Bob Neal

For those of a Christian bent, we are in Advent, a season of great promise. For the many more who are of a secular bent, we are in gift-buying time, a season of great profligacy.

Whatever one’s bent, though, late fall and early winter are seasons of high stress, sometimes of anxiety and depression yielding to the forces of mental illness. Some 20% of us have one form or another of mental illness, but we have, at best, an incomplete system to help them.

Time was, we had a mental health system. A terrible system, to be sure, with up to half a million of us locked in “hospitals.” I remember a woman being released after more than 50 years in the Allentown Mental Hospital in Pennsylvania. Her illness? She spoke only Magyar, like lots of Hungarian-Americans, and no one understood her. Said she spoke in tongues.

The system slowly crumbled until, on June 27, 1975, The New York Times reported, “The Supreme Court ruled unanimously today that mental patients cannot be confined in institutions against their will and without treatment if they are dangerous to no one and are capable of surviving on the outside.”

Since then, the usual response to mental illness has been to sweep it under the rug. Students at Yale University are suing the school for ignoring their mental health issues, saying Yale tried to get them to leave school rather than help them deal with the problems.

If you read Mark LaFlamme’s story in the Nov. 25 Sun Journal about Justin Butterfield’s tortured life that led to his being arrested and charged with killing his brother, you know plenty about our incomplete mental health system. And about sweeping problems under the rug.


Butterfield told police he had killed the “terminator.” He intends to plead not guilty by reason of insanity. Time and again, he had been sent to hospital or jail for actions resulting from mental illness. Time and again, his ex-girlfriend said, he was held for 72 hours and sent home.

Then, if you read Mark’s column five days later (“Butterfield’s dark night of the soul“), you might well have begun to wrestle, as Mark did, with the question of who is the victim here. You might conclude that Butterfield was a victim, as was his brother, as was his ex-girlfriend, as were his kids.

As I was running for the Maine House of Representatives this fall, no issue sparked deeper discussion with voters than mental illness. Almost without exception, voters agreed that we need a complete mental health system. When I asked about paying for it, they said, in a nutshell, “whatever it costs.”

I was coming to believe my mission in the House would be to round up support for taking those first steps toward a complete mental health system that could treat the vast majority of the mentally ill, help them avoid harming themselves and help them avoid harming others. The voters in House District 58 had another idea. I lost, so I won’t be taking that first step.

Meanwhile, we see the consequences of ignored mental illness everywhere. No treatment for thousands living on the streets because their mental condition keeps them from coping safely with life. No treatment for thousands of veterans who came home with trauma invading their daily lives. No treatment for thousands who fall victim to addictive drugs, legal and illegal. No treatment for thousands who can’t get through a day without anxiety or depression.

I don’t pretend to know all the solutions. But I believe I know how parts of a complete system would work. And we can look at steps other states are taking.


A complete mental health system wouldn’t send police to deal with mental breakdown. They are trained to use or threaten physical force to restore order. We can’t ask them to counsel people holed up in a house threatening to harm a family. In Minnesota and Oregon, 911 dispatchers send mental health workers on calls when mental illness may be part of the issue.

A complete mental health system would have a network of “group homes,” where patients with similar illnesses could live with supervision by trained mental health pros. Supervisors would make sure the clients took the prescribed meds.

That was the idea when we scrapped the old system, but the promise has been broken time and again. A plan that New York Mayor Eric Adams unveiled on Tuesday would mean a huge increase in such housing. Now, about four in five New Yorkers who want to check into group homes can’t get there.

The part of Adams’ plan that jumped out at me was requiring that those taken in for mental health treatment would not just be held for 72 hours, then released. They would be placed in long-term housing, in coordination with the unit treating them temporarily.

A complete mental health system would use more talk therapy, instead of relying so heavily on pharmaceuticals and Zoom sessions. I can’t imagine that talking on Zoom delivers all the nuances that a psychiatrist or psychologist could pick up in person. My Zoom experience is that I can zone out of a meeting at any time, and wander back in when I want.

A complete mental health system would have elaborate screenings for people who are having difficulty negotiating the world. We can’t risk sending the next Magyar-speaking woman into a virtual cell. But we can find those who need treatment and steer them toward it.

Yeah, we need a system, top-to-bottom, and as many voters told me, “Whatever the cost.”

Bob Neal has been touched by mental illness. When Neal was 10, his father killed himself, leaving a widow and five children. His oldest sister fought bipolar disorder for 30-plus years. Neal can be reached at [email protected].

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