To clarify, there is no confirmed diagnosis that Lanza suffered from any mental health problems, but speculation is running rampant, and most are jumping to the easy conclusion that the withdrawn, socially awkward young man probably had Asperger’s Syndrome, an autism-spectrum disorder; some reports even suspect that his rampage was motivated by a fear that his mother was attempting to institutionalize him.
Institutionalization, though, is becoming an archaic solution, much to the detriment of many. In recent years, Georgia, along with most other states, has shut down almost all of its psychiatric wards and begun transitioning to a more outpatient, community-based approach to mental health care. While the latter approach works for many and does save the state money versus long-term housing, I believe that by focusing too much on the community approach, our mental health resources are doing a great disservice to millions of citizens. Furthermore, community care is, by its very nature, reactive rather than proactive, and does nothing to address the strains and traumas of life that lead to many mental health patients needing remediable treatment – including medication or hospitalization, or both – in the first place.
I have seen firsthand how outpatient community mental health care both succeeds, and fails. For patients who have a history of diagnosis, who have a support system of doctors and family, community care is ideal. Here in Walker County, for instance, organizations such as Lookout Mountain Community Services and its Cornerstone day program provide essential peer support and counseling for citizens recovering from substance abuse and mental health crises. In many such cases, this type of care works brilliantly. However, for members of the community who are on the fringes, who have never been diagnosed, and who are just enough of a danger to themselves that they become homeless, confused, paranoid, but not yet violent, community care might as well be on the moon for all the good it does them.
If it sounds like I have a personal investment in this topic, it’s because I do. I have a family member in this very situation. She has never been diagnosed, and her refusal to ever see a counselor or psychologist, who could have pointed her toward therapy and medication years ago, only grew stronger with time as her paranoia deepened.
First she lost her job. Then her house. Then her car.
She believes that the FBI is out to get her, and that I’m working with them. As a result, she cut off all contact with me.
I’ve searched for her. I’ve called every organization there is. And finally, I tried to have her involuntarily committed. However, the overworked psychiatrist at the hospital emergency room declared that, because she didn’t seem to be enough of a threat to herself or others, she could come to the outpatient community care program, but didn’t qualify for inpatient hospitalization, monitoring and medicating. Then the doctor gave her a bus ticket and sent her on her way, knowing full well that someone with her level of paranoia would never attend any voluntary outpatient program.
And this was after I had testified to the local probate court judge that at least two local shelters had turned her out for frightening other residents and making threats, and that I was personally terrified to take her in myself in for my genuine fear that her instability and her belief that I was involved with the FBI would cause her to do me physical harm.
This was 18 months ago. I haven’t seen or heard from her since. I don’t even know if she’s still alive. Having to make that choice between her safety and my own was the hardest thing I’ve ever done. I don’t wish it on anybody.
But this isn’t just one woman’s case. This isn’t just one sob story I’m telling. This same sort of thing happens to millions of people all across the country. There are so, so very many who just need shelter, care, understanding, and yes, often medication, too. And if the red tape surrounding the institutionalization process had been loosened in recent years rather than solidified, perhaps a good percentage of them would get it.
Don’t get me wrong, I have no desire to revert back to the dark ages of psychiatry, where people, most often women, could be institutionalized on a whim and subjected to the worst sort of experimentation, torture and “treatment.” We need to have regulations in place to protect the very people we are trying to help. But I believe the current regulations have created far too narrow of a funnel for people to fit through, and untold numbers are spilling out over its sides.
We need, as a culture, to change our perceptions of mental health care from a stigma to a necessity. We need to look at mental health as a form of lifetime preventive care, and put more emphasis on making sure that children always, always have a trusted, licensed counselor who has the time, resources and desire to be a listening ear and a role model for those who might have problems at home or perhaps just don’t quite fit in. Without proper counseling, many teens and young adults with overbearing stressors, possibly including Adam Lanza, learn to cope with their problems in unhealthy, and sometimes violent ways. Many others will later develop mental disorders that could have been caught early, and perhaps prevented, with regular mental health checkups. I am not suggesting Ritalin for every kid. I am not saying that every child is a potential killing machine. I am simply stating that there are so many who don’t have the proper support system to attend to their emotional needs.
I am sure that Nancy Lanza did the best she could for her son, for whom she seemed to care deeply. I am sure that she tried to get him counseling and therapy if he appeared to need it. But perhaps something was missing. Perhaps he felt stigmatized, and began to hide his psychological distress to avoid the stigma of receiving mental health care. Honestly, this is all just speculation; we will probably never know. But there are plenty of other young adults out there who feel that way.
And plenty of older adults, too. Like my mother.
Wherever you are, mom, I hope you’re okay. I love you. I miss you. And I hope that somewhere, somehow, you’re getting the care you need.
Christi McEntyre is a reporter for the Walker County Messenger. She can be reached at email@example.com or 706-638-1859.