We cannot continue to shrug our shoulders about mental illness

Not long ago, in late fall, a man in rural Maine fell into the depths of mental illness, symptoms of which included paranoid delusions and anxiety-inducing behavior. His concerned family alerted the authorities again and again, but no help came. There were no resources available; any treatment or hospitalization was short-lived. One day, after escalating violent behavior, he killed.

I’m not talking about Robert Card. I’m talking about Justin Butterfield.

After several years of gradually worsening schizophrenia, Justin Butterfield, then 34 years old, decided his brother murdered Gabriel Damour on November 24, 2022. Thanksgiving morning. Last February, he was found not guilty by reason of insanity. After the Lewiston shootings, the facts about Robert Card’s struggles, and his family’s attempt to help him, all I could think about was Justin’s case.

The first thing you need to know is that ‘mental illness’ is an umbrella term that covers a range of conditions and is more common than you might think. According to the National Alliance on Mental IllnessEvery year, 1 in 5 American adults experience a mental illness (including me!). And for most people with mental illness, a combination of outpatient therapy and medication management, along with possibly a short inpatient stay for stabilization, is usually sufficient. And the vast majority of people struggling with mental illness pose no danger to anyone around them. But there is a small percentage of people who develop a serious and persistent mental illness that, if left untreated, can lead to violence.

The key words there are ‘if untreated’. By all accounts, Justin Butterfield was a good partner, brother and father while he was on his meds. That also applied to Robert Card. They too were victims of their mental illness. They weren’t monsters or movie villains, they were people. People. Mr. Card is dead. Mr. Butterfield is in a mental institution and will likely remain there for a very long time, and even if he were released, he would have to live with the knowledge that he killed someone he loved.

This kind of behavior is not inevitable. We don’t need to lock up people with serious mental illness. There were multiple paths that could have led to different, safer outcomes for these men – including a functional “red flag” law, instead of the “yellow flag,” which is confusing, overly bureaucratic, and difficult to implement in an emergency . Card and Butterfield could have refused treatment all they wanted – if the guns in their homes had been removed, they wouldn’t have been able to hurt people.

If you or a loved one is unfortunate enough to be dealing with chronic mental health issues, you may find that there is no real “system,” just a handful of resources, most of which are underfunded and do not communicate with each other. other. Usually the police are called first, because the police are our first responder for almost everything, especially if someone is acting threatening or perhaps just strange.

The police then transport the person to the emergency room. The emergency department stabilizes them or places them in a psychiatric facility for treatment. These stays usually do not last long. That shouldn’t be the case. And if it appears that the patient has been sufficiently stabilized, the patient is released. Sometimes follow-up community supports are available, but often they face waiting lists and loved ones doing their best to keep them stable. Can they afford their medications? Who knows. Can they go to a pharmacy to refill it? That’s the patient’s problem! The lucky ones survive and recover. For the unfortunate, their condition begins to worsen until someone calls the police, and the cycle begins again.

The truth is, there is no safety net in Maine for people suffering from serious, persistent mental illness. You either have the means to pay for private treatment, you end up on a waiting list of months or years, or you go without. Psychiatric treatment is expensive and labor-intensive, but also highly individualized with respect to the patient. A method that works for one person may not work for another, making it difficult to produce resources and services at scale.

Furthermore, the most serious cases of mental illness often involve anosognosia, or a lack of awareness that someone has a mental illness. A person who does not have the ability to understand that he or she is sick will not seek treatment. Otherwise they end up in the cycle of police – first aid – home. Or police – first aid – streets.

As a state and as a society, we have decided that we would rather not fund services. The occasional violent death is just the price we pay for low taxes. It is more pleasant for the average citizen to turn his head and never have to deal with the mess of pain, poverty and madness. It’s uncomfortable dealing with mental illness. Believe me, I feel you in that; I’ll never forget that first shift at the walk-in clinic where a patient came in and told me he was having suicidal thoughts. I have witnessed the police being called for erratic behavior. However common these incidents may be, I have never had confidence in them; I never felt like I knew what I was doing; and I never felt that the solutions we offered were any good.

What happened to Butterfield and Card will happen again if nothing changes and we continue to go about our business with our heads in the sand. One time is an anomaly. Twice? In two consecutive years? That’s a pattern. And it won’t be a surprise. In the aftermath of whatever horrific event makes the news, reporters will learn that the perpetrator has had a million and one warning signs and has been reported to authorities in the past as a potential danger to himself or others.

There will be documentation that the family asked for help but found nothing. Experts like me will say: how could they be granted access to weapons? Politicians will shake their heads and say how tragic it is that mental health care in this country is so underfunded and disrespected, and then the budget will not meaningfully increase it.

The average citizen will shrug and say some people are just crazy, because it’s easier to dehumanize a struggling person than to have empathy. And mental health workers like my fiancée will continue to be overworked and underpaid every morning to advocate for their clients.