We're All In This Together

Any thoughts I might have entertained on the subject were called into question on January 11, 2008.  Not that I ever gave it much thought.  It had touched my family, but we'd managed to ignore it. I worked along the edges, but never did more than dip a toe in the water. It was an issue for the other.  It wasn't my concern.... right up until the point when it was completely my concern.

A mentally ill young man killed my little friend; I confront the aftermath every day of my life.  Bullets shattered a sunny, Saturday morning, along with my hip and my sense of safety and security. Who is that young man over there, muttering to himself?  Why is that woman staring blankly at the sky?  I see danger around every corner.... might they be mad?

And if they are?  Do I walk past without saying anything?  Do I mutter and turn my head?  Do I complain to the woman behind me in line?  I watch that happen, and I wonder if, perhaps, there isn't a better way.  

My first cousin was adopted at birth.  Fifty-some years ago, regulations and background checks and information on family of origin were provided grudgingly, at best.  My cousin was a cute baby who became a schizophrenic young man.  He stole the centerpieces at my wedding, hiding them in the bushes nest door.  He was loud.  He was unpredictable.  His parents were flummoxed.  

There was therapy and there were half-way houses and there was tough love.  My mother and her brother weren't close. We got together on holidays, but they never spent much energy keeping in touch.  My cousin was damaged goods; it was easier to avoid them entirely.  You had to be on your guard when you were around him; keeping Daddooooo's behavior in check was enough for my mother.  She didn't need to worry about another human being who might fly off the handle.  

After all, what would she do?  What could she do?  Therapists and medication and structured work experiences had been tried, to no avail.  Her brother joined NAMI and worked on legislative solutions. Community-based treatment, the second half of the 1970's de-institutionalization movement, was without funding or local support.  No one wanted a house full of mad men in the neighborhood.  No mall wanted a walk-in counseling center in the space next to the Nike outlet.  Insurance didn't recognize the issue as one requiring consistent, long-term management, and, as he aged, my cousin's insurance coverage went from private to public assistance.  The lines for care in that segment were stretching out the door. 

Still, my cousin, like my shooter, roamed the streets.  His friends, like the shooter's friends, gradually disappeared.  It's exhausting to try to fix crazy... and even more so when the patient refuses to accept reality. It was easier to ignore it all.

For my mom, that was easy.  We lived our lives in separate towns.  We didn't have to be confronted with bizarre behavior. As we got older, my cousin stopped arriving with his family for events.  No one ever asked where he was.

No one ever asked.  

How lonely that must have been for my aunt and uncle.  How isolating to have a part of your family dismissed like unwanted mail. How frightening to feel that the burden rested solely on their shoulders, knowing that the help they needed was no where to be found.  

They tried. They found a program that worked.  He stopped disturbing their sleep with loud, uncompromising demands made from the front porch in the middle of the night. His younger sister learned to cope with him, as her parents aged and she became the responsible adult. She has her own son, and she has her brother, too.  He doesn't know how lucky he is.  She cares.  She asks. She stays involved.

I understand my mom's reluctance to deal with the issue.  It was what she learned from her own parents - if it's not good news, stay away.  Immigrants, they had developed a framework to protect themselves from a strange, new world.  My cousin's madness, my shooter's madness, their strange worlds are so easily avoided... until they intersect with you on a sunny, Saturday morning.

Can't we do better than this?  The mentally ill are here among us, trying to make their way in a world which is as odd to them as they are to us. Medication, counseling, organization and community can combine to integrate those with needs into the mainstream. This is true.  I read the research in school  

But, it's not cheap. It's not easy.  It's not comfortable.  It forces us to come face to face with questions most of us would like to ignore. What does it mean to be okay? How much deviation from the mean can a society accept?  How much help can an adult be required to obtain? Where will that help be delivered, by whom, at what cost?  

While we mull those issues, the mentally ill are walking among us.  Youngsters, like my cousin and my shooter, ought to be able to rely on the grown-ups in their midst for assistance.  When the adults are committed, as were my aunt and uncle, a real life can be cobbled together from the fragments mental illness has left behind.  My cousin is living in a sheltered space, working at a meaningful-to-him job, contributing and participating in society.  My shooter, whose parents ignored the warning signs, the requests from teachers and administrators and their child's friends, who paid no attention to behaviors that were just not right, is living in the US Medical Center for Federal Prisoners in Springfield, Missouri.

According to Pam Simon, who knew him in middle school before he shot her at the Safeway, our gunman was a quiet, well-behaved, gentle young man. I want to believe that our tragedy could have been prevented if someone, if anyone, had done more than complain.  If someone - his parents, a neighbor, a family friend - if anyone, had intervened, my life would be very different right now.

We are all in this together.  It is past the time to stand on the sidelines and watch the situation worsen. Funding is tight, time is precious, resources are scarce - that's all true and I don't care.  Our fellow humans are suffering, some silently, in the shadows, and some violently in parking lots.  It is in all of our best interests to recognize that we all have am interest in the solution.