Congress, schizophrenia and Obama’s proposals

{mosads}This problem is not new. Richard Lawrence, suffering from schizophrenia, was the first person to try and assassinate an American president when he shot at President Andrew Jackson in 1835. Charles Guiteru had syphilis of the brain when he assassinated President James Garfield in 1881. There have always been occasional homicides and other tragedies, many involving public figures, associated with untreated severe mental illness.

What is new is that such tragedies are happening much more often. Beginning in the 1950s, we began emptying state mental hospitals without providing for treatment of the mentally ill individuals who once benefited from them. The consequences were illustrated in 2000 by the New York Times analysis of 100 “rampage killings” that took place between 1949 and 1999. In the 30 years between 1949 and 1979, there were only 10 such mass killings, but in the 20 years between 1980 and 1999, there were 90 of them. Among the killers, “more than half had histories of severe mental health problems.” The New York Times list included Russell Weston’s 1998 attack on the Capitol Building in which he killed two Capitol policemen; he had untreated schizophrenia and was seeking a “ruby satellite” with which to reverse time. However, the list did not include other tragedies such as the 1980 killing of former Congressman Allard Lowenstein by Dennis Sweeney, suffering from untreated schizophrenia, or the 1981 attempted assassination of President Ronald Reagan by John Hinckley, also afflicted with untreated schizophrenia. In addition to the New York Times analysis, two other studies have reported that such mental illness-related homicides are increasing.

Given this situation, the response of the Obama administration to the mental illness aspects of these tragedies has been disappointing. The Biden Task Force, convened to make recommendations, logically called upon the Substance Abuse and Mental Health Services Administration (SAMHSA), the lead federal agency whose responsibility is to reduce “the impact of substance abuse and mental illness on America’s communities.” However, SAMHSA has no expertise in, or even interest in, the consequences of untreated severe mental illnesses. Among SAMHSA’s 574 employees, there is only one psychiatrist, and his expertise is in the treatment of drug addiction. SAMHSA’s 41,804-word planning document, “Leading Change: A Plan for SAMHSA’s Roles and Actions 2011-2014,” does not even mention schizophrenia, bipolar disorder or major depression. When SAMHSA was asked to provide testimony for the Biden Task Force, they brought in one of their grantees, Dr. Daniel Fisher, who has stated that schizophrenia is not a disease of the brain but merely “severe emotional distress” and “a life changing experience which is very enriching.” Such views are far outside of scientific psychiatric thinking.

Thus SAMHSA had nothing useful to contribute to the Obama administration’s proposals for dealing with the epidemic of mental illness-related tragedies. At this point in time, nothing has changed and we should expect such tragedies to continue. If change is to come, it will have to come from Congress itself. A useful start in this direction was the March 5, 2013, forum on violence and severe mental illness sponsored by the Oversight and Investigations Subcommittee, Energy and Commerce Committee. Representative Tim Murphy deserves credit for setting this up; it was a good step in the right direction.



Dr. Torrey is executive director of the Stanley Medical Research Institute and Mondics is communications director for the Treatment Advocacy Center.