How do we deal? -- Gazette.Net


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Montgomery County State’s Attorney John J. McCarthy asks a serious question. Unfortunately, county leaders and residents have chosen to take it rhetorically.

The question is: “How do we deal with people who have persistent mental health issues and intersect with the criminal justice system?”

As a county — and as a state, and as a nation, really — we have no good answer for him.

Last week, in “On the edge,” reporter St. John Barned-Smith described how in two weeks in January, the county was rocked by three heinous homicides. All allegedly were committed by people who either had mental health issues in the past or likely were suffering from mental illness at the time of the killings.

A mother and her friend stab four children, killing two, in what they believed was an exorcism. A man walks into a 7-Eleven and kills a clerk, slashing and stabbing him 75 times. A young man is shot (by his father) as he fatally stabs his mother.

How do we deal with people like this? Currently, it seems, we wait for them to commit a crime and put them in jail.

People can be involuntarily committed to an institution only if they are dangerous to themselves or others, said Dr. Alan Newman, a psychiatrist with Georgetown University.

As Newman pointed out, the definition of dangerous is narrow, which means many people can’t be forced to get the care they need. Likewise, many people would have not committed offenses had they gotten that care.

“We shouldn’t be waiting until someone breaks the law to get treatment,” said Dr. Raymond Crowel, the county’s chief of behavioral health and crisis services. “There’s a conflict in the way the system is structured.”

It’s taking a toll on our jail. Barned-Smith cited statistics showing that falling crime rates mean fewer people in our jail, yet a growing percentage arrive with mental health issues.

A natural reaction is to turn to the Maryland General Assembly. Lawmakers have at least four measures to consider that could help the ill get help they need.

One bill would make it easier for health care workers to commit individuals involuntarily. Another would let courts order treatment for individuals with disabling mental illness who struggle to adhere to their voluntary treatment.

A third would allow the forced administration of medication under certain conditions. A fourth would ensure that offenders with a history of mental illness and substance abuse get services before and after their release from incarceration.

Although the Montgomery crimes in January create a new urgency, these issues aren’t new to the lawmakers. Legislative committees considered the fourth bill last year, but took no action, according to the General Assembly website.

These aren’t easy decisions for Annapolis. As much as a store clerk should have the right to complete a day’s work unharmed, the mentally ill have rights as well. These measures must be crafted carefully.

It’s important to insist the legislature protect us all, but we must resist human nature.

It’s easy for us to turn to the State House, insist our leaders take action and applaud when laws are enacted. When the applause dies down, we forget that the problems exist and direct our attention elsewhere.

No matter what legislation passes, we’re left with McCarthy’s question. How do we deal with people like this?

What’s necessary is a realization that we need to treat mental illness with the same vigor that we treat physical illness. Federal, state and local governments must allocate resources to care for the mentally ill. Nonprofits must, and do, devote time and energy. Churches must, and do, as well. And finally, families must, and do.

Somehow, it isn’t enough.

Sometime over the past 30 years, we’ve decided it’s acceptable for care for the mentally ill to be optional. If money’s tight, programs close, initiatives are shut down, centers are shuttered. The result is a young man who suffers from bipolar disorder living on the street or a young woman without the support to cope with her delusions.

We need our statehouse and county seat to do better. We need our hometowns and our churches to do better. We need to do better.

Money and concern will only go so far. It’s time for a sense of urgency.