The crux of the federal government’s longstanding complaint against Mississippi’s mental health system is that the state has been institutionalizing too many of those who suffer from mental illness.
A federal judge has agreed and is ordering Mississippi to devote more of its resources into developing a mental health system in which the care is community-based, such as is provided in this area by Life Help mental health center.
The intent of the change is good.
People suffering from treatable mental illness do better if they can stay in their homes, receive family support and have professional resources nearby to provide counseling and monitoring of their medications.
Locking the mentally ill up against their will in large state hospitals, such as at Whitfield, should only be a measure of last resort. Those beds should be limited to those cases in which the mental illness is so severe that the person has become a danger to themselves or others, or when the home environment is so dysfunctional that the person with mental illness is worse off living that way than in a state facility.
The distaste for mental institutions, however, can also go too far, creating its own dangers in the desire of keeping people out of them.
For a case in point, there’s the frightening story of Nikolas Cruz.
A jury in Fort Lauderdale, Florida, has been hearing testimony about Cruz’s life, including the time he was in his mother’s womb, as it weighs whether to recommend a death sentence or life in prison without parole for a school massacre he carried out in 2018.
Considering the troubled trajectory of Cruz’s life, it seems almost predestined that he would wind up killing himself or somebody else. In this case, it was 17 somebodies who were killed — students and staff at a high school that a year before the slaughter shuffled Cruz off because he was scaring the bejeezus out of everyone.
According to the testimony at his sentencing trial and previous reporting, Cruz was born to a prostitute who abused drugs and alcohol while she was carrying him.
He and another male child, who was born of the same mother, were adopted by a childless couple who had the financial means to raise them but were too old to deal with the behavioral challenges that came with the boys. The family dynamic became even more complicated when the adoptive father died of a heart attack when Cruz was 5. That left his mother, in her mid-50s by then, to raise Cruz and his equally hard-to-control brother by herself — a task she was obviously not up to.
Cruz, probably because of his abysmal prenatal care, was developmentally delayed. He was bullied by other kids, including his younger and more popular brother. He was socially awkward and showed early signs of an uncontrollable temper. By the time he was in middle school, he and his brother were destroying their home and tormenting their mother. If Cruz lost a video game, he would get so angry that he would destroy the TV on which he had been playing and put holes in the wall with his fists or a baseball bat.
He had a severely damaged brain, and it only got worse with time.
By the time Cruz was in high school, he was harming himself, talking about suicide and about shooting up a school. He was never institutionalized, even after guidance counselors at Marjory Stoneman Douglas High School recommended that he be forcibly committed for a psychiatric evaluation, a good year and a half before he turned a semi-automatic rifle on that school.
His mother, who died four months before the shooting, appears to have been part of the problem. Over a four-year span, she called sheriff’s deputies to her house at least two dozen times to deal with Cruz, his brother or both. Social service agencies were assigned to try to help her. But she made excuses for Cruz, too, and downplayed his potential threat to others.
She didn’t want him committed, and no one who could have overruled her wishes took the legal steps to have him institutionalized. That was a tragically fatal error.
In Mississippi, I don’t hear the judge or the court-appointed monitor suggesting that the state mental hospitals be closed. What I do hear them saying is they need to be better managed.
Some beds in the state hospitals are being taken up by those who shouldn’t be there. Others who should be there are in jail cells, where their condition deteriorates further because they don’t get the medicine they need or the care of professionals trained in dealing with mental illness. Still others who need institutionalizing are homeless.
Community-based care for mental illness is the ideal, but it cannot be the only option. When a person’s mind is so far gone that it poses a clear danger to the afflicted individual or to others, humane institutionalization is the only responsible course. Nikolas Cruz is a horrific reminder of that.
- Contact Tim Kalich at 662-581-7243 or firstname.lastname@example.org.