According to the Washington Post, Arizona has a law on the books that enables anyone to identify a potential victim of mental illness, and remand them for treatment:
Under Arizona law, any one of Jared Lee Loughner’s classmates or teachers at Pima Community College so concerned about his increasingly bizarre behavior could have contacted local officials and asked that he be evaluated for mental illness and potentially committed for psychiatric treatment.
That, according to local mental health and law enforcement officials, never happened.
“To the best of our knowledge, he was never and is currently not enrolled in our system,” said Neal Cash, president of the Community Partnership of Southern Arizona, which provides mental health services in Tucson and Pima County for the state. While most of those it serves are on Medicaid, Cash said anyone diagnosed with a serious mental illness would be in its system.
This is all well and good, but WaPo is leaving a lot out, and indirectly blaming Loughner’s teachers and classmates for not taking advantage of the law. First of all, Arizonans generally don’t appear to be aware of this law. Second, it requires them to petition a court – a laborious procedure that a mere acquaintance may not be willing or even equipped to undertake. Third, Arizona’s lax gun laws failed to catch what Pima Community College did do to Loughner – suspend him from school and disallowing him to return without a mental health clearance. Even if this didn’t trigger anything in the gun background check, you’d think this would have raised the awareness of the people most inclined to get counseling for Loughner, his parents.
But the most glaring oversight here, what WaPo waits until paragraph 21 to tell you, in a story told almost entirely from the perspective of mental health professionals in Arizona, is that the state is one of the worst in the nation at delivering mental health services, and cut back significantly on its mental health programs during the Great Recession in order to balance their budget. That’s not paragraph 21 information; it undermines the entire premise of the article. Adam Bonin, in conversation with mental health expert Prof. Mark Heyrman, brought this up right from the beginning:
Heyrman: In my perfect world, when a student was suspended from school for mental health reason, the college would be required to link the student to mental health services or at least an evaluation by a community mental health provider. That, of course, would require the state to make services available to those who were unable to pay.
Q: So when we see articles that note that Arizona cut its budget for mental health services by $36 million last year (37% of the total budget), that matters [...]
Heyrman: It matters A LOT! You are going to see more people with untreated mental illnesses across the country as states deal with the financial crisis. Some will be homeless, some will get arrested, some will commit/attempt suicide, some will suffer in silence (or burden their relatives) and some will end up in hospital emergency rooms. Almost every state is facing this problem.
How could you write an article suggesting that it was a snap to find treatment for a mentally disturbed individual in Arizona without foregrounding that such treatment has been drying up for years? Even if some peer of Loughner’s had the foreknowledge to use the Arizona law on the books, with those scarce resources it’s certainly plausible that he would have still slipped through the cracks. And the cutbacks in mental health services invariably hit at access and promotion; nobody knows about the services available, because if they did, the programs would quickly become oversubscribed. As Amanda Marcotte notes:
Some people are lucky enough to have insurance that not only covers mental health services, but makes referrals, but those people are rarely 22-year-olds attending community college. It’s not like there’s a centralized, low-cost mental health service similar to Planned Parenthood for reproductive health services. Maybe there should be, but in our country, getting more funding for this kind of necessary health care infrastructure is like pulling teeth.
The problems with our mental health systems in the U.S. are just part of a larger problem with health care in general—people fall through the cracks, diseases that could have been prevented or minimized with early interventions instead fester and become bigger, more expensive problems down the road, and we don’t do enough to connect the available services with the patients in need.
It’s a weighty enough burden to place on a classmate or friend or teacher to commit a fellow student, one who was increasingly closed off from the world. Most people don’t have psychology degrees, and though several came forward to say they felt threatened or creeped out by Loughner, predicting that individuals will turn violent is an inexact science even for professionals. But it’s certainly that much harder to identify and treat those suffering with mental illness if the programs are being dismantled block by block. I’m sure that 37% cut made for a nice patch in the budget process, but there were – and will continue to be – significant and severe consequences for that. Contra WaPo and the people it interviews for this piece, it’s not as easy as dialing M for mental health to reach a large team of caring professionals. At least not in Arizona in this day and age.