There’s something to be said for the old Soviet way with mental illness. If what you’re thinking is wrong, then mental illness it is and you go to the hospital for some political therapy. If you take some action (commit a crime against the State) based on your incorrect thinking, you are packed off to jail or sent to a prison camp. It’s a brutally functional approach.
As we begin working through the challenge of redesigning mental illness, we should probably start from a place that is somewhat kinder. If we truly believe we are dealing with a health issue, we ought to bring our ethics around “healing the sick” and “human dignity” with us. And so let’s start with a really basic tentative working definition of mental illness.
Let’s propose that mental illness means some phenomenon that’s not benign, and is something that someone with a rudimentary level of training in counseling or psychology or related fields might be expected to identify or try to make better. This definitely includes all the phenomena that licensed professionals in today’s “behavioral health” field are currently expected to handle, like depression, mood swings, hallucinations, anxiety and the like.
The definition also takes us into some violent territory: school shooters, workplace violence, some domestic violence cases. In other words, cases of “expressive violence” (where someone breaks down under external or internal pressure and lashes out), plus cases where people act under delusions or assumed violent identities (reacting to nonexistent threats or assuming the personality of a violent fictional character, historical figure or celebrity). We expect our mental health system to prevent these sorts of incidents, yet they happen again and again.
In the aftermath of these incidents we see missed opportunities to detect, prevent or defuse these attacks. Someone could have, should have done something.
It seems obvious that our society needs a way to actually prevent mass murder. Because we are redesigning mental illness, we get to specify how that might happen, and who might participate.
How much training should it take to recognize one of these incidents as it scales up?
Shouldn’t everyone know a little bit about this?
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