Ethical Houston

Literature and films have often been the catalyst for change.  One such movie was the 1975 film, One Flew over the Cuckoo’s Nest.  The now classic film about the institutionalization of the mentally ill came at a time when great advances were being made in the treatment of the mentally ill.  It was only inevitable that as a result of both of these events that there began a process across the United States to deinstitutionalize treatment.  The idea was that persons with mental illness could be treated best with medication and counseling in the communities where they lived.  They could be with family members or live in group homes and be treated by community mental health programs. 

 In many parts of the country this became a reality.  But in other parts, including Texas, it became an excuse for cutting services since, at that time, advocacy groups for the mentally ill were not well organized.  The result was that many mentally ill persons were just turned loose and if families could not or would not take care of them, they ended up on the streets or in prison.   Much of that situation still exists in Harris county today.  It seems that often in our culture we only address a portion of a problem rather than looking at it holistically.  Consider the situation in Texas and in particular Harris County.  Texas is at the bottom of per capita spending of any state in the country and “Harris County is fourth from the bottom in per capita funding of any county in the state” which makes Harris County on a per person basis rank at the bottom of any state. (Schnee, 2006).  But this is not just about money, even though money is necessary.  Here are some other Harris county statistics to consider:

• About 140,000 adults who experience mental health conditions suffer a severe mental illness, which is severe depression, bipolar disorder, and/or schizophrenia.
• Almost half of adult Harris County residents who suffer from a severe mental illness could not access treatment from the public or private health systems.
• Over 20 percent of inmates of the Harris County jail have had a history of mental illness.
• Almost 20,000 Harris County youth needed services from the public mental health system each year, but the majority (76%) did not receive treatment services.
• More than 62 percent of the 16,000 youth in Harris County Juvenile Probation Department have a diagnosable mental illness.
• In 2009, 5 mentally ill persons in Harris County were killed by the police.
• No new public mental health beds have been built in Harris County in the last 30 years.  In fact, there are fewer beds available.

(Local plan of MHRA of Harris County 2006-07)

It is only with the advocacy of such organizations such as NAMI (National Alliance for Mental Illness) and DBSA (Depression, Bipolar Support Organization) and The Mental Health Association of Houston have citizens been able to make changes in the system as it now stands.  And the MHMRA of Harris County does a good job with the funds that they have.  But to me it’s a bit Cuckoo to move from one antiquated and medieval form of treatment to a system that is woefully inadequate and where families have to fight so hard for services for their children and loved ones and where the mental hospital of last resort is our jails and prisons. 

 When government is considering funding for programs, whether mental health or criminal justice, healthcare, or education they leave out massive amounts of needed services in the name of being fiscally responsible.  The statistics above show the severe lack of services for the mentally ill. And the figures I’ve cited don’t even address the housing issue, which is critical.

 What are the ethics of a society that will not take care of the least of these among us?  Having worked with families who have family members with mental illness, I know that the problem goes far beyond the issue of mental illness.  Mental illness creates other problems for society including criminality, drug and alcohol abuse, domestic violence, child abuse, and the break up of families.  These problems are not just the fault of not having an adequate mental health system.  They’re all interrelated and have a bearing on the health and well being of the society as a whole. 

 As a society, we have to recognize our interconnectedness and see the ethical and moral implications of these issues.  We can’t hide the mentally ill, the homeless, the criminal offender, the addict and the unemployed or underemployed away from the rest of us who consider ourselves “normal”.  And more importantly, we can’t hide ourselves from these realities. Hard as we try, the world will break through our gated communities and security systems and even with guns and special patrols will make us prisoners in our own homes.  Some would say that world already exists. 

 Some would say that I’m advocating socialism.   It only becomes socialism when we decide that it is the government’s job to take care of the poor and the sick and the impoverished.  Some believe it is either the responsibility of the impoverished individual to get themselves out of their predicament or for the Church or charities to provide for the needs of the poor.  But it requires a commitment and a covenant on all our parts to change things.  But there’s a personal price to pay.  Who of us is willing to take the homeless into our own home, to give the ex-offender a job or invite him/her into our churches and to pay for the man on the side of the road who was accosted, robbed and beaten?  And who among us is willing to take in an aged person with no resources and give them a home in their old age or adopt a child with special needs?  I’m not talking about just giving the homeless man on the corner a dollar and thinking that we’ve done our duty.  Society pays a price for the acts of the irresponsible and the impoverished.  But who among us is not impoverished in our love of neighbor.  In most main line church denominations, over 50% of members do not give at all.  So, what is the price of having 30% of the Texas population living in poverty?   

 What is your ministry and how much of your time do you devote to it? How much do you give to your church or local charities?  How does one decide where they can do the most good?  And how will we prioritize our time and resources to fulfill that ministry?    

           The line “one flew over the cuckoos nest” is a bit of a misnomer.  Cuckoos don’t have nests of their own. They’re parasites, laying their eggs in the nests of other smaller birds and pushing one egg out of the nest to make room for their own egg.  They fit into nature’s scheme. And it’s been that way since the first cuckoo laid the first egg in her neighbor’s nest.

 How do we fit into the greater scheme of things?  Do we have to bend to the way things are, or can we bend towards the way things should be?  Last week, a good friend of mine said, “but the gospel is so hard.  Did Jesus really mean that in order to obtain eternal life that we had to give everything away and then come and follow him?”   I hope that we will all struggle with that question and set our eyes on bending towards the way things should be.  With God’s help, in time, the way things should be, will be a reality.