Guest Commentary: Mental Illness a Disease, Not a Character Flaw


Nuts, crazy, lunatic, maniac, psychopath, wacko – words I frequently hear used to describe people suffering from mental illness. Would we refer so callously to people suffering from cancer, muscular dystrophy or Parkinson’s disease?

Mentally ill individuals have a disease, not a character flaw. Mental illness is not something people choose. It does not discriminate based on age, class or ethnicity. It affects all segments of society. Approximately 10 million Americans struggle with serious mental illness (schizophrenia, bipolar disorder and major depression), but millions are going without treatment as families struggle to find care for their loved ones. As with any other serious illness, people suffering from mental illness need medical treatment. Therein lies the problem.

State laws vary, but all states set strict controls on involuntary hospitalization, limiting it to circumstances when a person is an imminent danger to self or others, or likely to become so. These laws give people with severe mental illness the right to decide when, where, how, or even if they will receive treatment. Today’s laws, although well intended, were mostly written decades ago, in response to an era when doctors and hospitals had broad control over their patients. Mental institutions, as they were called then, became a dumping ground not only for the mentally ill, but for the disabled, the handicapped, and the elderly. Eventually, a public outcry led to laws forbidding the state from forcing treatment or medications on mentally ill people. Once you turn 18, you have a civil right to refuse treatment and remain mentally ill.

Severe mentally ill adults are not capable of making rational decisions regarding their treatment. They can lose touch with reality and lack the ability to recognize they are ill. Families must watch their loved ones descend, sometimes slowly, into Code Red territory, because current laws do not allow them to push help onto a deteriorating person until he or she reaches the crisis stage. Only when an ill person becomes a danger, as determined by a judge at a commitment hearing, can they be involuntarily hospitalized and treated. But by this time, it is sometimes too late.

What about proactive treatment before tragedy? Mass shootings are on the rise. Suicide is the 10th leading cause of death in the U.S., killing more than 42,000 people yearly. Schizophrenia, bipolar disorder, and major depression are among the top contributors to those on disability. Untreated mental illness not only results in suicide and homicide, but substance abuse, crime, and homelessness. Our failure to care for the mentally ill comes at a high cost – not just in economic terms, but also in wasted human potential. Yet with proper diagnosis and treatment, many patients are able to overcome mental illness, contribute to society, and live a normal and happy life.

In November of last year, the Helping Families in Mental Health Crisis Act (HR 2646) legislation introduced by Tim Murphy, a Republican from Pennsylvania and the only clinical psychologist in the House, and Eddie Bernice Johnson, a Democrat from Texas and psychiatric nurse, advanced out of the House Energy and Commerce Health Subcommittee. House Speaker Paul Ryan recently indicated plans to move this mental health reform legislation to the top of the 2016 agenda. The bill currently has the strong bipartisan support of 185 co-sponsors.

The Helping Families in Mental Health Crisis Act would revamp our mental health system and ensure that people suffering from severe mental illness receive the care they need to recover and not be a threat to themselves or society. It would increase the number of inpatient psychiatric beds, authorize court-ordered assisted outpatient treatment for individuals with a long history and pattern of proving a danger to themselves or others, and make adjustments to HIPAA privacy laws by helping patients get treatment for their illness before they reach the violent breaking point.

I lost an adult son to suicide. He suffered from untreated bipolar disorder. Although too late to save my son, HR 2646 would save the lives of others struggling from untreated mental illness by enabling them to receive treatment sooner, making them less likely to reach a violent breaking point. Yes, tragedies might still happen, but many tragedies would be prevented with proper mental health treatment.

Dottie Pacharis

Fort Myers Beach

Author, Mind on the Run – A Bipolar Chronicle and Mental Health Advocate