Mental Illness and Families: Realigning Laws & Science
Family involvement is key to fixing our mental health system
Posted Jul 21, 2015
Arlene and Robert Holmes had lived with the ravages of serious mental illness long before their son James donned his kill suit and shot up an Aurora, Colorado movie theatre, slaughtering 12 people and wounding 70 others.
According to testimony from the Colorado trial, Arlene’s father had been diagnosed with psychosis and was hospitalized after wandering naked in his Carmel backyard. Robert’s father first experienced mental illness as a West Point cadet. Robert’s twin sister, diagnosed with schizoaffective disorder, takes medications and has been hospitalized multiple times. James tried to kill himself at age 11. As a high school sophomore, James began having intrusive, unwanted thoughts telling him to kill people.
Yet, in her prayer journal, Arlene says she agonizes over what she and her husband might have done to address their son’s condition – if only they had known it existed. Before July 20, 2012, she says, James’ worst offense was a speeding ticket. She told a San Diego County newspaper, “We didn’t recognize he was ill and needed treatment.”
As the mother of a 22-year old daughter diagnosed with bipolar disorder and borderline personality disorder, I have to scratch my head. With an 11-year old son who tried to commit suicide and later, as a teenager, reported hearing voices urging him to kill, Arlene and Robert had to have known James was ill and needed treatment. What they most likely did not know, however, was what to do about it.
The sad but real answer is that, because James was an adult, there was little Robert or Arlene could have done.
America's mental health system is in crisis largely because families are excluded from participating in the care of loved ones. According to the National Institute of Mental Health, in 2012, there were approximately 10 million adults in the U.S. with serious mental illness. Our legal system bans family involvement despite sound scientific evidence showing that, when families are involved, (1) better treatment decisions are made because health care providers gain a more accurate understanding of the patient's history, and (2) rates of treatment adherence are higher and rates of hospitalization are lower.
Before my daughter Sophie turned 18, I was integrally involved in her care. I talked with her doctors and made sure she took her medications each day. Once Sophie turned 18, my husband and I went from valued members of the health care team to pariahs. Now 22, Sophie is addicted to methamphetamine and lives on the street. Her father and I have begged to help her. She continues to refuse treatment.
Last month, Rep. Tim Murphy (R-PA) and Rep. Eddie Bernice Johnson (D-TX) reintroduced their groundbreaking Helping Families in Mental Health Crisis Act, H.R. 2646. This bill, which has generated bipartisan support as well as backing from several professional associations, breaks down barriers for families, enabling them to work with doctors and mental health specialists and be meaningful partners in the front-line care delivery team for people with mental illness. This is a critical next step.
The pain inside Courtroom 201 in Aurora Colorado seared as the judge read the guilty verdict, sealing James Holmes to a destiny of either life in prison or death. Robert and Arlene lost their son, and the families and friends of the 12 people who died mourn their losses.
Such wrenching sadness demands that something be learned. We must realign our laws with science and compassion. Listening to and empowering families will help ensure that tragedies such as this never happen again.