Tackling the Mental Health Crisis (or, there really are no words)

As you know, my blog (and my life’s purpose) is about operating from a place of Love rather than Fear. I try not to get caught up in the downward spiral of current events unless I can offer an educated opinion without succumbing to fear-based rhetoric.

That being said, I feel compelled to write about the latest shooting that occurred one week ago at a small church in Texas – to approach this horrific epidemic from the perspective of a professional school counselor.

My sincere belief is that focusing on gun control alone misses the point, because it doesn’t address the root cause. Don’t get me wrong…I have no heartache with adding additional common sense legislation, like some of the ideas suggested by Nicholas Kristof in this recent NYT opinion piece (although it would be helpful if we enforced the laws we already have). In fact, I think smart guns – those that require a fingerprint to operate, for example – could be an effective way to reduce some suicides, prevent gun accidents involving children, and thwart gun thieves.

Nevertheless, the fact remains that we have a severe mental health crisis in our country, and instead of addressing it, we fixate on the red herring of gun control. Not only are we not taking active steps to stem the tide of mental illness, we deliberately defund programs, limit parents’ rights, and make it increasingly difficult for the mentally ill to receive appropriate treatment.

Now, I understand that there are millions of Americans who experience mental illness each year (1 in 5, according to the National Alliance of Mental Illness), and the vast majority do not engage in acts of violence. Nevertheless, one would be hard-pressed to argue that a mass murderer doesn’t suffer from some type of mental illness. Mentally stable folks don’t intentionally kill people.

After the Sandy Hook shooting, the immediate outcry was for stricter gun control, quickly followed by intense blame leveled against Adam Lanza’s mother, who was called an enabler, presumably because she didn’t do enough to prevent the inevitable. In a shocking and heart-wrenching blog post written in response to the events at Sandy Hook, Liza Long shares the struggle she faces in raising her 13-year-old, mentally ill son and pleads for better mental health services:

A few weeks ago, Michael pulled a knife and threatened to kill me and then himself after I asked him to return his overdue library books. His 7 and 9 year old siblings knew the safety plan—they ran to the car and locked the doors before I even asked them to. I managed to get the knife from Michael, then methodically collected all the sharp objects in the house into a single Tupperware container that now travels with me. Through it all, he continued to scream insults at me and threaten to kill or hurt me. 

That episode ended with her son being strong-armed into an ambulance and driven to the ER. Since there were no beds available in the mental hospital, he was released with a prescription and an appointment for a psychiatric follow up. Sadly, these stories are not uncommon.

The first nail in the mental-illness-treatment coffin was the closure of government-funded, state psychiatric facilities in the 1970’s, which were not replaced by community care. This action immediately deposited huge numbers of patients onto the streets. After the onset of the managed care system in the 1990’s, insurance companies contributed to the lack of funding and reduced services for the mentally ill. Hospital stays, for those lucky enough to receive one, were cut from 10-15 days to 4-5, forcing physicians to rely primarily on medication and outpatient treatment. Naturally, folks without insurance have even fewer options.

The Journal of the American Medical Association reported that, as of December, 2016, there were only “twenty-two psychiatric beds for every 100,000 people in the US, [compared] to Germany, which has 127 beds per 100,000; Switzerland with 91 beds; and France with 87 beds per 100,000” (Sacramento Bee). Not surprisingly, JAMA also reported that as the number of beds dropped, suicide rates increased.

Treating mental illness in children is extremely difficult. From my own experience, I can tell you that there are very few child psychiatrists, and even when a family is fortunate enough to find one that accepts new patients, treatment is long and arduous. Medication is often necessary to stabilize those with severe disorders, but a child’s growing body and changing hormones makes it challenging to monitor. Parents must be committed to the process, as it can take many visits and medication changes. Moreover, unless the parent has an extremely flexible employer, the time requirements can take a toll on employability and income. Therefore, many youngsters don’t receive the therapeutic consistency vital to their improvement

Without effective treatment, once these children grow up a good number of them wind up on the streets where they languish until they commit a crime. Then they become society’s problem. “A 2006 U.S. Department of Justice study found that three out of four female inmates in state prisons, 64% of all people in jail, 56% of all state prison inmates and 45% of people in federal prison have symptoms or a history of mental disorder.” In fact, the mentally ill are more likely to receive services in prison – at taxpayer expense – than out.

Trying to get a loved one off the street and into treatment isn’t for the faint of heart. Involuntary commitment laws vary by state, and the process is complex. The family must demonstrate that the individual is a danger to him/herself or the public, which is tough to prove.

The other option invokes the power of parens patriae. This doctrine allows the state to intervene in a person’s best interest, particularly with regard to children, the elderly, or the intellectually disabled. However, courts are reluctant to use this power in cases of mental illness due to the risk of violating the individual’s civil rights. In one extreme case, the Civil Liberties Union argued that a homeless, mentally ill, psychotic woman did not pose a threat to herself, because eating her own feces could not kill her. Since there was no imminent danger, there was no justification to usurp her rights.

It is within this broken system that family members struggle to save their loved ones. As we fight the health care battle on Capitol Hill, let us not forget to lobby for mental health resources. We must end the stigma of mental illness! Disorders of the brain are no less worthy of proper treatment than disorders of the body. We simply can’t afford to keep turning a blind eye to this epidemic, sitting back while the very fabric of our society is torn apart. Our indifference is killing us.

For more information on the statistics related to the crisis of mental illness, The Treatment Advocacy Center operates an informative website that offers state-specific mental illness data, including the number of mentally ill, the number of beds, and the number of mentally ill prison inmates.