She is a mother who murdered her children. She is a poster child for those who seize any symbol to force the reality of motherhood onto public display, right next to the Hallmark cards. She is Exhibit A for death penalty opponents, who add this saga to the growing portfolio of stories that make it too disturbing to remain undisturbed about execution. She is a cover girl, featured by Newsweek in its mass-market exploration of schizophrenia.

Now Yates is a convict, formally sentenced yesterday to life in prison. Through the kaleidoscopic lens of this case, the sentence seems positively pro-forma - merciful, even - because the death chamber was ruled out.

There is still a dirty little secret to the Yates case. She is not alone.

She is among hundreds of thousands of mentally ill people jailed for crimes committed because they are sick and there is, now in America, no place else to put them. And almost no one willing to treat them.

The Justice Department says about 16 percent of those incarcerated by states and localities have some sort of mental illness. Mental health professionals believe this guess is low. It is based on forms filled out by wardens. They do not know how to diagnose mental illness and have an incentive not to. It would put too much pressure on their medical budgets.

"We continue to see people who are treated as if they have behavior problems in prison, when really they are psychotic or have some other mental health problem," said Chuck Ingolia, vice president for research and services of the National Mental Health Association.

There is, in the community of those who know mental health, a word to describe what is happening. "Trans-institutionalization," Ingolia calls it.

This is how they describe what has happened since the 1960s. That is when, in a moment of benevolence, we decided too many mentally ill people were shut up in state mental institutions where conditions, often as not, bordered on the inhumane. There was no reason to shut someone away forever if he or she could be properly treated and live in a setting - a quiet group home - where people could be happier and more productive, even cheaper to care for.

The state hospitals were closed. The community homes, by and large, did not get opened. Too much neighborhood opposition. Too much money was supposed to be spent on them, with too many strings attached, some believed. During the 1980s, federal money that funded community mental health projects got turned into a block grant. It was not increased for a decade, and inflation ate it down to almost nothing.

Then there is the insurance problem. Few policies cover mental illness the same way they cover physical illness. You may be sick, and everybody knows it, but you must do without. The severely mentally ill often have episodes that cause them to lose their jobs, and so they lose their insurance altogether.

Now if you are mentally ill, you can't get insurance coverage and you can't get treated by the state, and so you may be more likely to get care inside prison than outside. We said a generation ago that we wanted to place the mentally ill in the "least restrictive environment." Now we lock them away in the most restrictive.

Most have committed no made-for-TV crime. It's the usual run of vagrancy arrests, petty thefts, vandalism and disturbing-of-the-peace that slams the mentally ill behind bars.

Soon enough, Yates could be joined in infamy by Peter Troy, the Lynbrook man charged with shooting up Our Lady of Peace Roman Catholic Church in the middle of Mass, killing the priest and an elderly worshiper. Troy was every parents' dream until he became every parents' nightmare: An honor-roll student during four years of study at a prestigious high school where he earned college credit; a participant in the academic clubs and the track team. Sometime after graduation, schizophrenia seized him.

Troy's prosecution will set off another round of chatter about whether he is mentally ill or criminally culpable.

But the thing to talk about is not these sensational stories. It's the quieter shame of living in the 21st century and treating the mentally ill as if it were still the 14th.

Copyright © 2002, Newsday, Inc.

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