Finding the middle for the mentally ill: Opinion

carrier.JPG Main entrance to the Carrier Clinic in Montgomery Twp.  
By Donald J. Parker

In the fall of 1972, a young investigative reporter named Geraldo Rivera found a way to sneak a camera crew into the Willowbrook State School for the Mentally Retarded on Staten Island. His television report, “Willowbrook: A Report on How It Is and Why It Doesn’t Have To Be That Way,” exposed the institution as a dangerous and deplorable warehouse for children. I, with legions of Americans, was shocked by the report and became part of the deinstitutionalization movement, in both developmental disability and mental health, over the next four decades.

We find ourselves today sickened by the tragedy of Sandy Hook Elementary and some of the unintended consequences of the movement to free mental health patients from lifetimes of institutionalization. Have we imperiled the lives of the students in Newtown, Conn., by going too far to improve the lives of the children in Willowbrook?

As in almost all social movements, work starts on one extreme of the pendulum and, invariably, swings to the other extreme before we find a lasting solution. We overreact in our support of our citizens’ rights to bear arms and the rights of behavioral health patients to comply with treatment regimens. As with most social issues, we are polarized by the strident ideology of the extremes taken by our political leaders, and the overexposure to media opinions that catalyze the polarization.
We need leaders to find solutions in the middle of the pendulum swing. There are positions on both gun control and mental health that can maintain civil liberties and provide safety for the public, including vulnerable children.

As a treatment provider, I know that mental health needs to be given an equal status with physical health. A mental illness can be as serious as a heart attack or burst appendix. We need time and resources to make treatment decisions that reduce the dangers posed by some patients. While only a very small percentage of the mentally ill become violent, we need to identify them and, where possible, protect them and society from their dangerous impulses.

We need the power to treat people who might pose a threat. If mental health screening is required for purchasing a gun, where will we refer those who don’t pass the test? If they are dangerous, we have an obligation to make sure they receive proper treatment, but our current resources are not equal to the task.

We need a nationwide standard for diagnosing and treating mental illnesses. Consistency of both the diagnosis and treatment process is critical in improving outcomes and reducing costs.

We also need the power to commit people to treatment, without forcing them into institutions. Institutional commitment is not always necessary. We need outpatient commitment laws that provide a treatment focused on individual and community safety, and allow patients to receive medications and care without expensive hospitalizations. This brings us closer to the middle — but the pendulum, by design, still must swing.

As a nation of politicians, providers and citizens, we need to end stigmatization of mental health. The National Institute of Health recognizes that more than 25 percent of our citizens need mental health care every year and only a fraction of those actually receive it, commonly due to stigma.

A national dialogue in the 1970s fueled four decades of deinstitutionalization. Today, in honor of the children of Newtown, let’s embark on a national dialogue on mental health reform that ensures safety to future generations of children by addressing the emotional, social and psychological well-being of our population.

Our new reform movement should start with the report, “Newtown: A Report on How It Is and Why It Doesn’t Have To Be That Way.”

Donald J. Parker is CEO and president of Carrier Clinic in Skillman.