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When I was an undergraduate, I took my meals at Yale’s “kosher kitchen” in a basement on the periphery of campus. Dinners were popular, but lunch was… intimate. Depending on the day of the week, lunch could be a gathering of a dozen, or just three or four. One semester during my sophomore year, I got to know a third-year law student named Michael. Our schedules overlapped on one of those weekdays when lunch was sparsely attended. Michael was a little older than most law students, and his gravitas was enhanced by his quiet confidence and his full beard. But there was also something else about Michael. It was a kind of heroic intensity, similar to the vibe I get from ex-military guys.
Over the course of the semester, I learned a little of Michael’s story. He had some condition that caused periodic blindness. The law school provided him a reader, when necessary, to read textbooks aloud to him. Fortunately, Michael had a remarkable memory and could recall all the material. Michael was well-informed, intelligent, and reasonable. He had seen something of the world between his undergraduate days and law school, and was an engaging conversationalist. He was someone I often turned to for advice.
After that semester, we lost touch. Michael graduated; I spent a semester abroad. Michael moved to New York City. I heard how he was doing from time to time through a common acquaintance.
A year later, Michael dropped his bombshell.
Michael published his story in the New York Times. It turns out that he was seriously mentally ill, suffering from severe schizophrenia. With the intense effort of family, friends, and psychiatric professionals, he brought it under control. And Guido Calabresi, the dean of Yale Law School, made it possible for Michael to attend, and graduate. As Michael said, “I went to the most supportive mental health care facility that exists in America: the Yale Law School.” Those episodes of blindness had been side effects from some powerful psychotropic medications.
After Michael went public, things continued to go very well for him. He got a book deal. Ron Howard even optioned his story for a movie.
And then, one day, our mutual acquaintance called in tears and told me to check the news. Michael Laudor had stabbed his fiancee, Caroline Costello, to death.
Laudor’s mother, Ruth, telephoned the police in Hudson saying she had received an especially frightening call from her son in the morning. She feared for the welfare of both him and Carrie, who had taken the day off for “personal emergency” reasons from her job at the Edison Project, a private education company that runs public schools in some states. Mrs Laudor begged the police to send a cruiser to the apartment.
A police officer was dispatched and let in by the superintendent of the building. The bloody scene inside, Carrie in a pool of her own blood, confirmed the mother’s worst fears.
As in the case of so many other schizophrenics, Michael was feeling well and had gone off his meds. And, as in the case of so many other schizophrenics, tragedy followed.
When Jared Laughner’s attack on Gabby Giffords prompted a gun control frenzy, all I could think of was Michael. When James Holmes shot up a theater in Aurora, Colorado, all I could think of was Michael. And after the Sandy Hook Elementary School shooting in Newtown, not far from my home, all I could think of was Michael. To me, the story of these murders was not about guns. It was about serious mental illness and people who desperately needed treatment.
One and a half years later, after the Newtown gun control hysteria has been beaten back, there is finally an opportunity to address the real problem. It has taken that long because the issue is complicated. Mind-bogglingly complicated. There are real tradeoffs of individual liberty vs. personal (and public) safety. And the mental health system has many, many moving pieces.
The opportunity comes in the form of a bipartisan bill authored by Republican Representative Tim Murphy, a practicing psychologist from Pennsylvania. As Ramesh Ponnuru explains at Bloomberg View:
Murphy thinks that existing government policies and bureaucracies don’t place enough emphasis on the severely mentally ill, instead catering to those with milder problems and the “worried well.” He also thinks they’re too solicitous of the “right to refuse treatment” when it is asserted by people who are too mentally ill to have a meaningfully free will. An inability to see that one has a severe mental illness can, he says, be a symptom of it.
So Murphy would prod states to set up mental-health courts that could order treatment for people with a history of arrests, violence or repeated hospitalizations. He would clarify federal law so that doctors could more easily share information about people in an acute mental-health crisis with their parents and caregivers. He would change Medicaid payment policies so that they no longer discourage long-term hospitalization for people with severe mental illnesses. He’d also make federal mental-health bureaucracies show evidence that they’re spending money in ways that work.
