On The Need For Mental Health Reform

So, back in 2008, a guy named Vince Li got on a Greyhound bus and, seemingly out of nowhere, started stabbing the young man sleeping next to him, 22-year-old Tim McLean.  Li would go on to sever his victim’s head, show it to the horrified passengers who were huddled on the side of the highway, and then not only remove other parts of McLean’s body, but eat them, as well.

In court, Li was found not criminially responsible for the crime, and sent to a high security psychiatric ward.

Less than 8 years later, he has legally changed his name and is preparing to live on his own again.

I have to say, I am really struggling with this whole thing. On the one hand, I understand that mental illness is a legitimate reason to not be held responsible for committing a crime. On the other hand, this man took the life of another, and while he may be feeling better now, the other passengers, the bus driver, the trucker who stopped to help, the police on the scene (one of whom has since taken his own life) and most of all, the friends and family of Tim McLean, will carry this horror and loss with them for the rest of their lives. I’m just not sure how I feel about someone causing – deliberately or not – so much pain and suffering to others, being able to just move on and live out the rest of his life.

I think this whole scenario serves to highlight the many issues and problems with the way mental health is handled, both in this country and possibly around the world. I think, even though great strides have been made, at its heart, we still don’t really know what to do, what to think, or how to feel. We can couch our thoughts into PC wording, or spread clever memes and hashtags on social media, but I am not sure anyone actually has any real understanding of how best to deal with mental health issues. I’m not sure it’s even possible to really understand, not for those suffering, and not for anyone who is not.

It’s not that people aren’t trying hard enough. I think it’s just such a vast and complex issue overall, and the fact that mental health is completely intangible, and invisible – we can’t touch or see the problem itself, only the external effects of it – that all makes it even more impossible to truly get a grasp on. In addition, actual focus on mental health – in terms of the wider public, at least – has really only come about in recent years, comparatively speaking. We hear horror stories of drilling holes in skulls to release the demons within whenever someone had a headache (along with pretty much anything that happened in asylums around the turn of the 20th century or so), we shake our heads in dismay at tales of electroshock therapy and the mishandling of postpartum depression. Even the effects of addiction and withdrawl haven’t been fully investigated and treated as of yet. There’s still so much more we don’t know or understand than we can claim to have a handle on, and that’s kind of terrifying, if you think about it.

We have procedures and punishments for those who break the law outright, deliberately and knowingly. Those have changed a lot over the years, too, as we learn more about incarceration and rehabilitation. We aren’t sure what to do with the criminally insane – those who seemingly can’t be rehabilitated and released back into the wild (aka civilization), so we keep them locked up indefinitely, for the safety of themselves and others.

But we have a very vague line drawn where accountability and responsibility is concerned, and that is part of the problem. We agree that some people shouldn’t be punished for crimes that they can not be found criminally responsible for. But…what can be done, instead? Can justice still be served if the offender can’t ever be held accountable for his or her actions?

Li claimed he’d been hearing the voice of God for a good 4 years before “God” told him to kill Tim McLean. There’s zero point in trying to find the logic in it. Like, God also said “Thou shalt not kill” – there was no caveat in that statement. And did God also tell Li to eat parts of the guy he’d been instructed to kill? To defile the body and cut pieces from it to put in his pockets? To show the head of his victim to the other passengers on the bus once he’d removed it? Did God create the aliens that he wanted Li to save the rest of us from?

Did God tell him to carry a big-ass knife around with him, just in case?

We’ll never know any of that, because we weren’t inside Vince Li’s head, and if we were, everything would make sense to us, because that’s how mental illness works. You see one thing; the rest of the world sees something else entirely. Everything you see is real, whether it’s actually there, or not.

In that way, reality is subjective.

So, basically, to Vince Li’s mind, he did nothing wrong. He was a hero, in fact, saving us from aliens, or whatever.

At the time.

But what about now? What does he think and feel abuot what he’s done now that he’s medicated and doesn’t hear voices anymore? His condition is currently not curable, so he must remain medicated for the remainder of his life. And there’s nothing to say that his treatment won’t need to be adjusted in the future to remain effective, so hopefully he’ll be closely monitored for the rest of his life, too, since he won’t be able to determine on his own if his reality is slipping again.

And that’s the thing, really, because who can tell? In the days and weeks leading up to the murder, no one noticed anything wrong or different about him. He’d been hearing God’s voice for 4 years, and apparently no one could tell anything was amiss. So how do we, as a society, know that we’ll still be safe even when he’s back out in the world, living on his own?

We don’t.

Maybe it’ll be fine, and he’ll never do anything like that again. But guaranteed there’s more people out there listening to the voice of God speaking to them and only them, every day. And no one around them can tell. There will always be more people slipping, and breaking from reality. There will always be crimes committed for which the perpetrators are not criminally responsible.

I realize that we can’t just lock everyone up and throw away the key, or hospitalize them until they die. I understand that, in this case as in many others, Li is and will continue to be closely monitored, even when he’s on his own.

But I think we need to find a better way. Some way to not only research and find new methods of treatment, but to also see that a better sense of justice is served. What Li did may never seem real to him, but it’ll never be anything but real to those who suffered as a result of his actions. There needs to be some form of punishment, some price to pay. Some attempt at atonement for crimes committed.

And not just in this case, nor just in cases where there is an added criminal element. We need to do better for mental health issues overall. Even something that seems simple from the outside – depression = sad, so therefore sunshine, laughter and hugs are the cure – is more complex to the person living with it, and to those around them who are affected by it. Hugs can sometimes be the cure for sad, but being sad isn’t the same as being depressed. Being sad is a mood. Being depressed is a condition. Hugs won’t cure depression any more than they cure a broken arm or a ruptured spleen. And that’s how we have to start thinking about mental illness in general. We need to treat it the same way we treat physical illnesses – as something that’s actually not all in our heads.

Even though it technically is in our heads, but not in a way that can be brushed off as irrelevant or easily remedied. It’s not something that can be quantified nor understood, even by the sufferer.

It’s a physical ailment of the mind.

As for when there is a criminal element involved…I just don’t know. There needs to be something in between institutionalization and rehabilitation/release. At least for the length of time a mentally competent person who’d committed a similar crime would receive in a court of law. Something that would allow for closer monitoring of the individual, as well as further research into the disease, the hopefully both understand and treat it better. Like a halfway house, but with stricter controls, medical and therapeutic monitors and less tangible access to the outside world. We don’t allow murderers out on unaccompanied day trips and the like while they are serving their sentence; the same should really hold true for those who kill while suffering a break from reality. The act is the same, the accountability is different, the punishment should be somewhere in between.

I think that might make it easier to determine what punishments would best suit others, too, like those who commit crimes of passion, or while under the influence of drugs and/or alcohol. Addiction is itself a mental illness, and while someone may commit a crime while they weren’t entirely in control of themselves as a result, there is still a price to be paid.

They always say the punishment should fit the crime. I think the real problem is that we’re slowly realizing that the issue is not nearly that clear-cut; not so black and white. It’s a series of complex layers that we’re only beginning to dig into.

So maybe the way we deal with it should have several layers to it, as well.

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1 thought on “On The Need For Mental Health Reform”

  1. I agree with you. He may be feeling better but he should just not be left to start a new life anonymously in a community that has no idea. I don’t know that he can be trusted to continue taking his medications. He needs to be locked up in a mental health facility and to be watched very closely. There has to be a middle ground.

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