The mentally ill are left behind
when we ask the wrong questions

© David Chartrand, 2006

    Public satisfaction surveys are all the rage among cities, counties, and school systems. Local officials want to know how they’re doing on the quality of police protection, roads, and schools.

   One question is rarely on these questionnaires, however: How well do we care for the mentally ill and emotionally disabled? Perhaps no one wants to hear the answer.

   In its recently released “Grading the States,” the National Alliance on Mental Illness concluded that America is flunking the test. The organization gave the nation a “D” for its treatment of the most fragile and frightened who walk among us. No state got an “A,” and only five — Connecticut, Maine, Ohio, South Carolina, and Wisconsin — got a B.

   Most interesting were the eight states that received an F on mental health services: Kansas, Iowa, Idaho, Illinois, Kentucky, Montana, North Dakota, and South Dakota. There is, it seems, a heartlessness in the heart of America.

   This doesn’t sound like the Middle America we’ve been reading about lately. Midwestern conservatives want schools to teach the message of Jesus, which, last I checked, is the gospel of compassion for the weak and sympathy for the unfortunate. The sentinels of wholesomeness and virtue are outlawing gay marriage, the teaching of evolution, sex education, and anything else that undermines the sacred institutions of marriage and family.

   Since nothing shatters families like untreated mental illness, you’d think these moral guardians would also be enraged about their communities’ treatment of the emotionally disabled. Faith involves believing in the unseen, so Biblical literalists ought to be leaping to the defense of those whose illness is dimly visible because it is so dimly understood.

   Ironically, however, the defenders of family values are often doubting Thomases when it comes to mental illnesses. Some subscribe to the Cruisean theory that clinical depression is a scam by the pharmaceutical industry. Defenders of family privacy consider emotional wellness a private, family matter. To Biblical purists depression is a spiritual malignancy that requires spiritual therapy. Others wonder whether the mentally ill are simply lazy. I mean, can’t these people, like, snap out of it or something?

   I’m sure there are other explanations, supernatural or other, for the heartland’s record on mental health. Maybe there’s a reason mental health services often languish inside government bureaucracies that cannot distinguish the symptoms of mental illness -- drug and alcohol addiction, juvenile delinquency, joblessness -- from the causes. Maybe those living the good life in middle-class suburbia can explain why they send their troubled loved ones to out-of-town treatment centers but don’t want such facilities located in their neighborhoods. We’d love to know why book-banning parents are concerned about the corruption of teenaged minds but aren’t so crazy about mental health screening or suicide prevention programs in the schools. Such are the attitudes in communities where countless children and adults commit or attempt suicide ever year — countless because no one bothers to count them The way to distance one's self from a problem is to pretend that it doesn’t happen to good families, like ours.

   While we’re examining our civic consciences, let’s talk about money. Let’s ask how Midwesterners build churches the size of football stadiums and football stadiums with rolling roofs, but never have any spare change for inpatient psychiatric units at their community hospitals. Let’s ask why cities cannot afford transient housing for the adult mentally disabled but manage to hand out tens of millions of dollars in tax subsidies each year for shopping malls, hotels, and soccer stadiums. Is it money we lack, or willingness?

   Surely this is not the real Midwest. Midwesterners care for their suffering neighbors. The plans were settled by the rugged and contentious, problem solvers who never accepted “No” or “It can’t be done.” The pioneer missionaries took scriptures literally, especially the part where Jesus said they would be judged by how they treated the least of His children. Midwesterners heard all this and shouted, “Amen!” Or maybe those were just the good old days.

   The mentally ill are complicated souls, but most have one thing in common: Fear. They live in constant dread of failing, of becoming a burden to others. Empty gestures like “Mental Health Awareness Month” are little solace to those who have learned the hard way that bypass surgery gets you a prayer chain at church but a bipolar episode gets you thrown in jail, or kicked out of school.

   Consumed with fear, a child cannot learn, a parent cannot provide for a family, a taxpayer cannot earn a living. The worst nightmare of all is the thought that you’re going through this alone.

   But they aren’t alone. Sooner or later, we’re all scared of something. If you ask me, that makes mental illness everyone’s problem. Because any one of us could be next.