We've lost our balance on mental illness

I once knew someone, many years ago, who was sent to a "rest home" by her aggravated husband. Today, you and I would call that "involuntary commitment," and the fellow was able to do it with relative ease because he was an important person who knew the right people, and because the laws were on his side.

This was a time, the 1970s, when a woman couldn't even be considered to have been raped by her husband in a number of states and teenagers could be "grounded" all the way to the psychiatric hospital.

It was a time when horrific places like Pennhurst were still operating, and anyone who grew up in the Philadelphia area knows what I'm talking about. Dante himself couldn't have conjured up something as infernal as this "hospital" where the patients were chained to their beds and starved for days on end.

All of this is to show that I am not insensitive to the plight of the mentally ill. I have had people in my own circle who have dealt with the problem, a serious and heartbreaking one.

Until recently, the laws were weighted far too heavily against the afflicted. You'll forgive the pun, but a mere generation ago, the general rule seemed to be "out of mind, out of sight." It was preferable to hide the people with invisible yet debilitating wounds instead of treating them compassionately.

But as with most things, the corrective pendulum has swung too far in the opposite direction. With the ACLU at the head of the charge, civil-rights activists have caused a sea change in the way that we deal with the mentally ill.

Too often, while understandably focusing on the rights and needs of the patients, we ignore the people who live with and love them. We lose sight of the pain and damage that an unbalanced person can cause in the lives of his family and friends.

These are good things.

What is not good, however, is the fact that civil rights now trump public safety when it comes to those who are potentially violent. The laws generally allow you to commit someone against their will if they have proven to be a danger to themselves or to others, which essentially means that someone has to take a steak knife to your throat or put the kitty in the microwave before they can be admitted against their will.

These ex-post-facto determinations are never adequate when dealing with a diseased mind. It is ridiculous to have to wait until someone actually commits a crime before minimizing the chances that they will be able to wreak mayhem, as Adam Lanza did on a cold December morning in Connecticut.

Of course, that doesn't sit well with the activists. In a recent column on Newtown, I criticized the ACLU for their campaign on behalf of the "fabricated right to be a public danger." Not surprisingly, the civil libertarians came out in full force, attacking my insensitivity to the "rights of the disabled."

One acquaintance sent me an e-mail that dripped with sarcasm and naivete when she wrote, "Really? You think the ACLU invented the rights of the disabled? ... I often disagree with your positions, as you know, but this was a purely gratuitous slam at the ACLU, which I think disgusting from any quarter, but more so from a person who claims to be thoughtful."

The ACLU is impervious to their rights, and it is quite possible that Nancy Lanza ran into one of those obstacles in Connecticut. The ACLU chapter in that state actively opposed a law that would have made it easier for Connecticut to institutionalize or even treat on an outpatient basis a mentally ill patient if it had enough evidence to believe that the person was dangerous.

The ACLU said that the bill would "infringe on patients' privacy rights." And so, it went down to defeat months before Adam Lanza went on his rampage.

This is not to say that we need to return to the days of Pennhurst. It is not a call for mass institutionalization of the quirky-but-harmless. As a noted psychiatrist wrote in the New York Times this week, the vast majority of the mentally ill are not dangerous, although they are disproportionately represented among those who commit violent crimes.