'A deranged, paranoid killer'
A gunman on a rampage. A shootout with police. Multiple dead. A stunned and grief-stricken country. A community asking, how could this happen?
This has become an all-too-familiar occurrence.
However, in Tehama County, where tragedy struck Tuesday, the warning signs were there: A person struggling with mental illness, described as “unhinged.” Repeated run-ins with law enforcement. A restraining order.
Tehama County, Sacramento County and 37 other counties, representing approximately one-third of the state’s population, have yet to implement Laura’s Law or similar lifesaving programs.
We have seen where the media narrative will take us now. Mental health experts will contradict the headlines, citing studies that most people with mental illness are not dangerous. Others will focus on the pervasiveness of guns in society, demanding stricter background checks for those with mental illnesses. The debate will devolve, and solutions will become even more elusive.
Maybe we are all just missing the real point: Our treatment system abandons people like Kevin Neal.
He was a man beset by delusions, well known to first responders, and frequently involved with the criminal justice system. If, despite his actions and obvious illness, he could not get appropriate psychiatric care, what hope does anyone with a serious mental illness have?
According to the gunman’s sister, Neal had suffered from delusions for decades. Deputies labeled him “not law enforcement friendly” after repeated encounters. On more than one occasion, they even placed his home under surveillance.
Still, he slipped through the cracks.
If only Kevin Neal’s experience was unique. As we know, it is not.
Towns and cities across California are besieged with chronically homeless men and women. It is clear to anyone that many of them are desperately in need of psychiatric care, but they are unable to access appropriate treatment. So they waste away.
Meanwhile, people with mental illness have overrun emergency rooms – facilities equipped only to respond to immediate crisis, not long-term need – and jails, which have become the new asylums, an awful last refuge for those the system has no other place for.
California’s treatment system must become serious about prioritizing care for people with severe mental illness, both at the point of crisis and throughout their lives.
Legislative proposals to divert those with mental illness into treatment after arrest are gaining traction. Similarly, initiatives that incorporate sound mental health practices and coordinate responses across the mental health and criminal justice systems are poised to help break down the silos that too often characterize the current process of care. There is real recognition that we must reduce the unnecessary criminalization of the mentally ill.
The irony, however, is that Tehama County already had a tool at its disposal to provide people like Kevin Neal with treatment; it just didn’t use it.
In California, Laura’s Law, which was borne out of another senseless tragedy, has helped counties successfully care for the most severely ill in the community. The program, known nationally as assisted outpatient treatment, specifically focuses on individuals who repeatedly cycle in and out of the system because of their mental illnesses.
Nineteen California counties have successfully adopted – or are in the process of adopting – some form of Laura’s Law, including small, rural counties.
Yolo County reported a 50 percent reduction in police calls involving individuals in the treated program, and a 90 percent reduction in the time spent homeless. Nevada County saw similar drops in incarceration, hospitalization and homelessness, and significant cost savings.
Larger communities have also recognized the benefits of assisted outpatient treatment. At his state of the city speech this year, San Francisco Mayor Ed Lee highlighted the program, explaining, “Laura’s Law works.”
Orange County, too, reported decreases in important indicators like the number of days spent homeless or incarcerated.
However, Tehama County, Sacramento County and 37 other counties, representing approximately one-third of the state’s population, have yet to implement lifesaving programs. County officials must not wait any longer.
We know many people are suffering in similar ways and not receiving the care they need. Whether or not they will become violent should not be our primary concern. Doing everything possible to ensure those obviously in need of care receive treatment should be.
John Snook is executive director of the Treatment Advocacy Center, a nonprofit that works to eliminate barriers to treatment for people with severe mental illness; firstname.lastname@example.org, @JohnSnookTAC.