Sympathy for Nick Kristof on His Piece on Mental Illness

The pull quote in Nicholas Kristof's recent Sunday Review column in the New York Times reads: "Should we respond to mental illness with sympathy or handcuffs?"

More than a bit simplistic, the pull quote, like Kristof's op-ed, glosses over the serious nature of the crimes, even the so-called nonviolent crimes, committed by some of the people in jail or prison who supposedly suffer from mental illness.

In my last column, I critiqued Kristof's piece, but I would like to expand on some of the issues I raised before.

Kristof cited a man named Russell, who is being held in a jail in Chicago on charges of burglarizing a garage.

Russell is one of the people Kristof highlighted because of the "nonviolent" nature of his crime.

I have compassion for Russell, who, according to Kristof's piece, "has been diagnosed with severe depression." Readers of my work know that I was once diagnosed with schizophrenia. I have also suffered from severe depression my whole life, and I understand how debilitating it is.

But I cannot condone Russell's burglarizing of someone's garage. Nor can I condone the commission of other crimes, however nonviolent they may appear to be, crimes like trespass, theft, shoplifting, all of which are mentioned by Kristof in his piece.

According to Kristof, Russell has spent "most of his adult life" behind bars for "one offense after another." While Russell does in some respects appear to be a victim, more than a perpetrator, of serious crime, he does not represent most of the recidivists in jail or prison.

Kristof points to a 2006 Justice Department study, indicating that "more than half of prisoners in the United States have a mental health problem," but many of those prisoners are not mentally ill at all.

Forensic psychiatrists will tell you that many of the prisoners who might qualify as having a "mental health problem" are psychopaths or have been diagnosed with anti-social personality disorder.

What does this mean? It means that many of these prisoners are hard-core criminals who often plan their crimes, including those that Kristof considers nonviolent like burglary and theft, and then show no remorse afterwards.

Not surprisingly, a lot of psychiatrists do not consider psychopaths or those with anti-social personality disorder to be mentally ill at all. Why? Because the vast majority of those with mental illness have never committed any crimes, have never been violent in their lives, and, if I am any barometer, show remorse and guilt over just about anything.

In my previous piece, I took issue with Kristof's claim that "some 40%" of people with serious mental illness have been arrested in their lives.

As I noted in that piece, psychiatrists sometimes have to call the police to pick up their patients who are wandering on the street. My point was to question the meaning of the word "arrest," since some of those who are "arrested" by the police have not only not committed a "nonviolent" crime, they have committed no crime at all. Unless of course they misread the situation and try to flee from the police or even resist arrest, occurrences that are not so improbable when someone is lost in a state of psychosis.

But there are other reasons why I question that "some 40%" statistic.

Given that we live in an age when so many people, particularly men, still refuse to admit that they are in therapy, when so many patients still exit unseen out of a back door when they finish their therapy session, how are we to know that surveys about mental illness are answered honestly?

Most people with serious mental illness, including schizophrenia, bipolar disorder and major depression, would never reveal their condition on a survey, but if they did, people like Nick Kristof would find out that they are working and doing reasonably well in a wide variety of professions.

Ask just about any practicing psychiatrist, and he will tell you that most of his or her patients are holding down jobs in fields as varied as academia, professional sports, law, business, medicine, journalism, even law enforcement.

I appreciate the good intentions of Kristof's piece. I absolutely agree with him about the need for more psychiatric beds in this country, a point that was recently brought home by the tragic suicide of the son of Creigh Deeds, a Virginia lawmaker.

But I disagree with Kristof's underlying premise that most of the mentally ill end up in jail or cannot hold down a job, like Russell, the inmate I mentioned earlier, who told Kristof that he had never been employed.

Most of the mentally ill, including the seriously mentally ill, blend in to society, as I have pointed out numerous times before. And most of us never reveal our disorders because of the perception, propagated inadvertently perhaps by people like Kristof, that we are criminals, even of a "nonviolent" variety.

Incidentally, I am not saying that ex-cons who have committed burglary and theft, among other crimes, don't deserve second chances in life.

More than a decade ago when my wife and I bought our home, we hired two men to help us move from my wife's condo.

As I was lugging boxes up the steps from the street, one of the movers, who had a swastika tattoo on his neck, noticed that I was wearing a pendant of the Star of David around my own neck.

He told me that he did not hate Jewish people, but that when he was in prison he had to show "pride in his race." I asked him what he had been in for.

"Nothing violent," he said. "Just assault and grand theft auto."

This mover was a remorseful man, who was trying to make a better life for himself. Like many decent ex-cons, he wanted to talk about his rehabilitation, about how well he was doing since he had gotten out of prison, about how he had to adhere to a curfew every night at the home where he was living.

I had nothing but compassion for him, especially when he asked me if he should get the tattoo removed.

"Yes," I said to the mover, who was neither mentally ill nor a hard-core criminal. He was just a man who wanted a second chance and was willing to work for it.

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