The Daily News By Peter Provet, Ph.D.
Once again, fear and tragedy strike at New Yorkers. An innocent woman, Tiffany Goldberg, is hit in the head with a slab of concrete, repeating the nightmare that happened to Nicole Barrett late last year.
In the Barrett case, a homeless crack abuser was accused of the attack, and the latest attacker has been described as a resident of a homeless shelter. Drug addiction and/or mental illness also may be variables.
And Andrew Goldstein, a man diagnosed with schizophrenia with a history of homelessness, was convicted of pushing a young woman to her death in front of a subway train earlier last year.
While we are all shocked and saddened by such acts of violence, there is a strong tendency to avoid attempts to understand them. As we empathize with the victims and their families, denial typically takes over – it’s too painful to imagine such events happening to oneself or one’s family.
We must, however, struggle to make sense of that which is most frightening and disturbing in our social world. To do so, we must first recognize that these violent acts are a result of the intersection of some of society’s most compelling and intractable problems: mental illness, substance abuse, homelessness and violence.
While each of these phenomena is highly challenging in and of itself, their combination can overwhelm the best intentions to understand and address them. But some basic principles can assist us:
- There are no simple causal connections among mental illness, substance abuse, homelessness and violence.
- While one may lead to another, random violence is most typically a result of their combination.
- Therefore, to limit such acts of violence, greater resources must be directed toward understanding and preventing manifestations of these intersecting social-psychological conditions.
This must be achieved through a psycho-educational campaign that establishes a context for discussion and intervention based on these principles:
- Mental illness, particularly when it is untreated, often leads to drug abuse as the afflicted try to self-medicate their psychic pain.
- Substance abuse worsens most forms of mental illness, destabilizing the personality, removing inhibitions and mimicking psychotic symptoms (the hearing of voices, increased paranoia, etc.).
- For a substantial portion of the homeless population, the lack of housing is largely a result of these conditions.
- Driven by the fear, confusion, emotional turmoil and deprivation that each of these conditions produces, separately and in combination, individuals can turn to violence that may be random or goal-driven.
There is a solution to this silent syndrome. The New York State Office of Mental Health is expanding the number of residential treatment beds to address the complexities of this population.
One model is called the enhanced therapeutic community. Individuals stay for a year in a residential program that integrates medical, psychiatric, social, psychological and familial treatment.
It is a self-help, peer-driven community based on the values of a work ethic, respect for self and others, honesty, responsibility and compassion.
Once stability is achieved, the individual moves to more independent living arrangements with consistent support.
Recent changes in the state – from Kendra’s Law to the court’s alternative-to-incarceration policy – strengthen our ability to get people who need help into the right program.
While Nicole Barrett and Tiffany Goldberg have survived their attacks, we must transform their pain into a committed search for solutions to this profound, interwoven set of human disorders.