Not long ago, in late fall, a man in rural Maine descended into the depths of mental illness, the symptoms of which include paranoid delusions and frightening behaviors. His worried family alerted the authorities again and again, but no help came. No resources were available; any treatment or hospitalization was of short duration. Then one day, after escalating violent behavior, he killed.

I’m not talking about Robert Card. I’m talking about Justin Butterfield.

After several years of progressively worsening schizophrenia, Justin Butterfield, 34 at the time, he killed his brother Gabriel Damour on November 24, 2022. Thanksgiving morning. Last February, he was found not guilty by reason of insanity. After the shootings in Lewiston, like the facts about Robert Card’s struggles and his family’s attempt to get him help, all I could think about was Justin’s case.

The first thing you should know is that “mental illness” is a catchy phrase that encompasses a whole range of conditions and is more common than you might think. According to the National Alliance on Mental Illness1 in 5 American adults experience a mental illness each year (including me!). And for most people with mental illness, a combination of outpatient therapy and medication management, along with possibly a short hospitalization for stabilization, is usually enough to manage. And the vast majority of people struggling with mental illness are not a danger to anyone around them. But there is a small percentage of people who develop severe and persistent mental illness that, if left untreated, can lead to violence.

The key words there are “unless treated”. By all accounts, Justin Butterfield was a good partner, brother and father when he was on his meds. So was Robert Card. They were also victims of mental illness. They weren’t monsters or movie villains, they were people. human beings. Mr. Card is dead. Mr. Butterfield is in a mental institution and will likely be there for a long, long time, and even if he is released, he has to live with the knowledge that he killed someone he loved.

This type of behavior is not inevitable. We should not lock up people who suffer from severe mental illness. There were several paths that could have led to different and safer outcomes for these men – including a functional “red flag” law instead of a “yellow flag” that is confusing, overly bureaucratic, and difficult to implement in case emergency. Card and Butterfield could have refused treatment all they wanted – if the guns in their homes had been removed, they wouldn’t have been able to hurt people.

If you or a loved one is unlucky enough to experience chronic mental health issues, you’ll find that there is no real ‘system’, just a handful of resources, most of which are underfunded and out of touch with each. other. The cops are usually called first because the police are our first responders to almost anything, especially if someone is acting threatening or maybe just weird.

The officers then transport the person to an emergency room. The emergency room either stabilizes them or places them in a psychiatric unit for treatment. These stays are usually not long. It shouldn’t be. And when pronounced sufficiently stabilized, the patient is released. Sometimes there is community follow-up support available, but more often than not what I get are waiting lists and loved ones doing their best to keep them stable. Can they afford their medication? Who knows. Can I get to a pharmacy to fill it? This is the patient’s problem! The lucky ones pass and recover. For the unlucky ones, their condition begins to deteriorate until someone calls the police, and the cycle begins again.

The truth is, there is no safety net in Maine for people who suffer from severe and persistent mental illness. You either have the means to pay for private treatment, you end up on a waiting list of months or years, or you don’t. Psychiatric treatment is expensive and labor intensive, as well as highly individualized to the patient. A method that works for one person may not work for another, making it difficult to mass produce resources and services.

In addition, the most severe cases of mental illness often involve anosognosia, or the lack of awareness that a person has a mental illness. Someone who does not have the ability to understand that they are sick will not seek treatment. Otherwise, they will end up in the cops – emergency room – home cycle. Or cops – emergency room – streets.

As a state and as a society, we have decided not to fund the services. A violent death now and then is just the price we pay for low taxes. It is more pleasant for the average citizen to turn his head and never have to deal with the mess of pain and poverty and madness. Dealing with mental illness is uncomfortable. Trust me, I feel you on this one; I’ll never forget the first shift at the clinic where a patient came in and told me they were having suicidal thoughts. I saw that the police were called for disorderly conduct. No matter how often those incidents happened, I never felt confident; I never felt like I knew what I was doing; and we have never felt that the solutions we offer are good.

What happened to Butterfield and Card will happen again if nothing changes and we continue to go about our business with our heads in the sand. Once is an aberration. Twice? In two consecutive years? This is a model. And it won’t be a surprise. In the wake of any horrific event that appears in the news, reporters will learn that the perpetrator has had a million and one red flags and has been reported to the authorities as a potential danger to himself or others.

There will be documentation that the family applied for help, only to find nothing. Experts like me will say, how would they have been allowed access to weapons? Politicians will shake their heads and say how tragic it is that mental health care is so underfunded and disrespected in this country, and then the budget time won’t significantly increase it.

Average citizens will shrug their shoulders and say that some people are just crazy because it’s easier to dehumanize a struggling person than empathize. And mental health workers like my fiancee will continue to wake up every morning, overworked and underpaid, to advocate for their clients.

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