Letters 04-06-2000

Burning Questions

The article "Danger to Children" (Paul Rubin, March 23) was the most moving and disturbing I've read since moving here last year. As a mother of three, it devastated me to think of what the children went through. Yes, I feel that their mother was wronged by the system, but her crime did appear to be planned, so it makes me question just how sick she was at the time -- she was lucid enough to plan the crime.

Name withheld by request

The mental-health professionals who failed Kelly Blake reflect the attitude of many in a community that fails the mentally ill. We admit to a large number of mentally ill homeless, then proceed to build a case against helping them. An example is a recent Doug MacEachern Arizona Republic article, "What will it finally take to end homelessness crisis?" First he admits to "a wide swath of humanity, dominated by the mentally ill," then proceeds to blame the same homeless for not seeking the aid available to them. Add those also blaming the mentally ill for not taking their medicine. In both cases, the critics expect rational behavior from irrational people, mentally ill people.

This attitude that shifts responsibility for a problem onto the least responsible members of society just makes the problem worse.

Herb. Knauss

The article about Johnny Blake really hit home for me. My mother was diagnosed with schizophrenia. She finally left when I was 7 years old. I am now 38. All these years I always wondered why. When I read this article, I found out why. Thank you! You answered a very difficult question for me.

Name withheld by request

I work in the mental-health system in this county and have done so for more than 15 years. Over that period of time, I have seen people improve dramatically and have seen people deteriorate as a result of illness. I have fought very hard personally and publicly in attempts to obtain and provide the best care possible given the tools available. The greatest majority of the people I have known working in this field have also done their best. Sometimes our best hasn't been enough.

I think, though, that much of your reportage over the past few years has not been aimed in the right direction. Whatever agency has been in charge of providing care to the seriously mentally ill has only been able to provide care "within the law" and within the budgets provided by our legislators. There are more people in need than there is money available. There is minimal money available to treat people with substance-abuse problems. There is not enough low-income housing or supervised housing available for those who need it. There is not enough money to provide counseling to those who could benefit from it. There are not enough case managers to adequately coordinate care with other agencies. Family-practice physicians are not well prepared to deal with the more acutely ill of this county, and some tell their clients that any medical concerns they express are "all in their heads." Our clients are feared by their neighbors, victimized by criminals, arrested and imprisoned themselves because they don't have a place to live, a place to bathe, a family to support them, regular meals, or the common respect we provide to other human beings.

Now, that being said, the agencies providing care to this population have not always been adequately prepared to handle the need, and mistakes have been made. Some of these mistakes have had tragic results, as in "Danger to Children," but one must also look at the fact that legally we cannot provide mental-health treatment to someone who doesn't request it, nor can we read minds. We cannot even get access to other agency records without first going through a lengthy legal process. This is done to protect the individual's right to privacy, but it also places a constraint on treatment providers. We can only treat what we are allowed to treat, what we are told about and what we can see.

It sounds as if Kelly Blake was hesitant to disclose the extent of her inner pain. Given the results of her act of desperation, it is natural for us now to look back and say, "How could anyone have missed her need?" I submit, however, that the urgent care center staff and the county hospital staff were not the people most familiar with Ms. Blake -- not the ones who could have noticed the changes in character and in behavior that preceded her visits to those facilities. We, all of us, professionals, paraprofessionals, family, neighbors and church family, failed her. Please remember that the system includes all of us, and not just the ones who are in the spotlight.

I hope that others will read this article and take an interest in better understanding the need for mental-health services and the limits of those providing treatment. I pray for Kelly, for her children, both living and dead, and for the countless others who suffer from the pain of mental illness. I work every day to provide the best service I can, and I know that there will always be those persons who "fall through the cracks" of our system and our knowledge. I hope that the general public can recognize the things we do that are helpful, that do work, that provide relief, that improve our clients' quality of life as well as those times when we fail. And pray for us, too.

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