“Bedlam Revisited”

Jonathan Kellerman writes today on “why the Virginia Tech shooter was not committed” to a mental institution before he went on his murderous rampage. It’s one of the best accounts of the movement to deinstitutionalize mental patients we’ve seen. Students from any era or discipline will recognize the scene rendered in the third quoted paragraph:

When I entered graduate school in 1972, so pervasive was the push to deinstitutionalize that a newly minted course was added to the mandatory curriculum: Community Psychology, a cobbled-together travesty that stood apart from all my other coursework due to its emphasis on polemics and aversion to science.

The basic premise of Community Psych–that severely mentally ill people could be depended on to show up for treatment voluntarily–never made sense to me. The core of the most common and debilitating psychosis, schizophrenia, is degradation of thought and reason. So the idea that people with fractured minds could and would make rational, often complex decisions about self-care seemed preposterous.

One day, I voiced that opinion in class, questioning if any mechanisms were being set in place to prevent a flood of schizophrenics from ending up on the streets, homeless, helpless, victims of crime and, in some cases, victimizers. The Community Psych professor–one of the liberationists–responded with a patronizing smile and a folksy account of the success of a program in rural Belgium or some such place, where humble working folk created a therapeutic milieu by volunteering to house psychotics in their humble homes and everything ended up peachy.

What’s important about this story, and you’ll catch it if you read the entire article, is that deinstitutionalization began as a radical questioning of the status quo for the treatment of severe mental illness; some of that questioning was seemingly quite valid. But that status quo was replaced by a poorly lit conventional wisdom, which has in turn become the status quo, which results in lunatics on the loose, so to speak, most of them harming themselves more than others and living more squalidly than their predecessors did back in the days when commitment was a more ready option.

The principles at work here apply to a lot of matters, particularly those where “revolutions” of one kind or another have occurred over the past forty years, an age of bamboozling and bungling in academia, government and things done in the name of science from which our great society might never recover. The present case of deinstitutionalization of the mentally ill being a synopsis of the dysfuntional “revolutionary” method at work.

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