Institutionalization Will Not Solve the U.S. Gun Problem

The school shooting in Parkland, Florida, has added some new players—and some old baggage—to the debate over guns and mental health.

The new players, the students from Marjory Stoneman Douglas high school who started the #neveragain movement, are leading a challenge against political complacency. The early signs are hopeful. If the movement keeps rolling, it will be the first student-organized and unified protest against mass shootings in U.S. history.

The old baggage, on the other hand, is the attempt to turn a debate over guns into a debate over “institutionalizing” potentially violent people before they have the chance to act. President Trump has been the most prominent figure supporting this idea, offering it during a White House meeting with Florida state and local officials.

“We’re going to be talking about mental institutions,” Trump promised, “and when you have some person like this, you can bring them into a mental institution, and they can see what they can do. But we’ve got to get them out of our communities.”

President Trump’s comments echo the “bring back the asylum” argument that has recently gained support from some academics and doctors. Locking people up long term, they say, will help remedy the “failure of community mental health care.”

But what is community mental health care? And how does it differ from institutionalization?

More than 50 years ago, largely in response to exposés of the inhumane, unspeakable conditions of people with mental illnesses warehoused in state mental hospitals across the country, President John F. Kennedy initiated the Community Mental Health Act.

The law had two parts: First, release people from hospitals into community health centers. Second, create conditions in which they had a chance to live independently, or with their families, and get the treatment they need. Help people, save money, reduce discrimination—it was a public policy trifecta.

So why didn’t it work? Because the second and crucial component—nurturing community-based supports—never reliably materialized. Fewer than half of the community health programs outlined in the policy’s budget, for example, were even built. A messy patchwork of services, incapable of helping all of those in need, eventually came to fill the void.

A few people were lucky enough to use that system, inadequate as it was, to find their way to freedom. But most were not. Instead of staying in their homes, they ended up homeless; instead of being provided with treatment, they ended up neglected; instead of living independently, they ended up shuttered away in prisons.

Their suffering—which is the suffering of real human beings, people with loved ones, hopes, and dreams—has been immense. And in much of the world, it is ongoing. Despite being a kind of hell on earth, these long-stay psychiatric institutions, these human warehouses, flourish all over the world.

Americans should not fool themselves into thinking these policies would fare better in the United States, either. As my colleague Aryeh Neier, the president emeritus of the Open Society Foundations, told me, for President Trump’s idea to work, “enormous numbers of American people would need institutionalization, for the long term, at immense cost. Inevitably, to try to save money, the institutions would be simply prisons. And they would still not reach people who [previously] never showed signs of mental illness.”

I know, firsthand, that there is a better way.

I have worked for more than 20 years to end the horror of institutionalization. I have seen living proof of what holistic, person-centered community care can do for those with chronic and serious mental illnesses. I have witnessed what can happen when these people—the people who are the program, really—are put first.

In response to those urging a return to institutionalization, then, we must echo the Marjory Stoneman Douglas high school students’ rallying cry—never again.

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Excellent, simple and right!

Excellent perspective ! The most difficult aspect of the entire issue is: How do we identify and prevent these tragedies when a majority of the perpetrators show no symptoms of Mental Illness ? Over and over again you hear, " He was such a good boy; This man was such a quiet and great neighbor, A terrific student and friend . ". Those flying beneath the radar like Austin bomber, Young Conditt. He was home schooled and belonged to a Christian Bible study and gun lovers group named RIOT. Parents were aware and supported the group and its ideals, which includes, getting people off Sex Offender registries, among other disturbing topics. So, if guns don't kill, people do, then doesn't logic dictate that people without guns do not kill. Or in this case, bomb makers... God help us !

So true! Thanks to you Judith I've also seen what holistic, person-centered community care can do for those with chronic and serious mental illnesses. Rehabilitation can't take place behind high walls or behind bars. never again!

Hi Robin, I read your comment and I'm interested to see if holistic, person-centered community care can help my son who has Asperger's Syndrome. I have fibromyalgia and chronic fatigue and I use the holistic way for dealing with my symptoms. Can you tell me who Judith is or how I can get in touch with her or someone who practices this type of holistic care. I can be reached at [email protected]. Thank you, Sherita Martin

The noble but misinformed #NeverAgain movement will make little difference without the recognition and profound reform of the problem of incompetent prescription and lack of close monitoring of SSRI psychoactive drugs -- which trigger suicidal and violent reactions in thousands of patients annually. #LookItUp

Hi Lou, I want to say Amen to your comment about the side effects of SSRI drugs. My son has Asperger's Syndrome and those drugs caused him to have drug induced psychosis, schizophrenia, schizoaffective behavior among other mental illnesses he was diagnosed with but it was because of the medication. He became so aggressive and was just not himself. It brings tears to my eyes just thinking about it. I was so scared of my own son I had to sleep with my bedroom door locked and with mace and a pipe under my bed because I didn't know what to expect. Even though he doesn't live with me anymore, I still sleep with my door locked. Thanks for putting that info out there.

1. We are culture of NO respect for human life, unless wealthy, powerful, politically connected or celebrities. We kill people all over the world and have been doing it for very long time.
2. Culture of abuse, bullying, nonstop dehumanization of the poor, sick, powerless, indigent. Non-payment of labor, sexual and emotional dehumanization by the powerful and wealthy and people in higher position. Also culture of depleted nutrition, medical care and heightened stress. Culture that blames all it's failings and the failings of the politicians and the system to the most powerless, using them as scapegoats to cover up the illnesses of our society and procedures in governance and falling policies.
3. The system is highly politicized with kick back demands, for voting, for almost anything.... provision of housing, job promotions, job offerings, power, raising benefits for jobs, and many other kickbacks, something like Chicago Mayor Dailey's political machine... and there is no end to it.
3. At the end scapegoating the most powerless, who don't even have the capacity to speak for themselves, THE MENTALLY ILL, for the failings of the society and the politicians.
4. Every single policy is to protect, enhance and multiply the wealth, power and ability to abuse and bully the "other", the one with no money, lower social and class standing.
5. The shootings are NOT fault of the mentally ill. Get off your high horses, get out of your ivory towers and look at the reality and yourselves, if you are capable of it at all.
6. Stop using these wretched of the earth for covering your shortcomings, just because you can do it easily. And also stop using people and specially the mentally ill as commodities for self enrichment!
Thank you for reading this!

Your comment about shootings not being the mentally ills fault is not entirely correct. Of course we need better background checks to not allow them to get guns in the first place. Now the statement is more correct.

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