Life is an ongoing “Recovery Room."  Usually a recovery room is equipped with skilled people delivering care and life-saving, heroic medical services. Thirty years ago, in the days of de-institutionalization, as poor as the available services were for the mentally ill in the communities into which they were being discharged, they were better than they are today in 2013.

As a therapist for the last 25 years, not shying away from acute mental health crisis or chemical dependency interventions, I only have experienced one suicide in my entire career. It was a patient who was like Adam Lanza — brilliant but socially beyond awkward; much more likely to be a victim of a crime than the perpetrator.  He was developmentally challenged in so many ways that to call him a complicated case would be an understatement.

In the course of his treatment, my heart went out him and to his clearly perceived view of society as being on the outside looking in. Whether his disorder kept him from connecting or society, as a whole, “saw him coming” and ran away from him, I remember he laid the blame squarely on his diagnosis of Asperger Syndrome.

The only person in the world who remained with him was his Mom, who was a frail woman, scared to death of her own son, with good reason to be. He had no one else who would socially connect with him hence she bore the brunt of his rage, wondering why she would ever bring a son in this world and subject him to the social isolation, feeling like a misfit and an inability to connect with anyone at all.

When I started in this business, I was reminded that “Necessity Is the Mother of Invention” and that, in the 1980’s, though mental health was an afterthought, we were much more creative as a society in developing programs for the mentally challenged. Who would have imagined that things would get so much worse in terms of available psychological and social programs?

My first stop in mental healthcare was in the early 80’s. at was a psychosocial drop-in center that offered a comprehensive support system, run by those with the mental health challenges. It was called Fellowship House and their program provided psychiatric support, psychological interventions, social support and even a residential setting. Additionally they provided a strong caregiver outreach that would at least be available for a mother to be tethered to.

I do not know if such services were available to Nancy Lanza or if because of stigma, guilt, shame and fear she did not utilize them, but I do know this…

We have descended into the world of psychopharmacology, acting as if taking only a pill could actually make a comprehensive and qualitative difference in someone’s life. I would suggest that many of the developmental challenges might certainly need a psychiatrist to be one of the supports on a three-legged clinical stool, to deal with the biochemical elements of their lives. But make no mistake that the psycho-social leg and the support leg for the caregiver of the person with the mental health issue are equally, if not more important to balance the individual’s continuum of care (stool).  Without these components, the clinical equation makes no sense.

Our mental health and social service systems have been tested and repeatedly, they have failed.  If we, as Americans, do not wake up and take action to reform the therapeutic context in which we deal with the mentally ill, they will continue to make headlines and we, as a society, will continue to pay the price.

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