Society's Failure to Help the Sick Costs Us More Than Our Humanity

Michael B. Coburn is a forensic psychiatrist in Van Nuys.

He walked into my office shaking from head to toe. He was supremely frightened, tense beyond words. With quavering voice and stumbling words he told me of his life of terror, of being raped by his father, of having no one except his confused and equally unstable wife, and of his attempts and continuing desire to die, to "put out the lights" and "not see the show," and his concern that he'd kill his wife first.

He was not that unusual among the walking wounded. There are thousands of mentally ill men and women like him, and we are abandoning them to their private horror and in so doing abandoning any right that we have to call ourselves civilized human beings.

In Los Angeles and all over the country, emergency care, hospitals and mental-carefacilities are closing, services shrinking, funding drying up; personnel are laid off, and they see their talents and compassion waste away.

"Money is tight," the governor says. "Budgets must be cut," the county supervisors say, and "Not in my neighborhood," we say.

But the mentally ill do not cease to exist just because we cease to see them. They didn't go away when then-Gov. Ronald Reagan closed the hospitals. They didn't go away when federal funding for mental-health clinics disappeared; they didn't go away when Medi-Cal coverage and public housing and mental-health treatment in the prisons and public housing and infant nutrition and scores more programs were cut. They didn't go away; they just changed their shape.

This man who was sent to me for an evaluation for Supplemental Security Income has nowhere to go, except to his disturbed wife whom he fears he will kill, who knows it, and who takes him in with her two children while provoking him by becoming pregnant by others. He is more afraid of becoming one of the homeless than he is of dying, or of killing. He isn't sick enough to get into a hospital again. And there is no place to keep him, no beds and no money. And very soon he will not even be able to get the barely adequate medication that he now gets from a county clinic; they are closing eight clinics. Money is tight. Budgets must be met. Not in my neighborhood.

He and others similarly impaired and similarly in pain will again change their shape. Some will be among the homeless; others will get sick enough to earn a hospital bed for a week, some will even stabilize and get well, and some will die. And some, many more than in the past, will lose control and end up in jail. Some will have only broken into a store or a car to sleep. Some will attack those who try to help, as happened in Santa Monica on Tuesday. And some will have killed a wife.

In failing to treat and care for our wounded we not only fail them, we break every moral commandment. We fail ourselves, deaden our souls and endanger our very lives. And, oh yes, we end up costing ourselves--in prisons, courts and hospitals --much, much more money than if we had cared for them properly in the first place.

So if humanity, morality and public safety aren't enough reason to do what's right, maybe saving money is.

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