RURAL ROUTES/Margot Ford McMillen

Nation Needs to Invest in Mental Health Again

I’m glad to see the debate on what-to-do-about-guns moving from bans to the issue of mental health. Prohibitions, as we see over and over again, don’t work. Here in my county, the merest sniff of a ban — any kind of ban — moves people to buying. If I was in gun sales, I’d love the conversation about gun control because it makes the fearful people more fearful. Call them hoarders if you want; the truth is that people who like something will keep buying, whether we’re talking about gun owners, violin players, quilt makers or collectors of porcelain poodle figurines.

In fact, the headline on our local newspaper one Friday in December was “Gun, ammo sales up.” And, last night on TV, there was a big, expensive advertisement for a gun show at the county fairgrounds. The pictures showed tables and tables of hand guns, laid out like pies at a bake sale. On opening day of deer season, our neighborhood, on the border of a national forest, sounded like a gun club. One neighbor counted more than a hundred shots squeezed off in the first hour.

And, yes, we had a record deer harvest, which is a good thing because we have a record number of deer.

But mental health, now there’s something we can actually work on.

Experts seem to agree on the qualities shared by these killers. Things like alienation, intolerance, preoccupation with violence, manipulation of others, lack of trust, depression, lack of empathy are all signs. And psychologists know how to evaluate and work with people who exhibit these symptoms. The problem is commitment. The problem is, in other words, money.

Since the days of Dorothea Dix, a woman who traveled the nation in the 19th century and encouraged governments to build asylums for mentally ill people, we have agreed that helping mentally ill people is a social benefit, one that we all must share. Our earliest asylums were well-financed, Victorian-era buildings, ornately decorated and placed in green, landscaped settings with the hope that beautiful surroundings would contribute to recovery.

It turned out that some people were helped and some weren’t. For some mental illnesses, there are physical problems — bad teeth, cranky liver — that can be fixed, effecting a cure. For others, the mere fact of companionship is the key. Back in the Kennedy years, there was money for mental health care and in 1968, the General Assembly appropriated $3,800,000 to build a six-building residential center for teenagers. In the complex, there were school classes, therapy sessions, art and dance classes, a fully-equipped garage.

But, of all the programs tried by that center, for children as young as 13 and occasionally even younger, people remember the Foster Grandparents, hired with War on Poverty funds. For this program, ten or fifteen elders took a bus to the center to talk to the kids, rock the youngest in rocking chairs, help them learn with arts and crafts and bake cookies.

Even after funding cuts, staff fought to keep the foster grandmothers going until 1991 when the entire youth center was moved to a mental health center that was part of a medical center. The great boom in pharmaceuticals was taking off and “clients” were released to the population. Sometimes they went home to the very environments where they weren’t loved, nobody understood them, no one could help, they were alienated — again. Even when there is money for medications, mental health sufferers can’t always keep track of where the clinics are, how often they should visit, how many pills to take and when to take them.

So … did the residential model help people? It’s hard to say since the follow-up hasn’t been done, but it’s clear that a lot of people were safer, both inside and outside of the walls. For years, back to Dorothea Dix, people in the state hospitals all over the nation had been responsible for something — their own community. They raised their own food, made their own clothes, furniture, rugs and even mattresses. They played music, made art, wrote newsletters. Many of them were there for lifetimes, abandoned by families.

There are only two books on the history of asylums. As a writer of one of them, I would like to see more attention to the success of these institutions rather than the failures. In the case of the asylum in my community, the years of best work were the years of the Kennedy era when there was, in the words of one social worker, “money for all that stuff …” There were plenty of failures, to be sure, and staff was grateful when pharmaceuticals got to the point that they could help. But community and caring, that’s what people needed.

It’s embarrassing, in this modern, technological age, to call for compassion and love. To call for baking cookies and rocking babies as well as pharmaceuticals. So, welcome to 2013.

We have a lot to work on.

Margot Ford McMillen farms and teaches English at a college in Fulton, Mo. She blogs at progressivepopulist.blogspot.com. Email: margotmcmillen@gmail.com.

From The Progressive Populist, February 1, 2013