Mental Health Care in America: What My Oldest Brother and Cousin Taught Me

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And the Lord saith unto him, Who hath made man’s mouth? or who maketh the dumb, or deaf, or the seeing, or the blind? have not I the Lord? (Exodus 4:11)

“Mom, why did God make me this way?”

Glenn, my oldest brother by eighteen years, was severely mentally handicapped. Though he was a middle aged man by the time I was a teen, he had a mental age of a five year old. And yet, even on that level, Glenn had a basic knowledge of theodicy: why would a good God make him the way he was?

Why indeed. I remember on different occasions Mom discussing whether Glenn’s disability was caused by a difficult childbirth with forcepts or a fall from a highchair. She usually landed on the highchair hypothesis because Glenn stopped talking for several months after that.

Glenn was the oldest of us five children and that made his disability especially difficult. He had to watch his four siblings grow up and surpass him on every level four times over. That made him angry, depressed and often mean. Many people think of Down’s syndrome when you mention the mentally handicapped. They immediately picture cute, cuddly, passive people with limited abilities.

But Glenn wasn’t cute, cuddly or passive. Instead he made sure everyone knew he wasn’t happy. Glenn filled our home with tension. We never knew what he would do next. He might raid the cupboards while we were gone and go on an eating binge. Or insult my sister and me. Or fight my dad. (Few people know that my dad broke his arm in a fight with Glenn.)

Or set grass fires in vacant lots.

Actually, the fires were a blessing in disguise. Acting on the simple premise that you can’t have citizens burning the neighborhood down, the authorities got involved. They declared Glenn a ward of the state of California and permanently institutionalized him in its mental health system. Mom and Dad took it hard. I overheard Dad tell someone on the phone the day after Glenn was taken from home, “Now I know what that verse means, ‘As a father pities his children, so the Lord pities those who fear him.'” But I have to say, I was relieved. Finally, after sixteen years, we had a semblance of peace in our home.

But it also exposed me to the whole world of public mental health. And as it turns out, Glenn wouldn’t be the only relative to give me a closeup view of our mental health institutions – or lack thereof.

Due to his severe bipolar disease, my cousin Milo had a flair for the spectacular. A resident of Nevada, he took on the cause of fighting legalized prostitution. In a particularly severe manic phase, he decided the best way to get publicity for his cause was to fake his own death. Unfortunately – or, rather, fortunately – he failed to realize that the authorities would probably deduce that dead people don’t use ATM machines.

But Milo’s manic magnum opus was his attempt to liberate Cuba from Fidel Castro. Just a few weeks before 9/11, and just a few miles from the flight school in Florida that some of the 9/11 hijackers used, my cousin took his own flying lessons. On his first solo flight, Milo left Florida’s airspace, flew to Cuba and crash landed on a beach near Havana with the intent of kidnapping Fidel Castro. Fortunately, Cuban authorities realized they had a nutcase on their hands and repatriated Milo back to the US, where he was arrested and tried for grand theft of a plane. (You can read the story here.)

Milo got probation. But soon he went off his medication again and broke his probation, with the result that he was sent, not to a mental ward, but to prison where he languished for many years.

So here is what I learned from my brother and my cousin’s experience with public mental health: First of all, there is one person in particular who is to blame for the current state of mental health care in America. And secondly, as America becomes more and more post Christian, it treats those with severe mental illness worse, not better.

At first Glenn’s facility and treatment were amazing. Pomona State Hospital, dedicated to treating the mentally insane, where Glenn was first sent, resembled a resort. Patients were housed in small single story dorms dispersed among acres and acres of manicured lawns and connected with rambling roads. It was beautiful. When I first saw it, I wanted to stay there.

But soon Glenn became a victim, one of tens of thousands, of a politician by the name of Governor Ronald Reagan, who began a policy called “deinstitutionalisation.” It completely transformed the way the mentally ill were cared for – or not cared for – first in California and then, when Reagan became president, across the U.S. (I want to pause here for a moment and say that I actually voted for Reagan on more than one occasion. I’m conservative in my politics. But on this one issue I believe he was sorely misled.)

Several articles have been written about the impact Governor, and then President, Reagan had on mental health in America (The New York Times, Solon, ), but I’m going to quote at length from an article published on povertyinsights.org by John Roberts entitled, “Did Reagan’s Crazy Mental Health Policies Cause Today’s Homelessness?“

But when I see people like this [the mentally ill who are also homeless], my first thought is always the same: Why isn’t this man institutionalized? He certainly is not living a dignified life out here on the streets.

When I ask my mental health colleagues about this, the one political figure that typically comes up is former President Ronald Reagan. Its like an urban legend in our field. People say the reason so many people with mental illness are homeless or in jail (one-third of all homeless individuals and half of all people behind bars) is because of President Reagan.

Really? What did he do? Let all of the mentally ill patients loose?

Well, yes, that’s exactly what they say he did.

Over 30 years ago, when Reagan was elected President in 1980, he discarded a law proposed by his predecessor that would have continued funding federal community mental health centers. This basically eliminated services for people struggling with mental illness.

He made similar decisions while he was the governor of California, releasing more than half of the states mental hospital patients and passing a law that abolished involuntary hospitalization of people struggling with mental illness. This started a national trend of de-institutionalization.

In other words, if you are struggling with mental illness, we can only help you if you ask for it.

But, wait. Isn’t one of the characteristics of severe mental illness not having an accurate sense of reality? Doesn’t that mean a person may not even realize he or she is mentally ill?

There certainly seems to be a correlation between the de-institutionalization of mental health patients in the 1970s and early 1980s and the significant number of homelessness agencies created in the mid-to-late 1980s. PATH itself was founded in 1984 in response to the significant increase in homelessness in Los Angeles.

And that is exactly what happened to my brother Glenn. He was “de-institutionalized.” Glenn was transferred from Pacific State Hospital to a residential home where he was jammed in with about a dozen other residents. Eventually, he, too became homeless. I had to travel from Texas to Los Angeles and ride the RTD for a week holding a large picture of my brother to see if anyone recognized him. Eventually the police found him sleeping in the back of a bus in South Pasadena.

That was Glenn’s experience. But my cousin Milo’s was much worse. Since de-institutionalization had already taken place when Milo was tried and convicted, the only recourse for him was prison. Milo received no treatment at all for his mental health issues during the many years he was incarcerated. When he was finally released, he was traumatized beyond recognition.

The sad part about all this is the lack of public outcry over the way the mentally ill are being ignored in our society. We see them all around us. One third of all homeless people are severely mentally ill. They need to be cared for properly. It’s time for Christians to rise up and tell our politicians something has to be one. The problem with a democratic society is that the mentally ill usually don’t or can’t vote. So they have no voice. So we Christians need to speak for them.

Will you be that voice?

This post first appeared in NewCommandment.org.

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