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Mental-health care: An issue at the heart of California tragedy

In the wake of the latest gun rampage by a troubled young man, there is much to ponder: the pervasive misogyny in society, gun culture, the fragility of life and seeming randomness of violence.

But one issue that has not received near enough attention is what this latest incident tells us about the state of mental-health care.

Elliot Rodger suffered from mental illness – though it is not clear exactly what his condition was. Both police and family members have said that the 22-year-old had been in and out of therapy for several years and had been prescribed psychiatric medications, which he declined to take.

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Mr. Rodger's family did everything in their power to get him help.

But when a loved one has a severe psychiatric illness, there is one thing every family will tell you: Dammit, it's hard to get them help.

It's cumbersome. It's frustrating. And, at times, it seems downright criminal how powerless families are to get help for those who desperately need it.

Mr. Rodger – who killed six people and wounded 13 others near the campus of the University of California Santa Barbara before taking his own life – was clearly troubled.

Police were sent to his home on prior occasions at the insistence of his family and after at least one other outburst of violence.

Police are not psychiatrists, or psychologists, or not social workers but the burden of judging the sanity/danger of individuals generally falls to them.

It is an unenviable but all too common task.

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In some large cities, more than one in four police calls now involve the actions of people who suffer from mental illness and doing something deemed socially unacceptable – from public urination through to threatening/harming others.

For the record, it should be noted that research shows that people suffering from severe mental illness are more than 10 times more likely to be victims of violence than perpetrators of violence. They are a far greater danger to themselves than to others.

There are, sadly, many many cases like that of Mr. Rodgers – people with untreated mental illness in the grips of psychosis. More often than not they end in suicide or other self-harm; but we only hear of them when the violence affects others.

Many pundits have said that this massacre was preventable: If only police had done more; if only the therapist had done more; if only he had been hospitalized. We live in a society that values freedom above all, and nowhere is that more true than the United States, where civil libertarianism extends to protecting Mr. Rodger's right to buy arms, despite being under psychiatric treatment.

Here is the bottom line: To help those who need help and refuse it (which is often a symptom of the illness itself) we need to restrain their freedoms.

Can we, in a democratic society, justify incarcerating or committing to hospital people who have committed no crime? Can we force people to take medication against their will for their own good and the greater good of society?

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These are the uncomfortable questions we have to debate if these all too common incidents are going to end.

It is too facile to say none of this would have happened if Mr. Rodger had been committed to a psychiatric facility or compelled to take medication.

But what we can say is that it should be a lot easier for families to make that argument.

We should value the right of people to be well as much as their right to autonomy.

Being sick with a severe mental illness – especially one that makes one hateful, vengeful and violent – is not a right. It is a bloody travesty.

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About the Author
Public health reporter

André Picard is a health reporter and columnist at The Globe and Mail, where he has been a staff writer since 1987. He is also the author of three bestselling books.André has received much acclaim for his writing. More

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