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Insanity and Guilt
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.
Published in General
SoS, this situation is personally heartbreaking and politically heinous – particularly on the part of those whose efforts allow the severely-mentally-ill to injure, kill or (as Dr. Charles Krauthammer eloquently put it after Newtown) “die with their rights on”. I applaud Mr. Murphy’s efforts, and appreciate what must have been a difficult post to write. Thank you!
A powerful and moving article. Thank you for posting.
If the bill were to pass, would Nancy Pelosi be among those locked away? Does she fear she might be? My questions are not a joke.
I can’t add anything to what Nanda already said. Actually, one thing: How incredibly despicable of the Democrats to behave so cravenly and so selfishly. It’s also incredibly sad that most of the voting public will have no idea.
There is a third option: legal guardianship.
I’ll never know why I even considered doing this except the foolishness of being 25: But I became my mother’s legal guardian. She suffered from paranoid schizophrenia. She had been hospitalized involuntarily.
To make a complex story short, I had edited a book written by some social workers in New York City (I think) who had done this for some mentally people, the idea being that they could rent an apartment and assume responsibility for it.
I was taking care of an uncle at the time who left $2,000 from his social security. If my mom, his sister, had inherited it, it would have disrupted her Social Security disability checks for a year possibly. So I used it to hire a lawyer–copyright, not family law :)–and he created this full guardianship for me. It took twelve visits to doctors before I found someone to visit my mom and certify that she needed a full guardian. But eventually I got it.
No professional I dealt with over the 25 years I looked after my mom had ever seen a guardianship like mine. But it was complete, like a parent’s.
My personal experience was with a very energetic person whom others shunned. Brilliant fellow, and a good guy. Tough as nails, too.
He went off his meds once, and that ended our friendship in a very messy way. I realized at that time that when he was not medicated, he lived in such an alternate universe that any friendship was impossible. We have not been in contact since then.
A year later I heard he jumped off a building in Manhattan. He actually survived this, though his legs did not. He is, since I checked just now, a highly productive member of society.
My family had a run-in with the mental health system because of an elderly relative who was fine when she took her meds. Feeling fine, she’d stop taking them, and the wheels would come off the trolley. Two of my aunts would visit her regularly, but never ever alone.
She was finally convinced to admit herself to a facility that would see to it that she got the medication she needed, but it was a long, slow uphill battle.
Thanks for the piece, SoS.
Excellent and compelling. Keep a close eye on any Dem-sponsored mental health legislation. Read the details. Notwithstanding the retail political blather, they are intent on “gun control” through this back door: 1.Health care providers must now ask whether or not you own a gun. It will be in a federal database. 2.Your prescription medications will be entered in a federal database. 3. The NICS system will be exempted from HIPAA protections. It will access your medication record. 4. Too “mentally ill” to own a gun will be defined as anyone ever prescribed any psychotropic medication.
This was the thrust of the mental health angle of the proposed Toomey/Manchin Bill. It will be back and it will be stealthy. They don’t care about the mentally ill. They only care about disarming the public. They will not stop.
Very informative Son of Spengler, thank you for writing and posting this.
Indeed, but unfortunately, par for the course for Mrs. Pelosi and her ilk.
This is a heartbreaking story, on all levels, including your friend Michael and the legislative hijinx.
Thanks to all for the kind words. Ordinarily I don’t like to get so personal on Ricochet, but I consider this the most important subject I’ve ever posted on. Call-your-congressman important.
In my focus on the mentally ill, I’m afraid I may not have emphasized enough the loss of their victims. Michael’s prospects have been shattered, but he is getting the care he needs now, and can still see his family. The families of Carrie Costello and the children of Sandy Hook don’t have that comfort. The idea that Democrats are playing politics with the lives and memories of such victims — past and (God forbid) future — makes me livid.
Yes, I neglected to say:
This is a heartbreaking story, on all levels, including your friend Michael, Carrie, and all the other victims. The legislative hijinx and deflection proposed by Pelosi et al must reopen the unhealed wounds for all the families in similar circumstances. I can’t comprehend the pain those families feel.
