-----------From Democracy Now-----------

Jared Loughner, Mental Illness and How Budget Cuts

Have Slashed Behavioral Health Services in Arizona

January 11, 2011

AMY GOODMAN: While federal investigators and the news media try to uncover the motivation behind the attack, the picture emerging of Jared Loughner is of a severely disturbed 22-year-old who was behaving in an increasingly erratic manner. YouTube videos and other internet postings under his name suggest an obsession with bizarre anti-government grievances, including ramblings about currency policies and language control through grammar. Acquaintances in Arizona said Loughner had distanced himself from friends and family members in recent years.

In September, he was suspended from Pima County Community College after five run-ins with campus police for disruptive behavior, being thrown out of class, students saying they were afraid, professors saying that they were afraid of him. College administrators told him he needed clearance from a mental health professional saying he would not present a danger to himself or others before he could return to classes. Pima County behavioral health officials have no record of Loughner seeking treatment in the public system overseen by the Arizona State Department of Health Services.

Saturday’s attack and Jared Loughner’s apparent mental health problems have shone a spotlight on issues surrounding mental health treatment in Arizona. The state made drastic budget cuts to behavioral health services in 2010. The unprecedented cuts slashed all support services for non-Medicaid behavioral health patients and took away coverage for most name-brand drugs. As many as 28,000 state residents were affected. Meanwhile, Arizona is facing even bigger budget cuts this year and is facing an estimated $1.4 billion deficit in 2012.

H. Clarke Romans is the executive director of the National Alliance on Mental Illness of Southern Arizona. He’s joining us from Tucson.

Welcome to Democracy Now! Talk about your response to what has taken place.

H. CLARKE ROMANS: Well, our response so far has just been to point out that the availability of services has diminished due to these budget cuts, and although there’s no direct link, it just makes it less likely that people would be able to get services, even if they overcome the stigma of admitting or acknowledging that they have these illnesses. It just makes the availability of services even more difficult to obtain.

AMY GOODMAN: What do you think needs to happen now, H. Clarke Romans?

H. CLARKE ROMANS: Well, I think that the legislature has taken a simplistic approach to solving the budget crisis, with respect to mental health services, at least. What we’re finding in the community is that the costs were not really eliminated; they were just pushed down to less visible areas in the community, and we’re responding to the difficulties with the most expensive form of services that the community has to offer to people. That’s emergency rooms, hospitalization, law enforcement intervention. So, the communities are spending the money, even though it appears that the lawmakers believe that they have actually cut the budget and saved money. It’s just coming out of a different pocket down at the community level. And I think that we need to acknowledge that it ultimately is less expensive in the community to offer necessary services. And this is all without respect to the devastating impact this has had on people’s lives.

AMY GOODMAN: What had been the effect of the budget cuts, specifically?

H. CLARKE ROMANS: Well, I can give a number of examples, but in particular, people who have a serious mental illness diagnosis beginning last July were denied any further coverage in a number of areas—case management, brand-name medications, access to support groups, transportation subsidies, and more recently, housing subsidies. So these individuals who have the most serious forms of mental illness were essentially, except for generic medications, were basically pushed out of the system. And these are individuals who have a serious illness, who, in many cases, were managing with a support network, are now being pushed to the point where they can’t manage. So they’re decompensating. There’s suicide attempts. There’s one woman that we know that’s very ill, but she’s been managing OK. She’s now been hospitalized for 36 days over the last six months.

AMY GOODMAN: These budget cuts under Jan Brewer—she, in particular, the Governor, must understand, with her son Ronald in a state mental facility for, what, 20 years after being convicted of sexually assaulting a woman, but was by reason of insanity, was the ultimate verdict. So she knows and was a mental health activist herself, the Governor.

H. CLARKE ROMANS: Yes, she was. And frankly, to my surprise and many other of my colleagues, I don’t think she put up a strong enough battle to, you know, at least protect or minimize the effect on mental health services. I think she succumbed to the—kind of the ideologues who were pushing a different agenda. And she did make some statements that she wanted to protect mental health services, but ultimately I think she succumbed to the other political pressures.

AMY GOODMAN: What about your own story, H. Clarke Romans, how you got involved with the Alliance on Mental Illness?

H. CLARKE ROMANS: Well, I’m a member of a club that no one wants to belong to. And people become members when things happen to them like happened to my family. My son Kenneth was a smart, athletic, good-looking, popular young man, when his behavior became a little unusual. And we didn’t know what was going on. And eventually—we were living in Belgium at the time—a school counselor at the International School of Brussels called us up and said, "Gee, I think maybe Ken should be out of school for a while." And we were like, "What?" So we went to the school. Ultimately we took Ken to the doctor, a psychiatrist. And the doctor told us Kenneth is suffering from the symptoms of schizophrenia.

Well, I’m a highly educated, intelligent man. I couldn’t spell "schizophrenia," let alone have any idea what a devastating effect that was going to have on Kenneth, on the family, and for the rest of his life. And so, even though my son was killed by a drunk driver here in Tucson on September 11th, 2001, I’m still involved, because I think the indignities that Kenneth suffered in his life were not right, and I don’t want to see that happen to other people.

AMY GOODMAN: What about schools reporting? I mean, the teacher who alerted you, that’s very important. But here was Jared Loughner in college. Every classroom, it seemed, the kids, the students, the professors were concerned. They were scared. He was very disruptive. What does it mean for a school to get involved? And why don’t they? I mean, in this case, Pima County Community College says they did. They kicked him out.

H. CLARKE ROMANS: Well, I think there are two levels here, and the rules of the game are very different. When students are in high school and they’re minors, the school and the parents have a little more control. I mean, a few articles that I’ve read so far in the local paper indicate that some of these behaviors were already manifesting themselves in the—in high school. I mean, I read some of his high school classmates reported, you know, unusual behavior.

