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She told us her name was Elizabeth. At the church across the street they knew her as Kat. She guarded her information like
a threatened mother animal in the wild. That's one of the characteristics of paranoia.
We let her cook in our kitchen. Sometimes she let us give her food; always packaged. She never accepted food someone
else had prepared. Sometimes she let us give her a blanket or waterproof covering. She never let us help her find a place
to stay indoors. She didn't like to be surrounded too long by walls and ceiling.
It took more than a year before we could piece together enough information to discover anything substantial about her.
The big break came when I happened to see the return address of an old, soiled letter. I traced the reference and was able
to start some communication with her two daughters.
She had been an English teacher with a Masters degree. Her daughter said she was a gifted teacher and her students loved
her. She was a loving and wonderful mother, until the illness began to overwhelm her. It overwhelmed them all.
For a while she lived with her daughter in Texas. When she accepted medical care she got better. But she believed they
were poisoning her with the pills. She let a faculty colleague give her shelter for a while. But even that became too frightening
to her. When everyone who loved her tried to get her into a hospital, she left for good. I don't know how long she lived
on the streets in Fayetteville. A long time.
When I called her daughter in Illinois she said it had been two years since she had heard from her mother. She cried
with relief to know she was still alive; she cried with frustration to know how hard it was to help. We tried offering Elizabeth
regular money from her daughter as a way to rebuild a connection. It was too frightening for her after the first time, and
she refused. To her, everyone was a potential enemy.
Just because someone needs psychological help and there are resources available to provide that help, it doesn't mean
they will get it. Elizabeth refused all. I hoped she would do something -- anything -- that we could interpret as a threat
to us or to herself. Then we could file for an involuntary commitment and hope that the doctors could stabilize her chemistry
so that she could become herself again and be competent enough to choose to accept care.
When the weather got extreme we worked out a deal with a compassionate prosecutor and police officers. They would pick
her up because she had become a threat to herself because she refused to come inside during the bitter cold. A mental health
professional was ready to make a quick evaluation. We hoped for the possibility of a commitment which would allow her to
receive medical care. On the day we scheduled to set things in motion, she managed to get herself arrested for loitering
before we knew where she was. By the time we found her, she sniffed the trap and disappeared.
I thought of Elizabeth and of her family when I learned the details of the tragic shootings at Virginia Tech. I grieved
for the sad helplessness of Cho Seung-Hui's family; for the individuals and institutions that found themselves unable to respond
to the signs of his illness.
A friend of mine who works tirelessly in mental health says we have a profound cultural challenge to face. Decades back
our nation defined what public education is. But we've never defined what public health or public mental health is.
In the 1960's John Kennedy offered a vision to create hundreds of community centers to deliver mental health care locally
in order to release people from centralized state hospitals. That vision never materialized. But deinstitutionalization
did. In the passion to get government out of our lives, over several decades thousands of persons suffering with mental illnesses
were "liberated" from hospitals; thousands ended up on the streets. Others went to homes and schools and businesses
where their disabilities simply overwhelmed the ability of their families and friends to help them. Much of the mental health
burden eventually fell to police and to prisons where we lock up people who can't cope -- sometimes for the most frivolous
of crimes; sometimes for the most frightful.
Maybe this horror in Virginia can strengthen our corporate will to address our mental health crisis constructively. It
is a tough challenge. It will take public and private cooperation to find some workable solutions. It will take a process
that balances individual rights with a person's medical incompetencies.
But isn't your physical and mental health as fundamental to your being as your education? We've made access to basic
education universal. What about access to basic health care? What about access to basic mental health care? Or, as Jesus
might ask, "What does it mean to love your neighbor as yourself?"
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