John Oliver takes on America’s approach to mental health

john oliver last week tonight
Still from HBO

John Oliver began his long segment with a joke: “Mental illness. The thing actors pretend to have in order to win Oscars,” But, as usual, nothing that followed was much to laugh about. In fact, as much as Last Week Tonight is a satirical news outlet, the jokes rarely add anything to the message. Oliver’s satire is, instead, one of a very serious biting critique that only adds humorous metaphors to lighten the mood of an otherwise grievous truth. The truth this week is that America doesn’t talk about mental illness, “and when we do, we don’t talk about it well.” Oliver points out that terrible names like wacko, sicko, and “cray cray”, are thrown around every day to describe the mentally ill, and that even TV personalities with “Dr.” in their name can get it wrong, before showing clips of Dr. Oz and Dr. Phil making ridiculous claims about mental health.

The biggest problem with the way we talk about mental illness, though, Oliver says, is that “One of the only times it’s actually talked about is, like we saw this week, as a way of steering the conversation away from gun control.” He then shows clips of Trump, Carson, and Huckabee saying that the mass shooting debate should be centered around mental health issues, not gun laws. “The aftermath of a mass shooting,” Oliver continues, “might actually be the worst time to talk about mental health, because for the record, the vast majority of mentally ill people are nonviolent, and the vast majority of gun violence is committed by non-mentally ill people.” He then makes a weird metaphor using a clip of Bill Cosby and Coca-Cola reaffirming the absurdity of using one instance of something to talk about an endemic problem.

He goes on to discuss the insufficient and sometimes dangerous ways the system has dealt with the mentally ill. In the mid-century, they were thrown into institutions that were so bad they earned the name “snake pits”, and although President Kennedy tried to shut down as many of those institutions as possible while he was in office, most of the patients from those institutions were forced into nursing homes, “and it’s not a great idea to stick a young person with old people and hope for the best.” Another way institutions chose to deal with patients was with “Greyhound therapy,” dismissing seriously ill patients too soon, then supplying them with a one way bus ticket out of town. One of the worst solutions, though, Oliver points out, is sending them to jail. Using the criminal justice to treat mentally ill is dangerous, for both police and patient. Half of all deadly force used by police involves the mentally ill. And while some police forces have training to properly intervene with the mentally ill, only 15% of law enforcement jurisdictions have crisis intervention programs. And taking that training is voluntary.

Oliver makes a pretty convincing case that the entire system needs an overhaul. One solution is assertive community treatments that help those whose mental illness affects their work and social relationships, by giving them the necessary support to excel in every aspect of their lives. In many states, though, assertive community treatments are in jeopardy, due to anything from budget cuts to Medicaid reimbursement, despite the fact that these programs usually pay for themselves. Oliver concludes by saying American needs to figure out how to fund these programs in order to save lives, and “if I remember, there are some politicians who seem to care.” He then jumps back to the clips of Trump, Carson, and Huckabee diverting questions about gun control by suggesting how important it is that we do more for the mentally ill. “Okay, fine, do it then!” cries Oliver, “Because if we’re going to constantly use mentally ill people to dodge conversations about gun control, then the vary least we owe them is a f—ing plan.”

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