I watched the movie The Soloist recently on the small screen while on a plane to Vancouver. The movie is based on the real life story of Nathaniel Ayers, a schizophrenic street musician in Los Angeles. In the 1970s, Mr. Ayers was forced to drop out of the prestigious Julliard School in NYC because of his schizophrenia. A journalist from The Los Angeles Times, Steve Lopez, noticed him one day and took an interest in his case.

Movies are always better viewed large, not on a small screen and not on a plane. It was hard to see what was going on. The scenes from the movie were pretty murky, the mentally ill shuffling past the viewer in an endless night of rotting humanity.

Two things from the movie struck me about the treatment of the mentally ill. It was clear to me that the clues were right there in the open about how to help someone, yet nobody was following through.

Clue number one. The doctor, at least I think he was a doctor, named David, at whatever that building was where the mentally ill were milling around, said to the journalist, “just be his friend.” Then he said something about friendship changing the brain chemistry. Key concept. Not practiced apparently in or near David’s building.

An institution is no substitute for friendship. Where was Ayers to get that kind of friend? It appears that Nathaniel Ayer’s family was not in contact with him while he was on the streets, so they were not there to provide this needed friendship. And, hanging around other mentally ill patients for long stretches doesn’t help people get better, it only reinforces their isolation. You need to hang around with people you care about and who care about you. An institution could, in theory, design a more caring program, by emphasizing more one-on-one interaction between patient and staff. All treatment programs should recognize the importance of a caring family. But families need help to continue to be caring in very trying circumstances.

Clue number 2. This is so obvious you would wonder why it isn’t being done on a large scale. Nathaniel Ayers was, once upon a time, a promising musician. He does well when he is playing his instrument or listening to music. Music also changes brain biochemistry, but why isn’t this rather obvious thing being factored into a treatment program? In one scene Ayers plays his instrument to an assorted throng of the mentally ill and they are enraptured by it, proving that everybody benefits from music, not just the musically gifted. I am more than just a little put out to read that the foundation started in Nathaniel Ayers’s name discriminates between the “artistically gifted” schizophrenic and those who are not. Let’s hope a client doesn’t get dropped from getting further help if it is learned that he or she is merely creatively average.

The idea to encourage Mr. Ayers’ skill appeared to come from the journalist and not from the insitution. Whatever that institution was doing, it sure wasn’t doing it for its clients. They continued, en masse, to be mentally ill.