And he would cut spending for a federal program called Protection and Advocacy for Individuals with Mental Illness, which funds state agencies that often sue and lobby to stop the sorts of mental-health policies Murphy backs. Opponents of the Protection and Advocacy program often bring up the case of William Bruce, who got out of a psychiatric facility over the objections of doctors thanks to such legal advocacy — and later killed his mother.
Murphy developed his bill over more than a year, in consultation with professionals, mental health advocates, and families. One third of the Murphy bill’s 77 co-sponsors are Democrats. However, another bill was recently introduced by Democratic Representative Ron Barber of Arizona, who used to work for Gabby Giffords and was injured in the Loughner shooting.
Barber’s bill includes none of these provisions. He thinks what’s most important is not to reform the existing programs — although he allows that they could do a better job — but to give them more money. His emphasis is on increasing awareness and early treatment of mental illnesses. He would fund bullying counseling at schools, for example, because bullying often leads to mental illness. That’s very far from Murphy’s focus on the worst cases.
Barber also rejects Murphy’s approach to the Protection and Advocacy program, saying the Republican’s bill “would basically abolish a very important part of our mental health system.”
Ponnuru is evenhanded in discussing both proposals, describing them as different good-faith approaches to the problem. He concludes that the Barber approach is more-of-the-same and should be rejected on the merits.
And it should. But there is more going on here. This is, as Kimberly Strassel wrote in the Wall Street Journal, “a raw partisan exercise in killing mental-health reform, shoring up midterm election prospects and protecting Democratic constituencies—all at the expense of the most seriously ill.”
Despite all the bipartisan consultation, Murphy’s Democratic co-sponsors are under pressure to walk away.
Mr. Murphy … had solicited Mr. Barber’s thoughts and was even working recently with his committee counterpart, Colorado’s Diana DeGette, in the expectation that she would come on board. All that ended when [Nancy] Pelosi decided that Republicans couldn’t be allowed any victory that might present them as bipartisan, compassionate and leaders on health issues. Mr. Barber and Ms. DeGette received new marching orders.
While Mr. Barber presented the bill (Ms. DeGette is a co-sponsor), the Hill reported late last week that Ms. Pelosi and Rep. Henry Waxman (D., Calif.) were “deeply involved in crafting” it. A lobbyist told the paper that “Pelosi and Waxman hope this legislation will blow up any kind of continuing dialogue with Murphy.”
What is the political motivation?
Liberals have been unhappy that Mr. Murphy has so successfully focused attention on mental illness, since it messes with their story line that the only issue is guns. In this warped universe, a bipartisan vote for a Murphy bill —an acknowledgment that mental illness plays a primary role in shooting tragedies—is a surrender on gun control, and potentially an excuse for some Democrats to drop that politically dangerous issue.
The Barber bill is no threat to these liberals, since it won’t be heard, and is simply another Democratic spending blowout. Pelosi-Barber strips out every consequential reform from the Murphy bill—outpatient treatment, privacy rules, commitment standards, Samhsa reforms—and settles for throwing yet more federal dollars at “mental health awareness.”
As such, Pelosi-Barber also protects Democratic lobbies that are currently feeding from the federal trough and want to continue doing so. That includes federally funded lawyers who fight to keep the seriously mental ill out of treatment, as well as to a huge array of Samhsa-funded anti-psychiatry groups, such as the National Coalition for Mental Health Recovery, that oppose treatment for those most sick.
This is crass political opportunism. It is also cruel and evil.
If Nancy Pelosi succeeds in killing the Murphy bill, there will be more shootings and more stabbings and more broken lives. And I will continue to think of Michael Laudor and Carrie Costello. But all of us should now also think of Nancy Pelosi, and the responsibility she and her caucus bear.