In the wake of yet another mass shooting at a U.S. school, it’s time for America to have one of its all-too-infrequent conversations about mental health. On Last Week Tonight, John Oliver looked into what we’re actually doing to help people with mental illness, and learned it’s pretty much nothing except prison. Great. Good start.

Although it’s convenient for politicians to bring up mental health after a high-profile shooting incident (so that they don’t have to address any of our problems with guns) “fewer than 5 percent of the 120,000 gun-related killings ... were perpetrated by people diagnosed with mental illness,” according to a February article in the American Journal of Public Health. And this trope doesn’t just downplay our lax gun laws, it erases the majority of people with mental illness in America, who aren’t shooting anyone, but are getting screwed by the system.

Turns out we’ve mainly tried to address mental illness by criminalizing it. Jails and prisons are our biggest provider of mental health care, outnumbering state-run psychiatric facilities 10 to one. And half of all U.S. incidents where police use deadly force involve a mentally ill person (and I know what you’re thinking, but it’s not the cop).

Oliver also brings up the shocking concept of “Greyhound therapy,” where facilities release someone early and send them on their way with a bus ticket out of state, to become someone else’s problem.

This is all extremely shitty, but mental health care costs money. Can we afford to do better?

Actually, yes. Oliver is a fan of Assertive Community Treatment, where teams of care providers actively help people with mental illness with everything from paying rent to finding a job to applying for various government entitlements. The goal is to keep people living independently in the community, instead of sending them into hospitals or the prison system.

It sounds expensive, but these programs basically pay for themselves, assuming we can figure out how to fund them.

“If we’re going to constantly use mentally ill people to dodge conversations about gun control, then the very least we owe them is a fucking plan,” Oliver says.


[Last Week Tonight]