After Newtown
The existing federal mental-health agency actually opposes efforts to treat mental illness.

Mourning the victims of the Newtown shootings, December 16, 2012.


Pity President Obama. During his predecessor’s eight years in office, only one high-profile mass killing occurred, when Seung-Hui Cho killed 32 and injured 17 at Virginia Tech. During President Obama’s first term alone, there were three. In January 2011, Jared Loughner killed six and injured 13, including Representative Gabrielle Giffords, in Tucson. In July 2012, James Holmes killed twelve and injured 70 in Aurora, Colo. And in December 2012, Adam Lanza killed 27 in Newtown, Conn. All of these tragedies were carried out by perpetrators who had an untreated severe mental illness, and President Obama and the nation in general now seem to realize that America has a major problem with untreated severe mental illness. Following Newtown, Obama promised to make “access to mental health care as easy as access to guns.”

Obama’s first step was to set up a task force under Vice President Biden to make recommendations. Biden, in turn, asked the lead government agency on mental-health services for direction. That agency, the Substance Abuse and Mental Health Services Administration (SAMHSA), is a $3.1 billion component of the Department of Health and Human Services. SAMHSA’s official mission is to reduce “the impact of substance abuse and mental illness on America’s communities.” The only problem is that SAMHSA knows nothing about severe mental illness and, indeed, is not even certain that it believes such illnesses exist. That was the beginning of President Obama’s problems.

What is severe mental illness? According to the National Advisory Mental Health Council, in response to an inquiry from Congress, severe mental illness includes schizophrenia, schizoaffective disorder, bipolar disorder, autism, and severe forms of depression, panic disorder, and obsessive-compulsive disorder. One measure of SAMHSA’s lack of interest in these disorders is its current three-year planning document, “Leading Change: A Plan for SAMHSA’s Roles and Actions 2011–2014.” Despite being 41,804 words in length and acknowledging that 9.8 million Americans are afflicted with what it refers to as “serious mental illness,” the SAMHSA plan includes not a single mention of schizophrenia, schizoaffective disorder, bipolar disorder, autism, or obsessive-compulsive disorder.

So, when it was asked to provide direction for the Biden Task Force, SAMHSA had nothing relevant to offer. It invited Daniel Fisher to provide testimony as a psychiatric expert. Fisher, director of the National Empowerment Center in Massachusetts, to which SAMHSA has given $330,000 a year for many years, has publicly stated that what is called severe mental illness is really just “severe emotional distress” and “a spiritual experience.” He also believes that “the covert mission of the mental health system . . . is social control.” Fisher’s former deputy similarly asserted that “mental illness is a coping mechanism, not a disease.”

Such views are consistent with views expressed by many invitees at SAMHSA’s annual conference. In 1995, for example, one speaker claimed that “schizophrenia is a healthy, valid, desirable condition — not a disorder . . . what is called schizophrenia in young people appears to be a healthy transformational process that should be facilitated instead of treated.” Similarly, in 2010, another speaker extolled mental illnesses as “extreme states of consciousness that are mad gifts to be nurtured and cultivated,” and he advised people with mental illnesses to stop taking their medication.

That the federal agency charged with reducing the impact of mental illness on America’s communities is sponsoring forums at which severe mental illness is extolled as a good thing has overtones of Lewis Carroll. But the situation is even more bizarre than that. SAMHSA’s only recommended “treatment” for all mental illnesses is the “recovery model” — in other words, everyone should simply recover. This is similar to the Caucus race in Alice in Wonderland in which the Dodo declares that “everybody has won, and all must have prizes.” The “recovery model” was officially defined by SAMHSA in 2004 as including ten “fundamental components,” the most important being that it is “self-directed by the individual, who defines his or her own life goals and designs a unique path towards those goals.” The “recovery model” includes no mention of the need for medication or other specific treatments. It makes no allowance for the fact that many individuals with severe mental illness are unaware of their own illness. This is an ideology, not a treatment. Under the “recovery model,” John Hinckley was defining his own life goal — the attention of Jodie Foster — when he shot President Reagan. Similarly, Cho, Loughner, Holmes, and Lanza were presumably attempting to define and achieve their life goals, too. Their actions would meet SAMHSA’s definition of “recovery.”