Our Crazy Mental Health Policies, What Your Doctor Knows That the New York Times Doesn't

You Can't Out-Think Crazy

John Stewart

http://www.latimes.com/news/nationworld/nation/la-na-jared-loughner-20110116,0,2115673.story

When I was in medical school there was a time honored ritual for students on their first psychiatry rotation. Students were put in a room and asked to speak with a schizophrenic patient. In that time before the universal use of anti-psychotic medications, you learned pretty quickly that people can be “crazy” in a far different manner than we generally use the term. They are irrevocably and tragically locked into their own private world, which is not accessible to others. They often do not respond to outside stimuli, but even if they do, their actions make no sense. These patients cannot function in society, cannot be reasoned with, cannot be bargained with, and do not respond to therapy. The first emotion the aspiring doctor feels is frustration, followed by resignation and eventually acceptance. Anti-psychotic drugs help, sometimes substantially, but patients don't like them, and frequently quit taking them.

Without firsthand knowledge, our natural tendency is to interpret mental illness in terms of our own experience. We assume the mentally ill are just like us, only more so. New York Times writers, politicians, and most of the population make this mistake, and do not understand that this disease cannot be understood rationally. As John Stewart points out so clearly, you cannot use reason to delve into the motivation of a schizophrenic, and doing so is useless.

1% of a population, or 3 million Americans are schizophrenic. Most exist at the borders of society. Even when treated, they function at a low level. Many become homeless, some self-medicate with alcohol and illegal drugs, and full recovery is very rare. Unless you are a mental health worker, ER physician or policeman, most of us go through our lives with only minimal contact with these unfortunate people. Nevertheless, they have major, if under-appreciated impact upon our healthcare system.

Unfortunately, as the Tucson tragedy has pointed out, many who make policy and form public opinion have no grasp of the issues involved. The decrepit level of political discourse in this country probably had little influence on the personal demons of Jerold Louugner. The care of the those with severe mental illness in this country has been and remains a tragedy, not addressed by Obamacare, more to come.