These are horrific stories. In 2012, Adam Lanza, a 20 year old with long standing issues with anxiety and OCD walked into an elementary school and gunned down 20 first graders and six staff members. At Virginia Tech in 2007, Seung Hui Cho a senior with a severe anxiety disorder shot and killed 32 people and injured 17 others. Again, later in the year, James Eagan Holmes opened fire in a Century movie theater in Aurora, Colorado killing 12 people and injuring 70 others. His attorneys have filed a plea of not guilty by reason of insanity.
As a person who has contended with mental health issues and a long-time advocate for those with psychiatric challenges, I am deeply saddened by these kinds of situations. This is about some of my own people acting in ways that are terribly wrong. At the same time, I do want to point out that this is not a one way street. As a study conducted by Prof. Linda A. Teplin of Northwestern University in 2005 pointed out, those with serious mental illness are much more likely to be the victims of violence than the perpetrators. Yes, some individuals who have mental illness have killed, but likewise members of mainstream society have also outright murdered people with mental illness for equally senseless reasons and at considerably greater rates. Thus, in speaking to the mainstream, I would have say, “You are not so innocent.”
In Connecticut, the first inkling we had of how murderous people in the mainstream could be was in 1998 when Andrew McLain, an 11 year old boy, died from traumatic asphyxia and chest compression four days after being admitted to Elmcrest Hospital. Later that year, The Hartford Courant published an investigative article entitled “Deadly Restraints” which reported that 142 deaths had been confirmed among psychiatric patients from 1988 to 1998 throughout the country; these deaths occurred as a direct consequence of the use of restraints and seclusion. The Courant further speculated that the numbers were probably much higher, more like 50 to 150 per year, but it was not possible to know for certain because of lax reporting requirements.
Most of these deaths occurred not because these patients were out of control, but simply as a result of senseless power struggles between patients and staff. And these kinds of circumstances continue on in the present day. As Pamela Spiro Wagner, a poet, author, painter, and psychiatric survivor with recent experience stated, “both restraints and seclusion are usually used in retribution or as the result of a power struggle which the institution necessarily “wins” when these methods are chosen…but are rarely used as the result of emergency situations.”
In 2006 another Hartford Courant article reported that from mid-1999 up until 2004, 100 patients in psychiatric hospitals died as a consequence of restraints and seclusion. In this article, reporter Dave Altimari quoted Curt Decker, the Executive Director of the National Disability Rights Network as saying it didn’t look as though much seems to have changed. Even now, from information I’ve extrapolated from the Office of Protection of Advocacy here in CT, still nothing appears to have changed much.
I say this with the one caveat that I cannot be absolutely certain since the CT Office of Protection and Advocacy, the CT Department of Public Health and the Centers For Medicare and Medicaid Services have refused to provide me with the concrete data I need. I’d also like to point out, that even if we did obtain the current data that is available, we still cannot be guaranteed its accuracy. While reporting requirements have been tightened, particularly since The Hartford Courant’s investigative report on “Deadly Restraints” there are no consequences to psychiatric facilities that fail to cooperate. Furthermore, from what I can see organizations such as the Centers For Medicare and Medicaid may have the data, yet they have simply chosen to do nothing with it. What is the point of tightened reporting requirements if the information they generate remains collecting dust in filing cabinets?
Nonetheless, I do have the recent testimony of Pamela Spiro Wagner who describes current conditions at the Institute of Living and other local psychiatric hospitals which we can only define as extremely brutal. As Wagner states, “Once you allow staff to use restraints a little, it only takes a little to use them a lot.” Further, on May 31, 2014 Lisa Chedekel of the online CT Health Investigative Team reported that studies indicate that CT hospitals restrain psychiatric patients at “more than double the national rate” and it restrains the elderly at seven times the national average. These statistics are very discouraging.
Another arena where people with mental health issues face death is in encounters with police. According to an article published in Salon in December 2012 by Natasha Lennard, a Maine based study indicated that of the 375 to 500 people shot and killed by police each year, one half are mentally ill. The exact numbers are unclear because even though law enforcement is mandated to report this information to the federal government, police departments simply refuse to do so and thus evade any kind of oversight and accountability for their actions.
Many of these deaths, like that of Andrew Mclain, are tragic in their foolishness. For instance, Lennard reports of an incident where a Houston man, a wheelchair bound double amputee with severe mental illness, was shot and killed when police saw him wave a shiny object which turned out to be a pen. According to the Treatment Advocacy Center people with serious mental illness were four times more likely to die in encounters with the police than members of the general population. Many of these police shootings occur within seconds of the police arriving on the scene.
In the past 13 years, 486 people have been killed in mass shootings. I will grant you that many of these shooters had some form of mental illness. But if you consider during the exact same timeframe how many people with mental illness were killed in restraints and seclusion or else in encounters with police you have numbers anywhere from 2,573 – 3,450. Of course, these numbers do not include the elderly diagnosed with dementia and other persons with mental illness who have died in restraints in nursing homes. They also do not include the numbers of elderly whose lives were cut short by polypharmacy or the excessive use of major tranquilizers, both very common treatment approaches which have been decried by the NIH.
My guess is that if psychiatric facilities and police departments actually reported the data accurately and the data was actually published, the numbers would probably lean much greater towards the higher number. Confirming that assessment, a more recent article in “The Washington Post” dated December 16, 2015 stated that for the year 2015 there were 965 fatal police shootings out of which 243 were of individuals with mental illness. Thus, if you look at the numbers of people killed in mass shootings, versus people with mental illness killed each year by virtue of having a mental illness, you can see that it isn’t just people with mental illness causing the damage. It is so called sane, good citizens who are killing, often for the most frivolous reasons. What is more, they do so without the mitigating factor of a mental illness as some form of explanation for such outrageous behavior. Clearly, these numbers could be reduced and have been reduced with better training such as the Memphis Model for police developed way back in 1988, but it appears to be more convenient to vilify people with mental illness and deny them their constitutional and human rights rather than learn to understand their cultural differences and serve them more effectively.
In response to the more recent mass shootings committed by Adam Lanza, several legislative initiatives around the country, including the Murphy Bill H.R. 2646 which has been proposed in Congress, seek to restrict the civil rights of people with mental illness through universal outpatient commitment laws. Citizens supporting these initiatives should look first towards controlling themselves because the numbers indicate that their actions are far more murderous towards persons with mental illness, not the other way around.