Privacy vs. Public Safety in the Mental Health Debate

Posted on July 12, 2010

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Well, it has happened again. Someone in a questionable mental and emotional state has committed a violent crime. Four people are dead, and this isn’t the first time the suspect has killed someone. While serving a 15 year sentence for manslaughter, Michael Ballard did receive anger management counseling, but he failed to continue the treatment after his release. So, now we are faced with the following questions. Was anger management all this man really needed, or should he have had more in-depth psychiatric care? Why, if he failed to keep up with the prescribed minimum treatment, was he even released from prison in the first place?

Several years ago, a student at Virginia Tech went on a shooting spree. He had already been identified as having mental and emotional problems that included extremely violent fantasies. Prior to the shooting, he had been admitted for observation and released from a local hospital without receiving any treatment. Despite his obvious mental illness, he walked freely about the campus and the surrounding community.

There are no easy answers here. The biggest hurdle is how do you balance the right to privacy with the need for public safety? The other major concern is cost. Mental illness can be a lifelong condition that requires expensive medication and on-going therapy. For many families and individuals, the cost becomes overwhelming. The fact that we continue to close state-run mental health facilities doesn’t help either. Furthermore, as we are closing these facilities we seem to be expanding and opening more prisons. Pennsylvania at one time had 22 State Hospitals and now has just 6. Coincidentally, the state has also gone from having 6 prisons to 27.

Unfortunately, when someone with a mental illness isn’t getting treatment they often can’t function on their own and end up homeless or committing a crime. Most of these crimes are non-violent. And I do understand that most people with a mental illness are not violent. I also understand that many people who commit a violent act do not have any sort of mental illness at all.

My question is, how do you know when to be concerned? Having been smeared by a local blogger whose mental and emotional stability has been questioned by our State Courts, I have a personal stake in this conversation. A strange man I’ve never met has created an imaginary person to which he has attached my face and my name for no other reason (that I can figure out) than he needs someone to be mad at. Maybe posting garbage on the internet is enough for this guy, but what happens when it isn’t?

There is an obvious need to reevaluate how we diagnose and treat mental illness as part of our health care system. It is time to drop the stigma and understand that the human brain, just like any other organ in the body, needs care. From this perspective, we can also address public safety issues. It is important that we learn to determine when someone is a threat to themselves or others, and when some type of intervention is necessary. The sooner we discuss these issues openly and honestly, the sooner we can develop solutions that provide psychiatric services to those in need and keep the public safe.

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