Civil liberties and Mental Health a thin line.

Earlier this month the internet was ablaze over a rumor that Jack Nicholson was retiring because of memory problems.  Jack is considered one of the best actors, certainly of late 20th century and has the distinction of being the only actor to be nominated for an Oscar in every decade since the 60’s. His first Oscar was for the movie One Flew Over the Cuckoo’s Nest in 1975 for his portrayal of  Randle “Mac” McMurphy  a small time criminal serving time at a Labor Farm who gets transferred to the Mental Hospital where he feels he can serve his time in the relaxed hospital atmosphere.  The film which was based on the novel with the same name published in 1962 went on to win several Oscars including Best Picture, Best Actor, Best Actress, Best Screenplay and Best Director but it is the subject of film which I want to discuss.

The book was published 1962, though it was written in 1959 by Ken Kessey and was based on his observations, communications with patients at the psychiatric facility he worked the graveyard shift on in Oregon. It came during the Civil Rights movement era and a time when the world was re-evaluating how dealt with mental patients. It aimed to humanize mental patients while at the same time condemn the practices of the staff in their treatment of their patients. In this area the book was a great success and has been cited by many as helping the Deinstitutionalisation movement.

Prior to this mental patients were institutionalized at Mental Hospitals run by the States.  In other words they were removed from society at large until they could rejoin society safely.  While the reasons for moving away from the system that had existed before are many, including the States wanting to shift the cost of care to the Federal government, new psychotic drugs that helped patients lead ordinary lives and the poor conditions in many of these psychiatric facilities but also the understanding of mental illness and developmental disabilities. The issues at facilities like Willowbrook in Staten Island, NY and its deplorable conditions and books and films depicting these problems made the Deinstitutionalization Movement unstoppable.  To this day closed Insane Asylums or Mental Hospitals are a favorite of Hollywood as a setting for horror movies even though the reference is not deserved.

The ideal was that with the advent of better drugs and the higher understanding that mental illness patients would be treated at community clinics or hospitals, with shorter stays, minimum of cost, at a better service for the patients. It would help remove any stigma attached and allow that person to rejoin society as soon as the medications stabilized them.  Mentally ill people would have advocates to ensure they would be treated as any other minority group and their rights preserved.  The reality is the results are mixed, while there are more people who are mentally ill and are functioning, contributing members of society, we also have thousands that were left homeless, unable to hold a job, or contribute in any way.

Part of the problem is that this new system is mostly dependant on Mentally Ill people to make health decisions that their own illness prevents them from making.  and the advocates that are supposed to look after them at times are more likely to enable a person with mental illness to remain homeless, living on the streets than assist or aid to have them involuntarily place at a facility, if they are against it.  It has also put restrictions of family members who are trying to aid them, requiring them to jump through hoops before help can be provided.

The Baker Act in Florida allows government the ability to send someone for evaluation, but a family member would need to get a court order to try to do the same at the hearing if the patient is not obviously psychotic chances are the Judge would deny the order.  Regardless the system is a catch and release system as, except on extreme cases all patients are eventually released, to a family member, a half-way house or even the streets.  Or in some cases jail, as they have become our mental institutions as a Human Rights Watch reports in 2003 that up to 56% of US inmates suffer from some mental Illness.

With the Naval Yard shooter, Aaron Alexis, also being a person who had sought or had received mental health treatment  in his case for an obvious psychotic episode, hearing voices and believing that neighbors were shooting microwaves into his brain, perhaps it is time we re-evaluate our Mental Health system, including the Supreme Courts decision in 1978 in O’Connor vs. Donaldson that a state cannot constitutionally confine a non-dangerous individual who is capable of surviving safely in freedom by themselves or with the help of willing and responsible family members or friends.  As Alexis has shown, he too, was thought to be non-dangerous until he got a shotgun and other weapons and decided to shoot-up the Naval Yard.

Mark O’Mara, George Zimmerman’s former attorney wrote a post on his blog. The Trouble With Using Mental Health as a Qualification for Gun Ownership he argues against the passing of any law that uses Mental Health as a criteria and makes some great points.  Perhaps rather than take away someone’s right we can just delay them, have a doctors  certify the person?  I am not sure if anything can be worked out in that regard except that our Mental Health system needs to improve.  No one can predict the next tragedy,  but sometimes the signs are there if we look at them.

As the Zimmerman case has shown the State is willing to suspend the civil liberties of a person when it suits it, and I am not advocating that be done with mentally ill people.  Everyone knew the Mental Health system was flawed, its time we pay attention.  Banning guns will not get rid of guns, and as the terrorist attack in Kenya showed us again, a gun-free zone is a slaughter waiting to happen.