A recent story in Mother Jones highlights the issue of the decrease in psychiatric beds nationwide, reductions in support for the severely mentally ill, and the terrible price paid by both the severely mentally ill and their families. Several times in the article McClelland refers to E. Fuller Torrey’s arguments that in addition to funding services for the severely mentally ill, states also need to change involuntary commitment laws to make committing people against their will depend on things in addition to imminent dangerousness. These issues take on a new salience with the recent mass murders perpetrated by people believed to be psychotic at the time of the murders, and often previously diagnosed with serious mental illness, and with the responses in the media that call for curtailing the rights of the mentally ill.

From a feminist bioethical perspective I find this issue quite perplexing. On the one hand, severely mentally ill women are often left to live on the streets where they are victims of sexual violence and live in deplorable conditions. Yet at least in some cases they choose this over available treatment and other assistance, including assistance from loved ones. Some severely mentally ill women and many severely mentally men end up in prison, which is more and more becoming the primary treatment locus for the severely mentally ill. Also of concern is that some mentally ill people are violent, most often towards family members, and in particular towards their mothers. Yet under the current system family members have no recourse until violence is perpetrated, and that recourse is typically, in the first instance, to involve law enforcement. Mothers and other family members of severely mentally ill adult children still love these adult children and recognize that they will likely end up on the streets without the care of their families. Yet at the same time they are afraid of their sometimes-violent adult children and are left with nowhere to turn for help.