I have had the privilege of working in Tucson's indigent-community mental-health system for 32 years. I work with amazing, resilient adults recovering from highly stigmatized, no-fault brain illnesses called "mental illness." I too live with a mental illness and am blessed that I have been able to work and contribute what I can.
The citizens I work with have severe life altering disorders, and we as a nation have failed to help many live in safety and with dignity. People do not choose to develop a mental illness. We attach stigmatizing words to them: "crazy" and "psycho." We see them walking around alone, pushing a shopping cart, talking to themselves, wearing three coats in the middle of summer. We look and cannot bear what we see; we have collectively chosen to turn away. We do not even see these people for what they are: in medical crisis. They are in crisis from mental illness, from heat exposure, dehydration, poverty and violence. Their brains did that to them. It is not a choice.
As a nation, we do not tolerate our vulnerable citizens with Alzheimer's and dementia living on the streets. Nor do we allow people with severe developmental disabilities to eat out of garbage cans and sleep in parks, washes, alleyways and abandoned buildings. This situation raises the question: Why do we allow ourselves to neglect and underfund services for fellow citizens with serious mental illnesses? Why do we turn away from those who are oftentimes too ill to recognize how compromised they are? Why don't we choose to help this part of our community who are so obviously vulnerable and in need?
According to the National Association for the Mentally Ill (NAMI) there are 12 million American adults living with a diagnosis of severe and persistent mental illness. Many of these individuals are dependent on public assistance. On average, individuals receive $740 per month in Social Security Insurance coverage. In other words, they are further marginalized by living in poverty.
We have laws that protect the Civil Rights of people with mental illness from involuntary evaluation and hospitalization. It requires lawyers, doctors and courts to work together to commit a person with a mental illness into treatment. It is often a long process. We have to wait until a person is so ill that they pose a danger to themselves or others. In the meantime, they get sicker and often less able to recover fully. I work with some people who have had psychotic episodes or were homeless or addicted to drugs who have told me that they wished that they had been involuntarily hospitalized.
While these laws protect rights, they also create a cost to society that is unmeasurable: The loss of what these citizens can offer back to us as a community. Loss of real human lives—employees, family members, friends, artists and writers.
I know that what I believe is antithetical to the Mental Health Recovery movement. It goes against the "Voice and Choice" movement of mental health activists. For me, the fine line we are talking about is: When we do have a choice about our medications and treatment, and when we don't, because our brain is not working properly. Our choices can and do get hijacked by our brain's misperceptions of reality. In certain situations for certain individuals, this can result in an inability to make decisions that will keep them safe or do no harm to others.
What if we were able to set the clock back on the enormity of mass shootings we have experienced, and some percentage of them never happened because we were able to intervene earlier for those who did have histories of mental illness? What if when people saw clear signs that individuals were not well, that the process of getting them help was not a struggle against inertia and apathy? How many lives would have been saved?
I believe in the Second Amendment. Yet, I can't help but acknowledge that when our Constitution was written, there were only muskets and rifles. No one at that time was planning on AR-15s.
The terms gun control and mental illness have been too often repeated in the same sentence as of late. What if we loosened the laws around involuntary evaluation and treatment for citizens with acute symptoms of mental illness and tightened controls and background checks involving weapons of war? What if there was meaningful gun control reform and meaningful mental health reform? These are not fantasies. We can decide to make serious, impactful changes. We would be demonstrating that we are serious about protecting life. We can start by getting serious about furthering the quality of life of our entire community.
Mindy Bernstein is the executive director of the nonprofit Our Place Clubhouse and its sister businesses, Café 54 and RE-THREADS Thift, which employ people with mental illness. "A Magical Night for Mental Health, a benefit for Our Place Clubhouse, is at 5:30 p.m. Saturday, April 21, at 54 E. Pennington St. More info at ctftucson.org/fundraiser.