Tucson CitizenTucson Citizen

We need more and better mental health care in Arizona, not less

Much of the arguing about cause and effect in the aftermath of Jared Loughner’s murderous rampage has centered on guns and caustic political rhetoric.

Those are the wrong arguments.

Jan. 8 was about crazy. We should be arguing about which of our laws need reforming so that families, friends, coworkers, teachers, classmates, mental health professionals, law enforcement and the courts can take quick, appropriate actions to get someone suffering a mental health crisis evaluated for their risk to themselves and others. And about the proper public funding for training people how to recognize crazy and for the complex behavioral health infrastructure needed to treat it.

One would have thought we would have had this argument already and solved the problem.

This isn’t the first time in the past decade the dark hand of Death has ravaged Tucson in the guise of mental illness.

In 2002 it was in the form of Robert Flores Jr. who killed three teachers at the University of Arizona nursing school. Two and half years ago it was in the form of Nick Delich who shot up a neighborhood with an assault rifle and then led police on a car chase across town shooting at them along the way, wounding one and killing another. It was only luck that prevented the death toll from being as high or higher than Loughner’s.

And between these killings there were many others by people in a mental health crisis that didn’t make the national news.

Consider Christopher Lambeth, who in 2005 murdered his grandparents with a knife and then lived with their corpses in Rillito for at least two days before he and the bodies were discovered. It isn’t always about guns.

As with the Flores, Lambeth and Delich shootings and the shootings in 2007 at Virginia Tech and in 2009 Fort Hood there have been numerous stories in the media the past week about Loughner’s bizarre behavior preceding the killings. When someone in the throes of madness snaps and kills, there are always “they should have known” or “someone should have done something” stories and editorials.

That’s because we usually argue about guns after those shootings and not about adequate access to behavioral health care and the proper treatment of the mentally ill.

Perhaps what makes it such a difficult issue is the loss of liberty. The Constitution makes it hard to take away someone’s gun. It makes it even harder to take away their liberty.

There will never be a time where some community college teacher who has a student repeatedly disrupting her class who she suspects is mentally ill can pick up the phone and call the guys in white coats to come take him away.

But she should be able to make a referral that is taken seriously and that starts the process of evaluation and treatment.

Where this really gets hard is once someone is diagnosed with a serious mental illness they must be monitored for the rest of their lives.

There is no cure for mental illness, as of yet, only therapies for managing it. The vigilance that families, caregivers and often the state must maintain to keep a seriously mentally ill person from “going off their meds” and entering a mental health crisis is exhausting – physically, mentally and financially.

Delich and Lambeth had already been diagnosed with schizophrenia before their killings and their parents had desperately tried to get them treatment and to keep them treated. The mania of madness wore them out. They needed help.

Which brings us to the Arizona Legislature and the state budget.

The state is spending more than it is taking in and the governor and Republican leaders in the Legislature have said “everything” is on the table for consideration of spending cuts. Last week they proposed rolling back Medicaid funding to pre-2000 levels, which will strip 280,000 Arizonans of their state health insurance.

There are 300,000 people in Arizona receiving state-funded mental or behavioral health care. Few are a threat to anyone. But some are or could be if the state cuts off their treatment. There a thousands more who should be getting treatment but they’re trapped in the gap between Medicaid and employer-subsidized health insurance. The recent health care reform law is supposed to close that gap. Republicans now want to widen it.

There is a Republican narrative that we would all be better off if we just got the government out of our lives and let people be responsible for themselves.

Perhaps. But then not everyone is capable of being responsible for themself.

Another options is for us as a compassionate society to decide that it is in all our best interests to chip in a little more tax each year to make sure that all of us receive adequate health care so that we’re all healthy and sane, not just those of us who can afford to be.

If our legislative leaders choose the first path perhaps they should begin thinking about what they will tell reporters when they call for comment for the “someone should have done something” stories the next time a young man loses his grip on reality and plummets into the dark abyss of madness.

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