Treat the severely mentally ill humanely and society benefits
July 28, 2019
By Donald J. Ross
Special to The Times
As a psychiatrist, I believe The Seattle Times article regarding the suspect, Christopher Morisette, who is accused of stabbing three people in downtown Seattle, lacked insight into the suspect’s situation and life. [ “Man accused of stabbing 3 strangers in downtown Seattle has been through ‘mental-health revolving door,’ mother says ”] And while we can’t focus solely on policing numbers or legal maneuverings, we can look at such situations from a moral and ethical perspective. Let’s focus on our commitment as a society to protect each other humanely without doing harm, and without discrimination.
Morisette’s birth mother exhibited symptoms of serious mental illness, giving birth to him in a psychiatric hospital, according to The Times. Likely deprived of motherly contact as a newborn, it was certainly not the sort of beginning any of us would have chosen for Morisette.
The article states that he was adopted by a caring family and was “diagnosed” with Bipolar Disorder at age 5. Five years old? If he did indeed meet the clinical criteria for a bipolar “diagnosis” at 5 (Bipolar Disorder cannot be diagnosed like a clear medical disease such as diabetes), he would have been quite irritable, moody, inattentive and violent at times. I wouldn’t be surprised about Morisette exhibiting this type of behavior; the first five years of his life could not have been easy for him or his family.
Given his history, Morisette would have established habitual patterns in dealing with the complexity of his feelings, thoughts, and behaviors. Like any of us, some of his habits might be perceived as socially more acceptable than others, but most of us are able to change our patterns through self-reflection, trial, and error. Those with early adverse experiences have increased the risk for maladaptive outcomes. Those outcomes include difficulties managing stress, insensitivity to reward, and dysregulation of emotion and behavior leading to increased rates of psychiatric disorders, interpersonal problems, and engagement in high-risk anti-social activities.
This appears to be seen in Morisette’s actions and history. His adoptive mother mentions his brushes with the criminal justice system following “a predictable pattern” and calls it the “mental-health revolving door.”
I can attest to this sentiment with great empathy, and there is no easy path to fixing it. Perhaps if we start by naming a few ways that we can treat people more humanely, it may lead to better, more positive outcomes for people like Morisette:
• End the incarceration of the mentally ill, like Morisette and his birth mother, either in prisons or asylums.
• Prevent the rendering of pseudo diagnoses like Bipolar Disorder for a 5-year-old.
• Provide continued access to psychological trauma specialists to children like Morisette.
• Create new options to involuntary treatment.
• Pass legislation to remove a criminal offense in the face of madness (England passed such a law in 1832).
• Fund programs that follow at-risk children for the onset/development of psychosis.
• Dampen the domination of pharmaceutical interventions in research despite there being no substantial psycho-pharmacologic changes since 1952.
• Improve the access to health-care providers (both inpatient and out), inaccessible to many and driven by financial and not clinical needs.
But the true root of this problem isn’t legal or systemic. It is a question of our commitment as a society to protect each other throughout our lives. We can’t start with heavy-handed police protection of one neighborhood because of one violent individual before addressing the root issue.
We start by treating these individuals in need as people, not second-class citizens. It would appear that Morisette is fated to return to the psych ward, to the birthplace of his difficulties. If nothing has changed since his birth, how can we expect a different outcome?
Donald J. Ross M.D., associate clinical professor, Department of Psychiatry, Trustee, King County Medical Society Member, supervising and training analyst, Northwest Psychoanalytic Society and Institute.