My experience in dealing with schizophrenia is unique. Most caregivers are parents or siblings. I was a daughter, so I had no other goal except to see my mom have a home and a semblance of a decent life. I didn’t feel in any way responsible for her illness, and I didn’t need to control her in any way. I didn’t feel that people were judging me because of her actions. So I was completely objective. And I learned a lot. And I need to write a book about this someday.
I also had access to the best psychiatrists for this disorder: the doctors at Harvard Medical School and Deaconess. My mom was doing so well at one point that people described it as a “miracle.” And it was. But it took a lot of care to reach that point.
The Murphy bill will help, but it will cause problems too.
The most promising news I’ve heard lately is that functional magnetic resonance imaging (fMRI) is now able to see parts of the brain light up abnormally when schizophrenics are at rest. Removing the human judgment part of the diagnosis will help families enormously.
Thanks, SoS for pulling all this information together. One small piece of this that hasn’t been mentioned is the way that Rep. Murphy’s bill utilizes research and policy that has been shown to be quite effective with better outcomes for the patient and the family system. However, the science and quality of care here clearly take a back seat to union and advocacy issues–just what the Obama administrations promised, right?
The harm done to these the seriously and persistently mentally ill is a disgrace, and ironically, the “choice” that is guarded so closely for them (e.g., right to refuse treatment, records and decision making privacy and protection) is shunned in other areas such as education.
SoS,
How sad!! I have been around people who have been mentally ill. Adjusting and getting the right meds are important. Sometimes I feel it inflicts those who think too much. They can’t let go. Also they can hear voices which must be strange. I wish I knew when I meet with them how much is them and how much is the muted form of them by drugs.
It sounds like Michael was paranoid to the point of violence. The mentally ill seem to speak another “language” and saying normal things at times can set them off. They seem so okay at times so it must have been a shock to you.
Well, I learned something today.
Very true. I will always consider it the greatest blessing in the world that I got to know my mom somewhat close to who she really was–a really beautiful, sensitive, elegant, intelligent person.
The medications are a godsend. They need to be handled correctly, however. I’m really nearsighted, and my glasses help me. But they would harm a person whose vision wasn’t like mine. It’s the same thing with the psych meds. And too many psychiatrists don’t understand them.
Like you I had a mother who was schizophrenic and for whom I was primarily responsible (as much as anyone could be and was allowed to be with the restrictions of the “reformed” legal system handling of the mentally ill) the last 25 years of her life. While there are some shortcomings in the Murphy bill it is much better than the alternative.
When most Progressives talk about mental health services they focus on funding of their constituentcies such as the psychiatric profession and widening the net of services for which they can get reimbursement and government employees to staff the services which mostly emphasize less severe mental illnesses which are easier to address and more lucrative. In reality Progressive politicians just don’t care about the severely mentally ill and don’t want to be diverted from their goal of gun control.
Just in case anyone is reading this thread who has a family member or friend who has been diagnosed with “bipolar” or “schizophrenic” disorders:
This doctor, Dr. Alexander Hyde, who passed away recently, has saved a lot of lives. He looked at extreme mental illness in the way doctors look at diabetes: it can be managed, and a person can live successfully with it, with a lot of help. I actually had him as my mom’s doctor for a couple of years–amazing doctor. He wrote a book, Living with Schizophrenia, that I relied on so much that it became rather worn out. I strongly recommend it. And when you are looking for a psychiatrist, try to find someone with Dr. Hyde’s view of the disorder.
One last point: Get a good cardiologist. The heart-mind link cannot be overstated. There’s something about a lack of oxygen in brain that is devastating.
Schizophrenia does not have to be a death sentence. You have to pay attention every day, but the afflicted can live a good life, and we can enjoy having these people around for a lot longer than was true in the past.
Well, I am dismayed to be the first to insert some skepticism here.
