After Tucson, Getting Involuntary Commitment Right

“If only” -- fill in your favorite agency or person here -- “had acted to deal with the shooter’s mental illness, the murders in Tucson, Arizona, would never have happened.” Many well-intentioned people have expressed similar concerns about the killer. And while it is certainly true that the involuntary commitment statutes of some states can be improved, that process is not as easy as some may think. It has taken about 40 years and a road littered with the tragic consequences of good intentions to bring us to where we are today in the identification and treatment of the mentally ill.

Many of the problems we now experience with the mentally ill and with involuntary commitment can be traced back to the early sixties, when a great many progressive attitudes, ideas, and policies began to take root. There is little doubt that the general state of mental health treatment in America at the time -- particularly in state-run hospitals -- was rife with neglect and abuse.

But as this sorry state became more widely known, did it lead to improvements? Not quite.

Remember that the sixties were the heyday of the counterculture, where the self-appointed intellectual elite enjoyed considerable persuasive power. Propounded by such luminaries as Harvard’s Timothy Leary, whose primary claim to academic fame was marinating his brain in LSD, slogans such as “tune in, turn on, drop out” and “don’t trust anyone over 30” became not only popular aphorisms but indicators of the paths to power -- power which directly led to our current dilemma.

In the illuminating Do Gooders: How Liberals Hurt Those They Claim to Help (And The Rest of Us), Mona Charen speaks to the atmosphere of the time and some of its driving forces. Charen explains that Thomas Szasz, author of The Myth of Mental Illness, “popularized the idea that mental illness did not exist but was merely a label that a rigid and intolerant society placed upon those who were nonconformists of any stripe [...]. Mental illness was a social construct, a prejudice, not a diagnosis.” Charen notes that Erving Goffman wrote an influential book called Asylums, in which he argued that all mental treatment institutions were essentially alike, and not for the better. Goffman “insisted that that most of the symptoms of mental illness displayed by residents of mental hospitals -- raving, hearing voices, paranoia -- were responses to being locked up, not evidence of illness [...].” Also enormously influential was British psychoanalyst R. D. Laing. “Laing argued that modern society itself was twisted and unnatural [...]. Laing taught that society’s coercion alienated human beings from their instinctive, natural, and intuitive selves. The people society called mentally ill were merely attempting to recapture the ecstatic and intuitive parts of their souls. Who were we, he asked, to label them insane when society itself was so sick?”

If this sounds familiar, that is because it is of a piece with the contemporary progressive meme expressed by Mr. Obama -- who, on the 2008 campaign trail, often called America the greatest nation in the world and then exhorted crowds to help him fundamentally change it. (As those who have been keeping track know, that intention is one of the few promises he has faithfully kept.)

One must not underestimate the influence that people like Szasz, Goffman, and Laing had on society and those treating mental illness. Their ideas -- however well-intentioned -- essentially boiled down to an idea that, heard today, sounds utterly idiotic: the mentally ill aren’t really sick at all, but have a supernatural sense of perception, perhaps even a more evolved consciousness than the rest of the everyday dullards (such as those clinging to God and guns, of whom Mr. Obama and his followers are so contemptuous).

All of these attitudes were brilliantly depicted and exploited in Ken Kesey’s novel One Flew Over The Cuckoo’s Nest (1962), which dealt with just that theme. And in case the ideas were beginning to wear off, they were reinforced by Milos Forman’s movie adaptation of the book in 1975, with Jack Nicholson brilliantly portraying Randall P. McMurphy, a petty criminal who tries to worm his way out of jail by pretending to be mentally ill. He becomes the Messiah of a mental ward, fights bravely against the oppression of the establishment, and ends up lobotomized, but his sacrifice leads another inmate, the Chief, a huge Indian, to salvation. In the final scene of the film, the Chief, with a superhuman display of strength, breaks out of the hospital, and to a thumping, Hollywood Indian-like beat, runs back to purity and goodness: the wilderness from which he came and to which, thanks to the Christ-like sacrifice of McMurphy, he can finally return.