Caring for the mentally ill: An obligation we owe to ourselves

Last Monday morning, Vincentians awoke to a tale of mayhem and murder without precedent in this country. For, in the space of a few hours, beginning late Monday night and continuing into the early hours of Tuesday morning, an assailant carved a blood soaked path of destruction from Campden Park to Kingstown Park, leaving four dead victims in his wake, all of them bludgeoned to death with a stone or brick to their heads.

Vincentians are distraught, terrified, and utterly perplexed at the extraordinary randomness of these killings. Fear thrives where the world appears unintelligible. But if the eye witnesses’ accounts of the erratic and confused behaviour of the alleged killer at the multiple scenes of the killings are indeed correct, they point to an area of public safety that Vincentians have utterly ignored: the treatment of the mentally ill.{{more}}

We cannot at this point divine the motivations and intentions of the alleged killer. But we do know this: the plague of violence in St Vincent and the Grenadines is not only a reflection of the grievances, greed, and ignorance of aggrieved people. Rather, some of this violence is also directly attributable to a subset of the mentally ill among us, whose descent into pathological behaviours is reflective of the systemic deficiencies in our treatment of the mentally ill.

Kingstown is, in fact, a living laboratory of Vincentians’ refusal to confront the predicament of the mentally ill. It is virtually impossible to walk through our streets without having to navigate an encounter with someone who is mentally ill. Some beg. Some sleep under the galleries. Some scour and scamper through the public garbage bins in search of sustenance. And while it is certainly true that not all persons engaged in these activities are mentally ill, it is equally true that for too many of our mentally ill, the Vincentian streets become their Last Saloon.

The price for membership in this saloon is huge. For mental illness is also often accompanied by physical illness. The lives of the mentally ill on Vincentian streets is dreadful – nasty, brutish, and short. And mentally ill women face the additional burden of sexual exploitation and sexual assault by men who are quite often indisputably sane.

The streets may be the Last Saloon for too many of our mentally ill, but it is their homes which are the first incubators of all of them. The movement of the mentally ill from the homes to the streets is not particularly difficult to understand. Two things apply. As is the case for everyone else, mentally ill people age – and if the first seeds of illness had begun in childhood, by the time they are adults, they may simply be beyond the control of their families. Second, and allied to the first point, over time, families can become overwhelmed with caring for their mentally ill. Under these circumstances, the road beckons as the last refuge of the mentally ill. And what had begun as private pain could and sometimes does escalate into public menace.

Insanity relieves perpetrators of legal responsibility for the crimes they might commit while insane. A legally insane person cannot stand trial. To be sure, insanity, as defined in a court of law, and insanity, as defined by medical experts, are not necessarily one and the same. But for the victims, and the public at large, these distinctions are quite irrelevant. The only meaningful question is this: how do we protect ourselves against the crazed actions of the criminally insane?

The answer to this question is one word: compassion. We show compassion when we put in place a set of mechanisms and processes which encourage and permit the early diagnosis and treatment of mental illness. We show compassion when we offer families meaningful support to aid them in their care of the mentally ill, and particularly as they age. We show compassion when we treat mental illness not as a symptom of deeper character flaws or moral weakness, but simply as another ailment in our imperfect bodies. We show compassion when we do not ostracize or exploit the mentally ill, but defend their rights as valued members of the Vincentian family. And it is absolutely compassionate to permanently, and humanely, confine those whom our medical experts certify as posing a lethal threat to themselves and others.

Life will never be without risk and government cannot be everywhere every time. But in a world which brings new stresses to more fragile or vulnerable minds every day, caring for the mentally ill is not simply a gift we give to them. It is also an obligation we owe to ourselves. We cannot deter the criminally insane. But with proper medical treatment, we can reduce the threat they pose to themselves and the broader Vincentian society. This we must do now.