This is heart-wrenching babble of the most insidious and misleading sort. Where is the common sense and
fear of abuse? The drugs are extremely variable in results with real people and very dangerous. Do you wnat to be Guinea Pig? Any of you who will take geodon or prozac etc ….. twice and keep the same opinion has some credibility. Mental health treatment is a semi-barbaric culture of some well meaning charlatans guessing and the use of mental health to create tiers of rights in the already corrupt and obscene Justice system is asking for the American Gulag to be even more like the original. It already exists. Wake up Sheeple!
In my reading and in the doctors’ offices in which I sat, I met no kids of schizophrenics. Interesting to find on Ricochet someone who has had a similar life experience. :)
There are two mes: the one who wants to say to the world, “Stop. We can handle this!” and the other who wants to round up every psychiatrist and politician and send them packing. So much ignorance. I could tell so many stories. Ugh. Sometimes my mom made more sense than all of them put together!
I was involved with three involuntary hospitalizations. Since I was the engineer of one of those hospitalizations, I’m unclear as to how the Murphy bill will change things. I’ll take your word for it, though, that it will help.
My mom’s hospitalizations were four to six weeks. I am pro deinstitutionalization. I hate the mental hospitals and group homes. Everything I did was to keep my mom out of them. I don’t want the country to go back there.
The Murphy bill alarms me. In the 1970s, only 7 states had the death penalty. Now 32 do. I always look at that as a sign that our country has given up on trying to save people. I am afraid the community care for the mentally ill is going the same way. We are giving up. And Sandy Hook was the last straw. I get it.
The Murphy bill, while a good thing initially, I think will harm a lot of people who are mentally ill and could be helped.
The patient care dollars never followed the released mentally ill patients. They were supposed to. That’s why there is little to no treatment in our communities.
Someone once wrote that the reason that schizophrenics don’t get care is they are dirty. Even the doctors recoil from them. I think there is some truth in that.
I agree with you. Look at the Justina Pelletier case in Boston Children’s Hospital.
That said, in the hands of a good doctor, those medications can save lives. A surgical scalpel can kill people too.
Everyone has a life-changing moment. Mine was at 19: seeing my mother inside Danvers State Hospital. I don’t want the country to go back there. And it will be, when the Murphy bill is passed. That said, it will put the problem out of sight, and maybe a few violent people will be confined.
But I also follow the cases of the people on the psych meds who are acting out the visions they are seeing. These medicated people are dangerous. I’ve been following these cases for years, the latest being the Colorado movie theater shooting. The psychiatrist needs to be on trial. I blame the psychiatrists for these violent events. And guess who won’t show up?
I was unaware that I am a “Well meaning charlatan”.
Our organization does keeps people alive. We are not selling snake oil. Before you make such a blanket statement, you might actually martial some resources to back it up.
For what it’s worth, I’m not sure it’s possible to be a well meaning charlatan.
We have closed too many beds in this nation. In 1970 there used to be 200 beds per 100,000 citizens. Now there are less than 20. What we need is more money in the community to take care of the Mentally Ill, and Acute care centers in the community. Like this one that we are building.
There is not a private sector solution as there is no money to be had for Severe and Persistent mental illness. (SPMI)
Having worked with families desperate to help clients that refuse treatment, I understand and support more power to intervene. Time and again people we got help against their will have thanked us for the intervention after they stabilized. It is not ideal, but it is more humane than letting someone live under a bridge because he refuses medication.
People with SPMI die 20-25 years sooner than the rest of the population. They do not get medical care, they live hard lives, and mostly are a danger to themselves. Americans, Christians, have a duty to their brothers and sisters who cannot care for themselves. As a culture, as a society, we have not care much at all.
Must resist driving a semi into the opening Bryan just left. . .Must resist driving a semi into the opening Bryan just left. . .
Having my mom committed was the hardest thing I ever did–my knees literally buckled under me. The social worker said, “Things will get better.”
And they did. For twenty years.
You are right, Mr. Stephens. And you are helping a lot of families.
(That said, I’ve met a lot of people who should not be in this business of helping the mentally ill.)
In Boston, the Department of Mental Health actually totally funds Harvard’s work because, as you said, there’s no money to care for these patients.