By Gerald J. Gleeson II and Jeffrey A. Crapko
When I started as an attorney many state courts did not have metal detectors at the doors. Now courthouses are becoming fortress-like: fences, bulletproof glass, berms and barriers. I am not sure what it says about our society or principles of equal and open justice when courthouse security begins to resemble that of a United States embassy in a dangerous country. Like everyone else, I loathe taking off my belt and watch, knowing the worst danger I pose is a bad turn of phrase during an argument. But like everyone else, I do as is expected. The point made to me every time I pull into the parking lot is that clearly things have changed.
Since law school, events like the Oklahoma City bombing, plots/threats to kill federal judges, and mass shootings like those at Columbine, Las Vegas and Parkland (to name just a few) have come to fruition where nothing like them had ever happened before. I am not sure if these events show the beginning of a decline of American society, but something is clearly wrong here. I know that I and those I know are not going to perpetrate such atrocities and are no risk to our fellow citizens. But others in this country do and have done such things. Perhaps the cause is our society's inability to properly address the issues related to mental health.
Early on, my experience with mental health issues was largely confined to prosecuting criminals who asserted the insanity defense.1 In hindsight, I confess to being a bit callous in approaching these cases. It was a matter of looking for evidence of "goal-oriented behavior" or hints that the defendant "understood right from wrong." And in cases where the defendant pled or was found not guilty by reason of insanity, the goal was often to keep the defendant (now a respondent in probate court) confined in mental health institutions. Since that time, I have had the opportunity to represent many individuals with various mental health issues, and these cases have caused me to rethink my views on the mentally ill and how little we as society do to address these issues.
The statistics on mental illness are eye-opening.
- Approximately 1 in 5 adults in the U.S. experiences mental illness in a given year.2
- Approximately 1 in 5 youths aged 1318 experiences a severe mental disorder at some point during their life. For children aged 815, the estimate is 13 percent.3
- 18.1 percent of adults in the U.S. experienced an anxiety disorder such as post-traumatic stress disorder, obsessive-compulsive disorder and specific phobias.4
- An estimated 46 percent of homeless adults live with severe mental illness and/or substance use disorders.5
- Approximately 20 percent of state and local prisoners have "a recent history" of a mental health condition.6
- 70 percent of youths in juvenile justice systems have at least one mental health condition and at least 20 percent live with a serious mental illness.7
- Suicide is the third leading cause of death for people aged 1014 and the second leading cause of death for people aged 1524.8
- Each day an estimated 18-22 veterans die by suicide.9
A major obstacle in our society is the stigma attached to mental illness. The fear of being labeled "crazy" or "dangerous" acts as a disincentive to seek treatment. Many fear (or at a minimum have a bias toward) the mentally ill. Those who suffer from mental illness fear negative consequences in school, work, relationships and parenting time. But in reality, people with mental illness "are no more likely to be violent than anyone else" and "people with severe mental illnesses are more than 10 times more likely to be victims of violent crime than the general population."10 Only 41 percent of adults in the U.S. with a mental health condition received mental health services in the past year.11 This is a population that deserves society's protection, not its scorn and fear.
A number of people I have represented were dual-diagnosed, meaning there existed both mental health and substance abuse disorders. Oftentimes the mentally ill self-medicate, causing any number of additional issues and problems. The statistics bear out that this is a common situation:
- Among the 20.2 million adults in the U.S. who experienced a substance use disorder, 50.5 percent had a co-occurring mental illness.12
The issues related to mental illness are by no means confined to the legal system. There is certainly an economic consequence. Serious mental illness costs America $193.2 billion in lost earnings per year.13
In seeing how our current system "treats" those with mental illness, we could and clearly must do more. But where do we start to address such an overwhelming problem? I would suggest we each begin with a hard look in the mirror; perhaps each of us could do the hardest thing that is, being nice and making an effort to include those who are often marginalized. This means reaching out to the "weird" person whom you would rather not talk to. Making an effort to get to know those who surround us. Being less quick to judge, and more quick to sympathize. While national solutions may be out of our individual reach, it is worth a reminder that kindness, inclusion, empathy and basic decency begins with each of us.
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Footnotes
1MCL § 768.20a.
2http://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-adults.shtml.
3http://www.nimh.nih.gov/health/statistics/prevalence/any-disorder-among-children.shtml.
4http://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety-disorder-among-adults.shtml.
5U.S. Department of Housing and Urban Development, Office of Community Planning and Development, (2011), "The 2010 Annual Homeless Assessment Report to Congress," https://www.hudexchange.info/resources/documents/2010HomelessAssessmentReport.pdf.
6Glaze, L.E. & James, D.J. (2006), "Mental Health Problems of Prison and Jail Inmates," Bureau of Justice Statistics Special Report, U.S. Department of Justice, Office of Justice Programs Washington, D.C., from http://bjs.ojp.usdoj.gov/content/pub/pdf/mhppji.pdf.
7National Center for Mental Health and Juvenile Justice. (2007), "Blueprint for Change: A Comprehensive Model for the Identification and Treatment of Youth with Mental Health Needs in Contact with the Juvenile Justice System," Delmar, N.Y: Skowyra, K.R. & Cocozza, J.J., http://www.ncmhjj.com/wp-content/uploads/2013/07/2007_Blueprint-for-Change-Full-Report.pdf.
8"10 Leading Causes of Death By Age Group, United States 2015," https://www.cdc.gov/injury/images/lccharts/leading_causes_of_death_age_group_2015_1050w740h.gif.
9U.S. Department of Veteran Affairs Mental Health Services Suicide Prevention Program, "Suicide Data Report, 2012," Kemp, J. & Bossarte, R., http://www.va.gov/opa/docs/Suicide-Data-Report-2012-final.pdf.
10"Mental Health Myths and Facts," https://www.mentalhealth.gov/basics/mental-health-myths-facts.
11Substance Abuse and Mental Health Services Administration, "Results from the 2014 National Survey on Drug Use and Health: Mental Health Findings," NSDUH Series H-50, HHS Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services Administration. (2015). Retrieved October 27, 2015, from http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf.
12Id.
13Kessler R.C., Heeringa S., Lakoma M.D., Petukhova M., Rupp A.E., Schoenbaum M., Wang P.S., Zaslavsky A.M., "Individual and societal effects of mental disorders on earnings in the United States: results from the National Comorbidity Survey Replication," Am J Psychiatry 2008; 165:703-711.
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Gerald J. Gleeson II, of Miller, Canfield, Paddock, & Stone PLC, is the 85th president of the Oakland County Bar Association.
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