The Safety Net

It was a hard week in Seattle this week. On Wednesday, a man opened fire in a funky neighborhood café, killing 4 people who were drinking their morning coffee. He then killed a 5th because he wanted her car, before he turned his gun on himself. This followed last week’s killing of a dad literally caught in the crossfire. He was just driving home and was in the wrong place at the wrong time when two men with guns violently argued. And not long before that a young woman died in the crossfire of another armed fight.

There have been many beautiful tributes to the victims. And also the expected questions about gun access, gang violence, and fate. But my mind keeps turning to our mental health system and the budget cuts that have nearly obliterated it during the recession. Not that it was ever that strong to begin with.

I didn’t know Wednesday’s shooter, so I don’t know if he lost access to mental health services that might have prevented this tragedy. By all reports, his family knew that he needed intervention and he clearly did not receive what he needed. But I cannot speak definitively to his case.

What I can tell you is that I have worked in social services and I know firsthand that there is not enough support for the vulnerable in our community. And the mentally ill are vulnerable. They need help and support, and help and support are by and large not available to them. Especially not to men. And especially not if they also need drug treatment, which many mentally ill people also need. When the brain chemistry is not right and there is no money for prescription drugs, street drugs provide an easily-accessed option for self-medicating.

We as a country have made the decision over and over again to deny mentally ill people access to care. We saw it in the 80s when Reagan and like-minded politicians closed state-run psychiatric hospitals and turned mentally ill people out onto the streets. We see it every time our cities, counties and states vote to increase money for police and jails while simultaneously stripping funding from crime-preventing psychiatric care facilities. We can see this issue playing out right this moment as we await the Supreme Court’s ruling on the Affordable Care Act, which seeks to prevent insurance companies from denying health coverage to people with preexisting conditions. And what is schizophrenia (and any other mental illness) if not a preexisting condition? How could one possibly afford treatment and medication without health insurance?

We vote, or we elect lawmakers who vote, against things that aren’t sexy in favor of sexier projects. More police? Sexy! More psych wards? Not sexy! Lower car tab fees? Sexy! Drug treatment facilities? Not sexy! I could go on and on in a litany of our collective short-sightedness. But in the end we pay for our lack of foresight. We would be safer if more people had access to drug treatment and mental health services than we would be if we had police officers stationed on every street corner. But we are too short-sighted to think about addressing the roots of the problems. We wait until violence has erupted and then we freak out and call for more police, while we lament and wonder what is happening to our city.

As a 21 year old, fresh out of college, I spent a year working in inner-city Atlanta as part of the Jesuit Volunteer Corps. My placement was in a soup kitchen and homeless outreach center, where I did everything from trying to help people get their Georgia State I.D. cards so they could find jobs to helping people access medical care. I can’t begin to enumerate the number of times I had men crying in my office, begging me to get them some help. For drugs, alcohol, voices in their heads, you name it. But no matter where I called, the beds were full. The state had a limited number of “free” beds and they were always occupied. My clients had to be about to harm someone before I could get any kind of intervention. They couldn’t just be ready to make change. There were no resources for that without private health insurance.

Surprisingly, it was different for my female clients. Beds were still hard to come by, but for everything from shelter to drug treatment, it seemed that there were more resources for women. I truly believe it was sexism. Women would clearly never choose to be homeless, or on drugs, or mentally ill. Women were vulnerable and needed protecting. So we allocated resources to the women.

I know the women being assisted needed that assistance. But I also think that all of the assumptions made about the women and their vulnerability were equally true for the men. Men made up the greatest numbers of the homeless at our center, yet there were fewer resources for them. Who suffered more mental health issues from going to Vietnam? Who was biologically likelier to develop schizophrenia? Who made up 90% of my clientele? And yet there were almost no resources for them. It was a bitter pill to swallow.

During that year, part of me rationalized what was going on by attributing it to being in the South. Surely on the progressive West Coast it was different. When I moved back to California after that year, I worked for a program that offered support to mentally ill homeless people in Santa Monica. I found that things weren’t so different in California. In California, they lamented the fallout they were still dealing with from the Reagan era “reforms” to the mental health system. Reforms that meant that the population of homeless mentally ill swelled, and that state-supported help for them was virtually non-existent.

Between then and now, we haven’t had any great societal shift towards allocating more resources to help those with mental illness. We still don’t like to talk about them, look at them, acknowledge that they are people with feelings. We would rather blame their actions on their suspected inebriation or something their parents did to them when they were young.

And then someone loses it, violently, and everyone wonders what happened.

What happened is that we have made it almost impossible for concerned family members to get treatment for their loved one against their will. We have made it unaffordable for underinsured people to get the help they need. We have created a situation in which someone has easier access to weapons than they do to therapy and medication. And this is what we have to change.

If we truly, deeply never want such a tragic, violent outburst to claim our friends and loved ones again, we have to make a safety net for the vulnerable among us. And those vulnerable have to include the mentally ill, the low income, the men.

Until we change how we look at the problem, this problem is never going to change.

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