There’s an old saying that “the road to hell is paved with good intentions.” In America, one could argue that the road to progress is paved with good intentions. Over the last century or more, this nation has achieved incredible progress, both in terms of industrial growth and technological innovation and in terms of the broadening of liberty and equality. But progress in some areas has led to a decline in others. As a society, we have been so focused on the slabs of the road—improving on their construction, developing new materials to enhance their strength and durability, increasing their accessibility—that we have failed to notice how the gaps between the slabs have widened. They are less connected. We are less connected. As a result, more and more of our fellows—often the most vulnerable among us—are slipping through the gaps. What Faustian bargain have we made?

From the Los Angeles Times:

Mental illness and the price of ‘free will’

THE PHONE RANG at 3 a.m. “Dr. Partovi,” the person on the line said, “I’m calling to let you know that William expired this morning.”

I’d first met William about six months earlier in May 2006 at the Venice Family Clinic after his release from a hospital where he was treated for congestive heart failure. I still remember his loud, childlike voice: “No, no … I’m not going to the hospital!” he shrieked when I told him that I wanted to refer him to Harbor-UCLA’s cardiology clinic.

William — I’m calling him that because medical privacy rules don’t allow me to use his real name — was 61. Six feet tall with gray hair, he dressed in T-shirts and pants that were a little too big. He lived alone in an apartment in Brentwood and had a sister in Canada and a niece in New Jersey.

Three years earlier, he’d had a heart attack and a stroke, and he now suffered from dementia, likely as a result of the stroke. It was quickly obvious to me that William could not take care of himself anymore. He spoke like a whining toddler. He was very stubborn, and his judgment was extremely limited. “My memory’s not good,” he’d huff if he couldn’t answer a question.

But one’s inability to care for oneself is not a criterion to receive involuntary treatment for the mentally impaired. And for many mentally impaired people without family nearby to rely on for housing, food and help in managing their medical care, the result can be disastrous.

A recent study of adults with serious mental illness who were treated in eight states’ public hospitals and clinics found that they died, on average, at age 51 — 25 years younger than the average American. The study’s lead author, Dr. Joseph Parks, director of psychiatric services for the Missouri Department of Mental Health, said that about three out of five died of preventable diseases. [full text]