Now that we have some distance and the initial emotional impact of the shootings in Arizona has subsided, this might be a good time to look at what can be learned from this tragedy. According to a USA Today/Gallup poll conducted a week after the shootings, 55 percent of Americans believe that the mental health system is at fault for its failure to prevent this heinous act of violence.
While the nation debated whether political figures and talk show personalities had created an atmosphere that promoted such violence, a majority of the public had already made up its mind that the nation's mental health system was to blame. Ultimately any society gets the mental health system that it deserves, or at least the one that it chooses to financially support.
Our own state of Indiana has not done any better. Changes in the Medicaid funding mechanism, without any new state funds to make up the difference, have resulted in what looks to be a 30 percent de facto reduction in funding and ultimately services. The state of Indiana has neglected funding any new mental health services for almost 15 years, relying almost totally on federal Medicaid dollars to pick up the slack. Now they’ve killed the Medicaid golden goose. Could an Arizonan tragedy happen here in Indiana? Absolutely!
Lack of funding is only one of three major factors. I don’t know how many mental health organizations have, as its first priority, preventing violent acts by identifying and treating at-risk individuals, although this seems to be the public expectation.
In a free society treating people against their will is always problematic. Back in the 1970s an argument was put forth that that mental health systems tend to share those most American of values, life, liberty, and the pursuit of happiness. The value of life is seen in services that treat people who constitute a danger to self or others. The value of liberty is seen in the doctrine of treating people in the least restrictive environment in the least intrusive manner that is effective. And the value of the pursuit of happiness is seen in the development of service continuums which actively promotes the quality of life for people with mental illness. Unfortunately the first two values (Life and Liberty) are often in conflict.