The tragic mass shooting in Lewiston, Maine took me back to reflecting on our family’s struggles with my dad’s mental health. It’s been some eleven years since I wrote about his mental illness, and how the system failed all of us. Robert Card, the subject in the recent mass shooting, bore many eerie and disturbing similarities to what I’d written many years ago about my dad. Not much seems to have changed in terms of the state of mental health care since then. Card’s symptoms were classifiable, diagnosable, and not unique.
My father died in May 2020 in a psychiatric institution while everything was still locked down during COVID. We weren’t allowed to see him in person before he died, but I’d seen him several times prior to that, where my older children got to spend some time with him, and he had been able to meet his youngest granddaughter. Prior to his full commitment, he was diagnosed with schizoaffective disorder, which is a form of schizophrenia with a component of a mood disorder. This presented through his life, and in the cruelty I experienced through my childhood, with many similar and disturbing parallels to what I’d read about Robert Card from his family. The hearing voices, the paranoia, the truly believing that others wanted to harm him in his own terrifying world was an understatement. He lived terrified and angry. He heard strangers whispering his name in public. He believed in an evil consuming people to conspire against him.
My mom was the only thing that kept him somewhat grounded through his psychosis during my childhood, and went through much the same as Card’s family trying to convince him that others weren’t talking about him or conspiring against him. In my late teens, they divorced for the sake of everyone involved, and he secluded himself; much like the reports of Card’s breakup with his girlfriend, this destabilization seemed to have sparked or accelerated a downward spiral. My dad became terrified that he was constantly being pursued by evil people, scanning his brain or trying to steal his body parts. He believed his doctors were trying to poison him. He had suffered from long-term ulcerations in his legs from arterial insufficiency, which eventually led to a chronic state of infection with giant holes and visibly exposed bone. He believed for a long time that aliens, or the devil, or just evil people – were conspiring to steal his legs from him. This came to a conclusion when his legs had become so bad that doctors told him the only option to survive was a double amputation, which played right into his terrifying psychosis. He refused, naturally, as it was his worst fear imaginable. We had the compassion to honor his wishes. He died soon after of anemia of infection. It wasn’t until after his death that I fully understood that all the cruelty he exhibited throughout his life was a product of his severe mental illness, and began to pity him for his own life having been stolen from him. Prior to getting sick, he had been a skilled draftsman working in nuclear power plants, and a relatively good father until I was around four years old. My hatred for him and his cruel and abusive behavior through my childhood somehow turned to compassion seeing him as a frail shell of a man toward the end of his life, and through ensuring that he was cared for as his guardian and someone he trusted, I found forgiveness and understanding.
I’m not a psychiatrist, and certainly not attempting to diagnose Robert Card, but the world that Card lived in – in his own mind – was likely similarly terrifying. There are obviously significant parallels across certain types of mental illness, and there are also parallel warning signs. I don’t say this to try and gain Card any pity, but to underscore how crucial it is for someone having a psychotic break to be able to undergo emergency involuntary care. Again, these symptoms are classifiable, diagnosable, and not unique. Our country’s medical privacy laws hide medical context, making it damned near impossible to get a sick individual emergency help, and that can turn deadly. It was no surprise to read that Card only spent two weeks committed. As I’ve written, it took three different incidents of violence before we could get an IEA (involuntary emergency admission) for my dad, and even then he was initially sent home because he hadn’t succeeded in harming the people he attacked. The mental health system is pitiably insufficient for patients in early stages of psychosis. If someone had taken the time to diagnose and treat Card, it could have saved the 18 victims he killed. While his commitment took place in New York, Maine’s mental health system is uniquely disgraceful, and has been neglected and underfunded for decades by multiple inept governors. Any help his family had tried to get for him would have gone absolutely nowhere in Maine. Maine’s “yellow flag” law, new as it is, is based on the same ancient and ineffective laws enacted by other states that ultimately depend on medical context families can no longer access due to HIPAA. They define a vague and inefficient process that relies on what is today an underfunded and dysfunctional system with multiple points of failure. Most law enforcement agencies don’t have the resources or the training to initiate the IEA process, and because they are well aware that it doesn’t work, rarely ever do. This event shows how difficult it is even for the police to get other police to do the right thing. It’s apparent that, at the very least, MSP should have jurisdiction and responsibility in handling IEA procedures and not the local Barney Fife.
We are probably going to see more instances of mental health tied to shootings unless the mental health system receives better funding at a state and federal level, unless red flag laws are introduced in states, and unless IEA and medical privacy is overhauled to account for the inability of an individual to give consent for an evaluation or even accessing medical context while in early stages of psychosis. The only reason my dad didn’t end up doing the same thing as Card is because at the height of his psychotic break, he didn’t have access to a firearm or the resources to buy one. He thankfully only had a hammer and a pipe. Yet even after three attacks on others, my dad still had the freedom to be able to walk into any gun shop and buy an assault rifle had he the means.
I’ve written at length about how adding semi-automatic rifles to the list of Title II weapons would have prevented many of these mass shootings, and I stand behind that. In Card’s specific case, at least ten of the victims were reportedly unidentifiable due to wounds from .308 tactical rounds in the head, and individuals that tried to charge him were quickly shot down. The severity and cruelty of his actions were absolutely dependent on his possession of an assault rifle. Card had tried to purchase a suppressor (already controlled under the NFA), which he was denied after admitting to his mental health history. Had he lied on his Form 4, the ATF background check could have red flagged him at a federal level, and possibly led to a police response. Were the rifle under this same restrictive classification, he’d have never taken possession of it, and several lives would have been spared. Still, Card owned handguns. There is no denying at least some lesser number of victims would have still been killed. Whatever that number is, it’s still too many. State red flag laws, well funded and competent mental health services, and an accessible and effective IEA procedure need to be in place before the next individual like Card has a full psychotic break.
This was clearly an escalating and emergent situation that his family was worried about, and tried to get him help for – for months. I know what it feels like to reach out for help and find nobody there. If the Maine National Guard couldn’t get anyone to care, a family certainly has no hope of preventing such a terrible tragedy. The State of Maine failed Card, the 18 victims, and all of their families. Had the state made mental health a priority up to this point, 19 people may still be alive today. Removing the rifle from the equation would certainly have reduced the body count and the brutality of the incident, but at the center of this mass shooting was a deeply disturbed individual who was seemingly left untreated, yet still allowed to possess firearms. The problem is not just a gun problem, or just a mental health problem – it is both. We cannot treat the mentally ill with abject neglect, and in the same breath believe that we can live in a healthy and civil society. We likewise cannot continue to have such a pitifully low standard for firearms ownership and expect that we can live in a safe society.