The difficulty for secondary schools is that if the teachers bring things to the attention of the parents and the parents take it to heart, that the school becomes financially responsible for a lot of assistance that the student might get. And due to budget cuts, a lot of principals and teachers, more or less, are instructed: don’t get involved, because if you do, the school is going to be financially responsible. And the schools are under tremendous financial pressure. So I think that’s a negative influence on the teachers. Even though school counselors and teachers deal with these students every day, they’re under kind of physical constraints.

When you get to college, it’s a different story, because, you know, by that time, generally the students are considered adults. The parents really don’t have any specific legal authority to force the person to do any particular thing. And only if a person is petitioned into the hospital due to their persistent behavior, there’s no way to force them to get treatment. They can be persuaded, and the college and the parents, I believe, have a role, a potential role, in persuading an individual to get help. I don’t know if the college did anything other than react to the negative behavior.

AMY GOODMAN: Finally, Pima County Sheriff Dupnik, he made the comment about the hate-filled language coming out of TV, radio, the talk shows. You have Jesse Kelly, the opponent of Congressmember Giffords, who put out a slogan that said something about targeting, taking on Giffords and bringing your M16 to a rally for Kelly. H. Clarke Romans, what this kind of explosive language does?

H. CLARKE ROMANS: Well, I think that it doesn’t help, particularly people who may have thought disorders or mood disorders, the part of their brain that would exercise caution—I mean, anybody that hears that kind of language may react to it. But people who are suffering from these mental process disorders don’t necessarily have the part of their brain that would set the boundaries. The cautionary or the commonsense parts of their thinking are not functioning properly. So, this kind of language has a much greater impact on individuals who are in that situation than on the average person who has, you know, the control of their thought processes and has in place the normal cautionary and restraining parts of the thought process. Many of these individuals, that part of their brain is not functioning properly, with bipolar disorder or schizophrenia. There’s all kinds of thoughts going on, and the normal constraints and rational thinking processes aren’t there. So when you pour gasoline onto a hot situation, the likelihood of a fire is a lot greater than if—you know, if things are not so, you know, combustible.

AMY GOODMAN: Just to be exact, what her opponent, the Tea Party-backed opponent of Congressmember Giffords—and let’s remember that Congressmember Giffords’ father said—walked into the hospital and said that the Tea Party was her enemy, that he blamed the Tea Party. But Tea Party-backed candidate, Jesse Kelly, said, "Get on Target for Victory in November. Help remove Gabrielle Giffords from office. Shoot a fully automatic M16 with Jesse Kelly."

H. Clarke Romans, I want to thank you for being with us, executive director of the National Alliance on Mental Illness of Southern Arizona.

The assassination attempt on AZ Representative Gabrielle Giffords in Tucson this weekend - and the related murders of 6 bystanders, including a child - was deeply disturbing. The young man who appears responsible is seriously mentally ill. I wouldn't be surprised if he's diagnosed with manic depression, the label I carry with me when I chalk.

During a press conference today, one of the responding law enforcement officers suggested that "the problem" is that we don't have the mechanism we had in the 1960's "to incarcerate them", leaving homicidal manics to wander the streets, buy guns, and take out elected officials.

Sadly, however, in Arizona about all we do with the seriously mentally ill is incarcerate them - most for petty stuff. For every one person we put in the hospital in this state for the symptoms of their illness, in fact, we put ten behind bars. Arizona has been fighting court orders to improve community-based treatment for citizens with psychiatric disabilities for over two decades, investing far more in our resistance than we would need to in the solutions. Lives have been damaged and irretrievably lost in the process.

Is this tragedy one which might have been prevented by better treatment, hospital, and residential outpatient options for people with serious mental illnesses? I don't know. Could it have been prevented by more criminalization, longer sentences, fewer options for health and recovery? Highly doubtful. At what point would the system have identified, stopped, and treated Representative Gifford's shooter, and what would that treatment have looked like if such had been possible?

At the least, though, the rest of us could have made it harder for him to buy a gun and less likely that he might see himself as a hero for using it.

I tend to believe there's more we could have done, too. If we didn't collectively alienate and demonize people with mental illness so readily, then maybe it wouldn't be so hard to recognize when one needs help and seek it. If we didn't brutalize them in custody so often, then maybe they wouldn't be so paranoid about people with badges, uniforms, and guns - people with state power - trying to hurt them.

Think about it: suicide is 100% preventable. Homicide really should be as well. We've studied this stuff pretty extensively. So why are political solutions to crime still designed to just appeal to fear rather than actually reduce violence? It's not as if we lack the research or evidence-based practice recommendations. We appear to simply lack meaningful state leadership with both the knowledge and courage necessary to push through both public mental health care improvements and compassionate sentencing reform this year. They're still looking at how to gut the schools and community services while packing the prisons as cheaply as possible.

I'd hope that this devastating assault on Gabrielle Giffords would wake up Arizona's state legislators to what we need to be doing here to prevent the next such tragedy, not how to punish all potential such evil-doers actively exercising our first amendment rights without threatening a soul.

Now that they feel they're the main targets of the violence so many people face on a daily basis, it's possible that things will get much worse for us before they get better, however. We could face draconian - even criminal - sanctions for not agreeing with our doctor's medication recommendations. We could find our psychiatric diagnoses and treatment non-compliance become an aggravating factor, not a mitigating one, adding years of isolation and harsh punishment to our possible sentences - be they served under lock and key in state hospitals or state prisons.

They tried to pass such legislation recently as it is (sorry - can't find the link now).

We'll see. In the meantime, anticipating that they'll need to find some scapegoats to further advance their fascist agenda with this incident, watch each other's backs out there.