LETTER TO THE EDITOR: State should re-open mental health facilities

DEAR EDITOR:

Mass shootings with semiautomatic rifles and pistols seem to be becoming an everyday event. People on one side of the aisle say the events stem from too much availability of guns. People on the other side of the aisle say the events stem from mental health issues. The problem is that the people on both sides of the aisle are right.

Even assuming hypothetically that these weapons could be outlawed, which does not seem very likely, there are tens of millions, perhaps hundreds of millions, of these weapons already in the hands of citizens now. The likelihood that these weapons will be voluntarily surrendered is very, very low. Even if there is enacted legislation aimed at controlling these weapons, it is probably going to be several decades before anything changes. We cannot wait that long.

Real change in the way we now address mental health issues could bring change within a year or two. Ten or 15 years ago, we were not having this tidal wave of mass shootings. Something changed. It is my belief that the major reason for the significant increase in the number of mass shootings can be pinpointed.

One of the agencies of the federal government commissioned a study of mental health issues in this country and how to deal with the mentally ill. The study was conducted by very intelligent and very well-meaning professionals. The result of the study can be summarized in a single sentence: “Community care for the mentally ill is better than institutional care, when it is properly funded.” The commissioners believed that the result of this study would be a massive shifting of government funding from mental hospitals to local clinics. Apparently, they all grew up in a world where politics and politicians do not exist.

Mental hospitals are expensive. Nobody wants to live next to a mental hospital. Very few people want to work in a mental hospital. Very few people who have a mentally ill family member want that family member to be in a mental hospital. So very few people complained when states like Georgia closed all of their existing mental hospitals. No one bothered to check to see if community mental health care got the funding that had previously gone into mental hospitals.

It was a foregone conclusion that, before the ink was dry on that study, Georgia politicians hungry to increase spending for things they wanted and still cut taxes would take a very minimalist view of “properly funded.”

When I was a young man, mental health issues were treated primarily with counseling. I was grown before psychiatrists discovered that most mental health issues are treatable, if at all, with chemicals.

Psychiatric medications can be very effective, but they are by no means a panacea. For one thing, no one has yet developed an effective medication for some fairly common mental health issues. For another, many effective medications come with very significant and usually unpleasant side effects. (“They make me feel like a zombie.”) Even very effective medications with few side effects sometimes take a very long time to become effective.

One particular medication that I know of must be administered with gradually increasing dosages over a five-month period in order to be effective. Attempting to speed up the process results in convulsions. Some medications become ineffective as the patient builds up a tolerance. Finally, many of these medications are extremely expensive.

In our city today, there is no place for a mentally ill person for whom no medication is effective to live. Neither is there any place for a mentally ill person who requires a five-month period until the medication becomes effective to live. Nor is there any place for a mentally ill person whose medication no longer works to live while a search is made for different or better medication.

No general hospital is really equipped or willing to admit a patient with a severe mental illness for more than a few days. The Crisis Center on 11th Avenue has about a dozen beds, which are usually full and cannot provide care for more than a week or two.

The present places in Georgia, aside from the streets and gutters, for the mentally ill to reside are Georgia city and county jails and the Georgia prison system. Ask any sheriff.

Jail and prison staff are tasked primarily to enforce custody and, very secondarily, to attempt rehabilitation. Dealing with the mentally ill is not a skillset often found among jail and prison staff. Perhaps more importantly, prisons and jails are most emphatically not funded to provide expensive psychiatric medications. I am aware of one county facility not far from Albany where the sheriff will immediately release any arriving prisoner who has a prescription for an expensive medication, because that sheriff has no funds to pay for the medicine.

The bottom line, if we want to make any progress at all in reducing gun violence and mass shootings, is that we must admit that closing Georgia’s mental health hospitals was an enormous mistake. The facilities are still there, although certainly now needing repairs and maintenance. Staffing will take a while and will require significant funds added to our annual state budget. I suspect that, if this does happen, we should also see a decrease in our city and county jail and prison expenses.

If we are able to muster our resolve and demand that Georgia re-open mental hospitals such as Milledgeville and Thomasville, then we will see a significant decrease in gun violence and mass killings. It is all a matter of priorities.

Michael C. Hall

Albany