There's something came up in the comments of the post about Mr. Tangent 19 that I meant to turn into a post of its own. Unfortunately, I never quite got around to it. In light of recent events, and the talk about the man who attempted to kill congresswoman Giffords, I think it's important to talk about this kind of thing, so I'm resurrecting the in-progress post now.
Quite frequently when I write a post about a particularly odd crank, someone will either comment or email me saying something like the following:
How fine a line is it between being a crank and being mentally ill, how do we differentiate between the two, and how should we individually treat those separate cases?
The gist of this line of reasoning is: the target of this post is obviously mentally ill, so why are you being mean picking on them?
When I look at things like this, I’ve got a rather blunt answer: why does it matter?
In fact, I've got an even better blunt answer: Why should it matter?
Over the last few years I’ve learned, from personal experience, what mental illness really means. Personally, I suffer from chronic depression (managed, quite well fortunately, through medication); and I've also had a lot of trouble dealing with pretty severe social anxiety. It's not a lot of fun. But it's also not relevant to anything I do at work, to anything I write on my blog, to any political or social or religious activity that I participate in.
I’ve learned from some of my friends about bipolar disorder and dissociative disorder. And I’ve got a cousin who is pretty much completely incapacitated by schizophrenia.
I've learned a couple of things from those experiences.
First: being mentally isn't a particularly big deal. There's a good chance that you know a lot of mentally ill people, and if you knew who they were, you'd probably be amazed by just how normal they seem.
Second: there is a terrible stigma associated with mental illness. That stigma is huge, and it colors everything about how we view mental illness and people with mental illness. The way that we look at someone mentally ill and baby them – say that we shouldn’t hold them responsible for what they say and do in public – that’s part of the stigma! And it's not anything close to benign. As almost anyone with any kind of mental illness can tell you, revealing your illness to your employer or coworkers can completely change the way that you're treated. You can go from being a go-to person on top of the world, to be an absolutely untrustworthy nothing overnight if the wrong person finds out. Nothing changes, except their perceptions: but because of the stigma that says that mentally ill people are irrational and untrustworthy, suddenly everything you say, everything you do, can suddenly become questionable and untrustworthy. After all, you're crazy. (Yes, I speak from bitter experience here.)
Virtually all mentally ill people function as part of society, without people around them even knowing about their illness. But the instant you find out that someone is mentally ill, the instinctive reaction is to say: “This person is mentally ill, therefore they aren’t responsible for anything they say or do” – and as a direct corollary of that: “I can’t trust this person with anything important”. I've seen this quite directly in person.
It's total bullshit. Most mentally ill people are just as responsible, trustworthy, intelligent, and reasonable as people who aren't mentally ill. Even many people with schizophrenia – one of the most debilitating, hardest to treat mental illnesses out there – can be fully functional, trustworthy, and rational people. I'll guarantee that every one of you reading this knows someone with a mental illness, and there's a reasonable chance that there's someone you know who has schizophrenia, but you don't know it, because they seem perfectly normal.
The thing is, we could know someone mentally ill for years and never notice anything odd. But for most people, the instant we find out that they’re mentally ill, our attitude changes. Suddenly they're not trustworthy or responsible: they're crazy.
If you’re well enough to interact with society, you deserve to be treated as a full member of society. And that includes the negative aspects of being a member of society as well as the positive ones.
In terms of that past post: the author of that piece of crankery is a practicing physician. Perhaps he is mentally ill. But apparently he functions quite well in his day to day life as a doctor – well enough to be able to practice medicine; well enough to be able to make-or-death decisions about how the medical care of his patients. He deserves the respect of being taken seriously. He doesn’t deserve to be pushed off into a bin of crazy people who should be dismissed as not responsible fdor their actions. If he wants to put his ideas forward, they should be treated just like anyone else’s – whether he’s mentally ill or just stupidly arrogant and ignorant doesn’t matter in the least. It’s none of your or my business whether he’s mentally ill. He’s a responsible adult. And that’s all that we need to know.
The only time that mental illness matters is when someone has something that they can't control. And that's very rare. Most mental illnesses don't affect our ability to be reliable, rational, trustworthy, functional members of society. We're not incapacitated. We're not crazy. We've got just got a chronic illness.
To connect this to the politics of the moment: lots of folks are pointing out that if you look at Giffords' shooter, at his troubles in school, at his writings in various places on the net, he's clearly mentally ill, so clearly no one is responsible for what happened.
I'm not a psychiatrist, obviously. Based on his writings, I'd guess that there's a fair chance that he's schizophrenic. And that doesn't matter.
He's a murderer. He carefully put together and executed a careful plan for a multiple murder. From everything that we've seen and heard, he knew and understood exactly what he was doing. The fact that he's mentally ill doesn't change his culpability.
Don't hold the millions of people who suffer from mental illness responsible for the horrific actions deliberately taken by one individual. And don't say that this one horrible individual isn't responsible for what he did.