With Mental Health Wellness Week coming up (November 10th-16th), it seems like a good time to revisit the tragedy in Tucson, Arizona in 2011. For those of you who do not know the details, on January 8th, Jared Lee Loughner shot into a crowd of people killing six and wounding 13 others. The carnage would have been worse but several people, including one man who had already been shot, were able to disarm and subdue him until the authorities arrived. What happened on that day showed both the best and the worst of us. Although the worst always tends to overshadow the best, we should not lose sight of the good that occurred because it tends to inspire us.
The event that brought everyone together was a fine one. Representative Gabrielle Giffords was hosting a “Congress on Your Corner” 
event, a true demonstration of democracy at its finest. In a large country such as ours, it is easy to believe that you don’t matter but an event like this helps people connect to the person who represents their interests and feel like they are heard. For the Representative, it offers an opportunity to remain grounded by ordinary people.
Despite our increasingly ugly political discourse, this event drew people from both sides of the aisle. At least two of the shooting victims – Judge John Roll and Phyllis Schneck – were Republicans but they still wanted to meet and converse with Representative Giffords, a Democrat. This is as it should be. Political leaders need to hear diverse perspectives so they can make the best decisions and people should not feel alienated by their Representative even if they disagree.
The people who were there are shining examples of the best our citizenry has to offer. Among the dead were people who volunteered in their community and others who were employed in public service positions. Once the shooting started, at least two – Judge John Roll and Dorwan Stoddard – protected others from harm with their lives. Several of the wounded also protected others by shielding them with their bodies. The courage demonstrated by “ordinary” people was astounding. The gunman was brought down not by professionals but by a woman and several men who expected to be shot but did what was necessary in spite of their fear.
After the shooting stopped, lots of people stepped forward to help the injured and dying. Daniel Hernandez Jr. saved Representative Giffords’ life while David and Nancy Bowman, a doctor and a nurse who were shopping nearby, immediately set up triage and tended to the victims. The response time of the professionals was also exemplary. The police arrived on the scene four minutes after the first call and the paramedics were one minute behind them.
Finally, there was Christina Taylor Green, a bright and vivacious 9 year old girl who saw hope where others saw tragedy. She wanted to make a difference and had just entered into the world of politics at her elementary school. A caring neighbor decided to take her to meet Ms. Giffords. All reports state that Christina was beaming, filled with joy, as she waited to meet her Representative. How wonderful that here was someone who was not yet jaded by politicians and politics, a girl who believed in the promise of democracy and the value of public service. Given the circumstances of her birth (born on 9/11/01) and the manner of her death, perhaps Christina’s legacy can be that, no matter our circumstance, we all can and should strive to twist tragedy into promise and make the world a little better for our presence in it.
Toward that end, I think we also must deal with the worst that happened on that winter day in Tucson in the hopes that we can prevent similar tragedies. Many people have weighed in on what needs to change to keep this from happening again, common-sense solutions like increased gun control and the elimination of violent rhetoric in our civil discourse. I agree with all of those things but I believe we must address the elephant in the room and that is the true reason behind why Jared Loughner chose to murder.
Mr. Loughner was diagnosed with schizophrenia, a diagnosis that I’m sure surprises few in the mental health community. Even before the official diagnostic pronouncement, it was clear that Mr. Loughner was severely mentally ill. His behavior was just too bizarre and, from all reports, his personality seemed to change in early adulthood, just about the time several major disorders begin. Thus, there were strong indications that something was very wrong with Mr. Loughner yet no help was given. And that is the crux of the problem with the mental health system in our country. We do not have much in place to help people who need it.
If you have a physical ailment, everyone knows what to do: call a doctor or go to the ER. There is no shame in it and there are some options available to you if you cannot afford it. However, if you are experiencing difficulty with your relationships, thoughts, feelings or behaviors, what do you do? If your child seems to be having emotional trouble, where do you turn? This lack of knowledge concerning mental health treatment becomes especially problematic when you consider that many people don’t want other people to know what’s going on with them for fear of being labeled crazy, insane or just plain nuts. Add to that the marginalization of the mental healthcare field and we have a huge mess.
Places for low-cost mental health treatment like counseling centers, community mental health facilities and even psychiatric hospitals and wards are perpetually underfunded and understaffed (and in the age of budget cuts, this will only get worse), mental health diagnoses and procedures are consistently paid at lower rates by insurers, and even other healthcare professionals seem to know very little about and undervalue what mental health professionals do. Perhaps most telling, mental health prevention gets very little attention.
As should now be evident by the actions of Mr. Loughner, the shooters at Virginia Tech and Columbine and a host of other gun-related tragedies both large and small, mental health treatment should not be in place only after people are in pain or cross the line; we need to be there before. We need to be on the front lines preventing things from happening versus just reacting to them. You can go into any drugstore and get screened for high blood pressure or receive a flu shot but where can you get evaluated for anxiety? Children in school routinely have their hearing and vision checked but very few are screened for depression. You can go anywhere from schools to the corner gym to your general practitioner to see physical fitness promoted but where are the places for mental health checkups?
We need to do better. If there were better mental health prevention and treatment options, we could see a lower incidence of everything from the usual disorders associated with mental illness to decreases in divorce, addiction, parenting difficulties and just general unhappiness.
I started this column talking about what went right in Tucson for a reason. The people who were participating in our democracy that day were there demonstrating their care for others. Many of them gave their lives. Our system failed them then but perhaps we can learn from their example and do better. We need to take this opportunity and address the glaring public health issue of mental health prevention and treatment. We need to remember Christina Green and her bright shining face, the very expression of hope. We need to remember her and the others and give their deaths meaning by correcting what went wrong. The first step is to do what they were doing: go participate in democracy. If enough of us raise our voices, they will have to hear.