a “riddle,” they will remain a “riddle” until all the evidence is thoroughly examined by experienced clinical psychiatrists.

I believe we already know the answer to the “riddle” as much as most of us ever will, or need to. Klein suggests it by using the archaic word “madman.”

Wasn’t it pretty clear before we all saw this stuff that there is no rational reason for this man’s actions? At best, any rational “cause” will wind up being just an irrational trigger for him to act on his delusions.

And “delusions” is the key word. Isn’t it also clear that this man was delusional? His thoughts and beliefs were disconnected from reality.

Of course there is a specific clinical diagnosis for what was wrong with him, and that diagnosis will likely be made sometime in coming days by people who know what they’re doing. Most likely that diagnosis is not going to add much to our understanding of why this happened.

For me, it’s enough to know that 1) he was seriously ill and 2) he was seriously delusional.

The really serious question is: what do we do now?

Why?

In the interest of perspective and understanding, I offer two simple quotes.

First:
“We’re trying to find someone who knew him. The university has been calling him a loner.”
--Amie Steele, editor of Collegiate Times, the campus newspaper at Virginia Tech

Second:
“In studying mass murderers over 25 years, my colleague, Jack Levin, and I have identified five factors that exist in virtually all cases.

“First. perpetrators have a long history of frustration and failure and a diminished ability to cope with life’s disappointments.

“Second, they externalize blame, frequently complaining that others didn’t give them a chance. Sometimes they argue that their ethnic or racial group or gender isn’t getting the breaks that others are.

“Third, these killers generally lack emotional support from friends or family. You’ve read the ‘he always seemed to be something of a loner’ quote? It has a grounding in reality.

“Fourth, they generally suffer a precipitating event they view as catastrophic. This is most often some sort of major disappointment: the loss of a job or the breakup of a relationship. In massacres at colleges and universities, it’s often about getting a grade the shooter feels he didn’t deserve.

“Fifth, they need access to a weapon powerful enough to satisfy their need for revenge.”

--James Alan Fox, professor of criminal justice at Northeastern University, in today’s Los Angeles Times.

Morally Wrong, or Sick?

Quote of the day:
“Over the years, some convergence of gangsta rappers and shock jocks and bloggers have given more and more people license to use words that were once washed out with soap, or blocked with bleeps. Sex sells, hate sells and the combination is boffo biz.”
--Ellen Goodman in Friday’s Boston Globe.

Quote of the day no. 2:
“What is cheating? We need to forget about the past and let us play the game. We’re entertainers. Let us entertain.”
--Barry Bonds

Where is the line drawn between consciously bad (or criminal) behavior and mental illness? This question gets ready answers from extremists on each side. Some think all criminals should be locked up, period. On the other side, some think that bad behavior is always caused by mental illness.

As always, the truth exists somewhere in the large middle, and it can be hard to discern. Here is one observation, from Chip Ward, former assistant director of the Salt Lake City library (from Tomdispatch.com):

“Take the case of a young man who entered the library spouting racial and ethnic slurs. He loudly asked some Latino teenagers doing their homework when they had crossed the border, and they reported his rude behavior.

“When a security guard approached, the young man started yelling obscenities and then took a swing at him. The guard tried to calm him, but on the next lunge, the guard took him down, cuffed his hands behind his back and called the police. They recognized the man. He had been let out of jail just two days earlier.

“That man’s behavior, of course, was not a measure of his character but of his psychosis. He was sick, not bad.

“If we accept that schizophrenia, for instance, is not the result of a character flaw or personal failing but of some chemical imbalance in the brain--an imbalance that can strike a person regardless of his or her values, beliefs, upbringing, social standing or intent, just like any other disease might strike one--then why do we apply to mental illness a kind of moral judgment we wouldn’t use in other medical situations?

“We do not, for example, jail a diabetic who is acting drunk because his body chemistry has become so unbalanced that he is going into insulin shock.”