Controversy arises over report on mentally ill people in public libraries

From The Library Journal:

Does a new survey released in the March/April edition of Public Libraries, the journal of the Public Library Association, indicate that “[p]eople with untreated severe mental illnesses may pose a greater risk to the future of America’s public libraries than does the invention of the Internet”?

Not exactly, but that’s the eye-catching lead from a press release issued by the Arlington, VA-based Treatment Advocacy Center (TAC), where two of the three study authors work and which is somewhat controversial in the mental health field for its stance promoting involuntary treatment of the severely mentally ill.

The line in the press release relies not on statistically significant responses but on a quote from a single respondent to the survey, the director of a public library in a small city, who said, according to the article, “This problem, not the invention of the Internet, could prove to be the final demise of the public library as we know it.”

Press release vs. articleThe article, headlined “Problems Associated with Mentally Ill Individuals in Public Libraries" (PDF) offers significant details about the design of the survey and the responses to an issue that librarians, notably former Salt Lake City Public Library deputy director Chip Ward, have been raising publicly. (Here’s a 5/28/08 LJ Q&A with Ward, who is also cited in the article.)

However, because the article was not initially online the public discussion among mental health advocates and librarians first came in response to TAC’s press statements, which to some degree overstate the results.

TAC, for example, stated that a the survey of “1300 public libraries found that 9 out of 10 library staff members said that patrons with a mental illness have disturbed or affected the use of the library by other people, with an almost equal number (85 percent) saying they have had to call the police as a result.”

“Our nation’s libraries are turning into daytime shelters for people with severe mental illness who need to be in treatment,” said lead study author E. Fuller Torrey, in the press release.

The article, however, indicates that a mailing list of 1300 public library supervisors was obtained from the American Library Association. From the list, 301 librarians were selected for the survey; 124 responded.

They were asked specifically whether there were more patrons who appear to have serious psychiatric disorders (a few = 35%; a lot= 23%), whether such patrons use a disproportionate amount of staff time and resources (61%), and whether they had to change any rules because of apparently mentally ill persons (34%), among other questions. Serious psychiatric disorders were defined as “individuals who appear to be talking to themselves (hearing voices) and/or behaving or talking in a very strange manner.”

As for disturbing or affecting the use of libraries, the most commonly cited behaviors were such things as being “loud and disruptive” and “shouting and oftentimes it is quite profane.” Next on the list were “offensive odors” and “hygiene.” The article continued by noting that “other disturbing behavior clearly associated with psychiatric illness included ‘stares at people fixedly’ and ‘talks to other voices in his head.’”

A TAC statement concluded that the “real culprit is the lack of available treatment for people with mental illness.” The article notes that most mentally ill individuals “are no more disruptive or dangerous than anyone else” but says approximately ten percent of individuals with severe psychiatric disorders may cause major problems in the library. Potential solutions include educating the staff, having consistent rules, and identifying problematic individuals. The article also recommends that libraries avail themselves of TAC’s resources.

The debateLiz Spikol, executive editor of Philadelphia Weekly, writes regularly about her struggle with mental illness; she criticized the study (based on the press release), questioning whether library employees were qualified to determine who has serious psychiatric disorders. “But the study isn’t about sympathizing with people with mental illness,” she wrote. “It’s about making them look like freaks.”

Librarian Michael Golrick responded on Spikol’s blog, “Clearly, you have never spent large amounts of time in a large urban library — I have, I have been responsible for running one. Most librarians are very forgiving if you respect the rules which are there to allow *ALL* to use the taxpayer provided services.”

A former library worker named Erin gave some broader perspective: “I used to work in a public library and certainly we had a number of patrons who exhibited symptoms of various mental and physical health conditions. Was this uncomfortable for some other patrons or staff? Sure.

But there’s no law against being uncomfortable in a social situation…. Patrons who actually violated rules (after reasonable accommodation) are another kettle of fish entirely. Some folks who exhibited symptoms and plenty of folks who didn’t exhibit symptoms were asked to leave because of behavior that made the library unsafe or unproductive.”