Mental Health and the American Problem

Emil Kraepelin, who in the 1880s helped cement how the West deals with schizophrenic individuals (he is called the father of biologic psychiatry), eventually came to see psychotic thought not as merely a "nature" problem, but also as a "nurture" issue. He saw culture not as causative, but as contributing, especially in its treatment. Nev Jones, PhD, has begun to delve into the ways in which culture exacerbates the lives of individuals with mental disease. 

Jones, who herself has had schizophrenic episodes, is now the leading advocate for re-thinking how the West must treat these individuals. Rather than simply rounding these people up and locking them away in a padded room, or--not much better--walling them off from friends and family and employers and classmates via society's ostracism, she sees a reinventing of treatment to allow for inclusion of the individual into their current culture. She isn't, as far as I know, an advocate for eliminating pharmacological care, but rather for the allowing of these troubled people to continue living their lives within the culture that they find themselves in, or, even better, of widening their circle of influence within that culture.

Currently our western culture views these people askant, and fearfully. They think of mass shootings and wonder...Will this guy go off and kill indiscriminately? Does he have a trunk full of guns? They think of James Holmes, the "Batman" killer, who gunned down 82 people in a cinema in 2012. James Holmes had tried to get psychological help just a few days before the shooting occurred. If James Holmes had successfully received some help, what would that help have been like? Would it have helped? It is doubtful, since current medical treatment is inadequate. 

As Jones makes clear, a person undergoing a psychotic episode needs to be in contact with their circle of influence, their friends and acquaintances, their culture. And the wider culture needs education on the elements of schizophrenia. It is not a cancer or terminal illness; many undergoing these episodes will revert to normal life. What makes it less likely for these people to live normally is a culture that cuts them off and treats them like prisoners. 

Those with mental illness are much more likely to be victims of crime. They are no more likely to be assailants than those in the wider population. For incidents of mass murder, such as the recent Las Vegas shooting (and we simply don't have enough data currently to make any conclusions as to the motives of the shooter), we should be ramping up our mental health care system, using the latest information concerning the best possible care for the best possible outcomes. (This doesn't obviate the need for common-sense solutions to gun regulation, either; we can do both.) 

Knowledge and action can reduce the incidents of mass shootings. And the lives of those with psychotic disorders can all be improved as well. Society wins; the patient wins. And if we lived in any other first-world nation it might well be possible.