In the fall of 1972, a young investigative reporter named Geraldo Rivera found a way to sneak cameras and a crew into the Willowbrook State School for the Mentally Retarded on Staten Island. His television report, "Willowbrook: A report on how it is and why it doesn't have to be that way," exposed the institution as a dangerous and deplorable warehouse for children.
I, along with legions of Americans, was shocked by the report and became part of the deinstitutionalization movement, in both developmental disability and mental health, over the next four decades.
Today, however, we find ourselves sickened by the tragedy of Sandy Hook Elementary School and some of the unintended consequences of the movement to free mental health patients from lifetimes of institutionalization. The question that emerges: Did we imperil the lives of the students in Newtown, Conn., by going too far in an effort to improve the lives of the children in Willowbrook?
As in almost all social movements, the work starts on one extreme of the pendulum and, invariably, swings to the other extreme before we find the lasting solution in the middle. The true danger in this phenomenon is our reaction when we experience the extremes in the pendulum swing. We overreact in our support of our citizens' rights to bear arms and the rights of behavioral-health patients to comply with treatment regimens. As with most social issues today, we are polarized by the strident ideology of the extremes taken by our political leaders, and the overexposure to media opinions that catalyze the polarization.
We need our leaders to find solutions that lie in the middle of the pendulum swing. There are positions on both gun control and mental health that can maintain civil liberties and provide expected safety for the public, including our vulnerable children. We must not delay in addressing these issues any longer.
As a treatment provider, I believe mental health needs to be put on an equal status with physical health. A mental illness can be as serious as a heart attack or a burst appendix. We need to be allotted the time and resources to make treatment decisions that reduce the dangerousness of patients.
Even while only a very small percentage of the mentally ill become violent, we need the tools and time to identify those individuals and, where possible, to protect them and society from their dangerous impulses. We need the statutory authority to provide care when sound clinical judgment is exercised and safety is found to be a necessary goal. Institutional commitment is a viable, but not always necessary, outcome of that informed decision. Outpatient commitment standards provide a less expensive and often effective treatment regimen focused on the individual and community safety. When participation in outpatient treatment is legally required, it reduces the chances of the much more restrictive alternative of inpatient commitment. This brings us closer to the middle - but the pendulum, by design, still must swing.
The fear, stigma and discrimination that surround mental health are the toughest barriers we must overcome in order to find a reasoned and balanced solution to the irrational violence that is being experienced at the hands of individuals with mental health problems.
The National Institute of Health recognizes that more than 25 percent of our citizens need mental-health care every year, and only a fraction of those individuals actually receive it. Imagine the national uproar if 25 percent of Americans had a heart attack or cancer every year and did not access treatment.
A national dialogue in the 1970s fueled four decades of deinstitutionalization. The flames were fanned by the exposure of the tragedy of inhumane treatment of children in Willowbrook. In honor of the children of Newtown, let us embark on a national dialogue on mental-health reform that ensures the safety of future generations of children by addressing the emotional, social and psychological well-being of our population.
Our new reform movement should start with a report titled, "Newtown: A report on how it is and why it doesn't have to be that way."
Donald J. Parker, of Hammonton, is the new president and CEO of the Carrier Clinic, a nonprofit mental-health treatment center in Belle Mead.