This article by Dr. John Grohol in PsychCentral (America's Mental Health) discusses the Stephanie Moulton murder and the reasons behind it. If you don't come away from it angry, there's something wrong.
This is, of course, not a new problem. De-institutionalization took hold in the 80's as a response to civil rights concerns. Advocates for disability rights pushed for integration and full participation in society, something they believed could not be achieved in institutions. All in all, a worthy and noble goal. Sadly, over the course of the last 25 years or so, de-institutionalization became mainly about money. Resources that were to be shifted to community treatment never got there. Political trends resulted in a dismantling of government provided services and an emphasis on private, so called non-profit agencies. These agencies have a lower staff to patient ratio and thus more patients for fewer workers, pay employees significantly less with minimal benefits, and often have high turnover of younger, generally less well educated staff who get some experience and move on to the few remaining government jobs or get out of the field altogether. The irony is that de-institutionalization has really served no one particularly well. Many former psychiatric inpatients found themselves inmates, as the Corrections systems took over from the mental health system when these individuals were unable to successfully navigate in the community and wound up in trouble with the law. Communities saw increases in homeless populations and, often, crime. Families experienced increased stress in desperately trying to find services for their mentally ill relatives. Taxpayers failed to see a reduction in taxes as resources were shifted to much more expensive correctional services. (In New York, this was a highly visible process as former psychiatric and developmental centers were converted directly into prisons.) In this context, violence is not only unsurprising, it is predictable. Stephanie Moulton is not the first nor will she be the last victim. In February, 2008, Dr. Kathryn Faughey (
Casualties of a Failed System and
No Justice) was murdered in her New York City office by David Tarloff, a psychotic patient who couldn’t find his intended target and killed her instead. Two days later and a thousand miles away, Steven Kazmierczak walked into a college classroom and opened fire, killing Daniel Parmeter, Catalina Garcia, Ryanne Mace, Julianna Gehant, and Gale Dubowski before killing himself. What did the killers have in common? Both had long histories of mental illness, revolving door hospitalizations, and repeated refusal of medication.
The system worked as designed – and somebody died.
