Saturday, July 5, 2008


I just finished reading the book Crazy: A Father's Search Through America's Mental Health Madness, by Pete Earley. It chronicles emergence of mental illness (bi-polar) in Earley's son and his travails trying to get treatment and stay out of the justice system. Interwoven with his son's story are the stories of four mentally ill people whom Earley connects with through the Miami/Dade County Jail system, which gave him wide-ranging access.

The book was disturbing on many levels, but it got to me on a personal level as I thought about my kids. The recurring motif throughout the book is that it's extremely difficult to get appropriate treatment, especially for those who need it the most. Civil-rights laws have given mentally ill patients an unquestioned right to refuse treatment, regardless of their level of competence. At the same time, the state hospitals that used to be available to provide treatment (even if it wasn't good treatment), have largely been shut down. The community mental-health centers that were supposed to replace them largely failed to appear.

The ten-year-old has shown some signs of both mood and thought disorders. This spring we had to make changes to his medications because he was hearing voices telling him to hurt people. The prospect of him being both autistic and mentally ill, and me not being able to ensure that he takes his medication, is terrifying.

The seven-year-old is almost certainly going to have to live in some sort of assisted-living setting. For him to live independently will require a rate of improvement that verges on miraculous. And we know an awful lot of children like him in his age cohort. There isn't going to be anywhere to put them all once we parents are no longer able to care for them. In order to pay for his long-term care, we'll need to leave him a multi-million dollar inheritance. Right now that seems unlikely.

I hope our country wakes up from it's Republican-induced slumber and remembers that as a society we have obligations to all of our citizens, not just the rich ones. Otherwise I don't know what will happen to our children.

1 comment:

hymes said...

Don't let Pete Earley's book scare you unduly. It is riddled with bias and inaccuracies about the ability to access care in my state of Virginia and if it is that inaccurate about his home state, I can't imagine it is accurate about other states. It is in fact extremely easy for a parent to commit their adult child in Virginia as a whole and just got a lot easier, too easy in fact. Earley lived in a part of Virginia that was and is an outlier and not representative of the rest of the state, also Virginia spends the majority of its budget on its mostly horrible state hospitals.

Prevention is the key, find a therapist or other provider who doesn't rely solely on drugs as treatment now and start working with them. That is your best bet. But if worst comes to worst, there isn't a state in the U.S. where commitment isn't extremely easy for a parent to obtain when a child adult or otherwise is really doing badly.