Politics & Prejudices: Our mental health scandal

Plus Geoffrey Fieger takes on the DAC

You'd have a hard time finding someone with a longer Detroit pedigree than Milton Mack, Wayne County's Chief Probate Judge. Two of his ancestors scrambled up the riverbank with Cadillac on July 24, 1701.

Today, from his chambers high atop the foot of Woodward Avenue, the judge can look down on the very site where his great-great-great-great-great-great-great-great-grandfather first scrambled ashore. Back then, some people probably thought Cadillac was mentally unbalanced for voluntarily venturing into an unknown land filled with "savages."

Today, as part of his duties, Judge Mack has to make difficult decisions concerning the truly mentally ill, many of whom end up in his court. Unfortunately, he's learned that, all too often, the system is far crazier than his clients.

"Legally, we still have an inpatient system in an outpatient world," he told me during a long conversation last week.

What that means, he added, is that Michigan has closed most of its inpatient facilities, but has never done what it needed to do in the way of providing adequate resources for outpatient care. The result is a highway to nowhere.

Mentally ill patients who once would've been institutionalized shuttle back and forth between the streets, jails, and prison. Many of them could respond to treatment, but they don't get it, and Mack is usually powerless to order it. Fifteen years ago, a brilliant young student named Kevin Heisinger was murdered in a Kalamazoo bus station by a paranoid schizophrenic who hadn't taken his medication.

Following that, the legislature passed something called Kevin's Law, under which a family member or guardian can petition a court for a judge to order outpatient treatment.

They then can appoint someone to make sure someone takes their medication, perhaps in a supervised setting.

But very few people know about Kevin's Law, or use it. Unless they do, Mack says, "it is easier for me to order an amputation" than order mental health care.

That has both a tremendous financial and human cost. "You don't need to institutionalize many of these people," the judge says. "They can get treatment and again become productive and happy members of society."

But their chances of doing that lessen with each psychotic episode, Mack says.

Institutionalization is really not much of an option anymore. Michigan has less than one-fifth the recommended numbers of psychiatric hospital beds per capita.

That's less than all but five states. There is a relatively easy fix, Judge Mack tells me: Lansing could and should give probate judges the power to use Kevin's Law on their own authority and be able to order outpatient treatment.

But that would require the governor and the legislature to change the mental health code, and they seem unwilling.

To some extent, this may be because they're reluctant to take away someone's right of self-determination.

But it's also because "policy makers don't understand that [most] mental illness is treatable," Mack says. From years of studying the problem, he believes at least a quarter of Michigan's 43,000 state prison inmates are among the treatable mentally ill. The percentage in county jails may be even higher. Some inmates have even asked to be locked up longer because someone there sees to it that they take their medication.

Today, state government spends about $2 billion a year on prisons. If there was a program of mental health treatment, it might well save the state hundreds of millions a year.

Ditto for county governments. What's baffling is that this really isn't a partisan issue. Democrats and Republicans should both be solidly on board. Yet they aren't, perhaps out of ignorance and fear. "I've always been interested in systems," Mack says. "How they work, finding a way to make them better."

Michigan's mental health system doesn't work, and after nearly a quarter of a century dealing with these cases, the judge is convinced he knows how to make it work better.

The tragedy is that they won't even let him try.

Fieger Blackballed?

There was a time when the Detroit Athletic Club was notorious for its exclusion of African-Americans and Jews, and, until the 1970s, women weren't allowed to enter through the hallowed front doors. (Jeans, however, are still verboten.)

Those days are gone, however. Or are they? Famously flamboyant attorney Geoffrey Fieger told me that a few weeks ago, Art Van Elslander, founder of the furniture store chain, told him he wanted to nominate Fieger for membership in the DAC.

"Well, I never was too keen on joining," Fieger says, "but I've been there a few times, and it is a good place to eat something and get a little liquored up before a Tigers game."

So he applied — and forgot about it till a couple weeks ago, when Art Van called. "I have bad news for you," he said.

"All I could think of was that somebody had died," Fieger says. But the furniture magnate told him "they want me to withdraw your nomination. They said more than 20 members would quit if Geoffrey Fieger was allowed to join."

"I don't know whether I find that more amusing or contemptible," says Fieger, the 1998 Democratic nominee for governor. "I don't know if it is because my father was Jewish, because of my politics, or they just don't like me."

Well, odds are it isn't because they think he couldn't afford the dues. The DAC's head of membership was out of town last week and did not return a message, and Elslander was in the Caribbean and couldn't be reached, so where things stand aren't entirely clear.

"But you know what?" Fieger says. "I don't care about the DAC. But I saw [Gregory Peck] in that old movie Gentleman's Agreement the other night, and when he faced anti-Semitism he said, 'I just want to look them in the eye when they tell me I'm not wanted.'

"That's what I want," Fieger says. "I want them to look me in the eye."

Don't hold your breath, Geoff.

Jack Lessenberry is head of the journalism program at Wayne State University and the senior political analyst for Michigan Public Radio.
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