Consider these scenarios. A popular college student leaves his fraternity house one day, stark naked. He walks three blocks to a stranger’s house, enters, turns on the TV and falls asleep. Moments later, the owner of the house finds him, takes aim with his Glock and kills the young man before he ever wakes up.
Or: an 18-year-old high school basketball star calls 911 to report child abuse because he can’t find any Chinese food in the house. When the police contact his mother, she rushes home to find her son sobbing on the front porch while a confused sergeant stares, watching his tears flow like rain.
Or: a young woman in Nebraska disappears the night before her parents’ thirtieth anniversary celebration—a surprise party she’d spent months planning. Two days later, she is found in Singapore, where she’s been picked up for shoplifting. Though Singapore has some of the harshest criminal penalties in the world, it also has some of the best mental-health care. So, rather than receiving a caning, the young woman is retrieved from a first-class hospital, diagnosed and medicated, her equilibrium restored.
Mental illness in the United States is misunderstood, criminalized, stigmatized and insufficiently covered even by so-called Cadillac insurance plans. If you think you don’t know anyone coping with psychosis or depression, you’re wrong: 58 million Americans (one in five) have some form of mental illness. If most of us don’t realize its prevalence, it’s surely because we’re afraid to talk about it. We’re a nation of fundamentalists about personal agency, and we’re skeptical of mental disorders as “real.” When a friend’s son wrote his family that he just wanted to lie down and die, one faction sent him Bible passages and told him to pray harder, while another sent him a copy of Ayn Rand’s Introduction to Objectivist Epistemology and told him to “take responsibility” for his life.
The insistence that the mentally ill are rational actors informs public policy, too: Jared Lee Loughner, who shot Representative Gabrielle Giffords in Tucson, Arizona, received treatment only so that a court could declare him competent to stand trial. Since 2009, states have slashed more than $1.6 billion from mental-health programs. There are no savings to be gained from such cuts. They simply transfer the costs elsewhere: nearly half of all state and federal prisoners and approximately one-third of the nation’s homeless are mentally ill. Since much mental disease can be treated, this represents a human rights crisis as well as a spectacular waste of human resources.
Indeed, the comments on websites discussing James Holmes’s massacre in Colorado look right past its very bizarreness. “He just wants attention” is a typical remark. Any recognition that Holmes’s acts were terribly sick is accompanied by the assumption that his state must have been immediately obvious to everyone around him, as well as an underestimation of how hard it is to intervene or hospitalize an adult who does not voluntarily seek help.