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Undoubtedly, a crisis exists in America’s service system for people who have mental illnesses, and it is particularly acute in the District. Last week’s cover story (“The Sick and the Dead,” 7/11) could have advanced public understanding of this crisis, but the Washington City Paper instead sensationalized the issue, propagating fear and reinforcing negative stereotypes of people diagnosed with mental illnesses.
Stephanie Mencimer’s story seems more concerned with titillating readers than presenting the facts. She devotes nine pages to demonizing people with mental illnesses, makes a flawed case for violating the rights of some of America’s most marginalized citizens, and glosses over the core problema shortage of meaningful services for those seeking help.
Mencimer is quick to draw a correlation between violence and mental illnesses, even as she acknowledges that the research to prove such a connection is tenuous at best. Several large-scale research projects (including the one she cites) find only a weak statistical association between violence and mental illnesses. The research also suggests that substance abuse, rather than mental illness, is a far likelier correlate to violent acts. “Serious violence by people with major mental disorders appears concentrated in a small fraction of the total number, and especially among those who use alcohol and other drugs,” according to a report released last year by the Council of State Governments’ Criminal Justice/Mental Health Consensus Project. In fact, 70 percent of jail inmates with mental illnesses are there for nonviolent offenses, according to the Bureau of Justice Statistics.
So if people with mental illnesses aren’t inherently violent, why are so many ending up in the nation’s jails and prisons? The dysfunctional mental-health system is increasinglyand inappropriatelyrelying on the criminal-justice system to fill in service gaps.
Mencimer’s assertion that forced treatment is the way to fix the system is shamefully misguided. All too often, people with mental illnesses have been discouraged from seeking help because the services they want and need are unavailable. Others are discouraged from participating in their own recovery by tactics they perceive as punitive. Some have suffered life-altering consequences from psychiatric medications, electro-convulsive therapy (“shock treatment”), or the inappropriate use of restraint and seclusion in psychiatric facilities. Disregarding these legitimate concerns is wrong, not just because it discounts the rights of citizens with mental illnesses, but because it undermines the effectiveness of mental-health services.
Furthermore, mandating treatment doesn’t solve the problem of availability or mean that someone with a mental illness will actually be able to get help. Individuals with mental illnesses already face long waits for limited services from overburdened public mental-health systems. Pushing yet more people into the system and moving them to the front of the line with a court order only exacerbates the problem and diminishes access for those who already voluntarily seek services.
Mencimer and the City Paper have done a tremendous disservice not only to people with mental illnesses, but also to the public. Mencimer’s story may move papers, but its dangerous lack of insight does little to promote solutions.
Bazelon Center for Mental Health Law