Category: Mental Health

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Conservative columnist Heather MacDonald recently bemoaned the mentally ill people roaming the streets of our city. She describes the failure of civil institutions to protect regular people from these people. Texas Republican Governor Abbott thinks that better mental health care is the solution to mass casualty shootings plaguing his state. Mental Health is the solution to these twin social ills the country is facing.

Better Mental Health certainly would help. The problem is what exactly are the solutions these Mental Health critics offering to meet these problems. Where will these mentally ill people be housed? Who will pay for their housing and medical care? How will their legal rights be protected? How do we identify the mentally ill? What will be the standard for involuntary institutionalization? These all call for the expansion of government oversight and infrastructure. They also all cost money.

How does this happen given the Conservative and Republican distaste for government regulation and taxes? Would they support an increase in taxes to insure that the mentally ill had suitable housing and healthcare? Would they support the psychological testing of gun buyers to determine if they have violent psychological problems? If protecting citizens is the goal, how much money are they willing to spend to achieve this goal? How do they propose protecting citizens from the criminally insane without a massive expansion of mental health and judicial systems? Prisons are not mental health clinics, putting the criminally insane into prisons

It is all well and good to point the finger at the mental health crisis but what are the mental health solutions? There are a lot of unanswered questions. Until these critics provide proposals to address these questions, their criticism is just loud noise to distract from the emptiness of their vision. They have absolutely nothing to offer that will solve these problems.

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The CDC found that over 50% of all Americans will at some point in their life be diagnosed with a mental health disorder, that 1 in 5 Americans will have a mental health disorder within a given year. A recent study from Indiana University found that 45 % of all emergency room patients are also suffering from mental health issues.These are large and significant numbers of people who need help. These are people falling into drug addiction and alcoholism. These are people who might snap and take a loaded gun into a shopping mall. Because mental health diseases are so widespread, almost ever American is affected by them. If these were physical ailments, alarms would be blaring across the country.

A yearly physical check-up is routine for most Americans — particularly after you have reached age 40. The check up is done whether the person is feeling healthy or sick. The yearly check up allows a doctor to evaluate what is going with the patient from year to year in the hopes of catching and treating hidden diseases earlier than waiting until the patient develops full blown symptoms.

Mental health, on the other hand, is almost always a reactive action. The person breaks down and his condition, now obvious, has to be addressed. This is hardly an effective approach. Early treatment is a better, cheaper and less toxic approach. Why wait until the person has mentally fallen apart when, if the person had periodic psychiatric check ups, any mental health issues can be addressed before a person has hit bottom.

Working with young people is a great place to start such a practice as mental illness often emerges after adolescence. It is also during people’s youth that they are free from parental control and are experimenting for the first time with alcohol and drugs. These illnesses and addictions would be found earlier and hopefully addressed before irreparable damage is done to the person. One of the reoccurring horrors of American life is mass shootings. Every time these shootings happen, people ask the question — what can we do to stop this from happening ? Since gun control is off the table, why not require universal mental health checks for every American — particularly young men who are most prone to these crimes. If mental health is the problem, then we need a mental health solution. A mental health check up fits the bill.

A lot of people still believe old ideas about mental health. It is a personal weakness not a disease. They claim that people didn’t need mental health professionals in the good old days. People were stronger. They just toughed it out. None of which is true. There is absolutely no evidence that people were tougher or stronger in the good old days. First, nobody measured it in the good old days so there is no way to prove this assertion. Also families hid away their problem members if they could so Grandmother never talked about crazy Aunt Alice. There is no better example of the widespread addiction problem in the USA in the good old days than Prohibition. The level of alcoholism was so bad that Americans actually banned alcohol consumption. The good old days weren’t so free from mental health diseases and addiction.

The good old days were free from effective treatment of these disorders. And this is why it is time for Americans to move away from the shame model of mental illness and go to the proactive treatment of mental illness. Nobody wants to be sick from cancer, the same thing applies to mental health. Nobody wants it. It is a horrible experience. Once of the principal reasons that cancer survivability has dramatically improved in the last century is medical professionals are now monitoring their patients and catching it faster. Why not try the same approach with mental illness?

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I think this is a fair question.

If more restrictive gun laws are impossible to obtain in the present political environment, which is about the only thing everyone can agree to, maybe we can get better mental health care instead. Since many Republicans describe mass killings as a mental health problem, let them prove their concern with better and easier to afford mental health care. Now I don’t buy that gun violence is just a mental health problem but I do agree that anyone who goes into a school and kills 4th graders has a mental health problem.

What causes young men to become a mass killer? Is there anything we as a society can do to stop them? Yes, if we can, ban the type of guns that allow this type of carnage to happen. But there is also a point to addressing the mental health issues that prompt these massacres. These men still are potentially dangerous to others and themselves, if possible, they should be dealt with before they do something horrible.

I don’t understand mass killers. I don’t think anyone does. This isn’t a jealous husband who breaks from the news of his wife’s infidelity. It isn’t a greedy child knocking off his parents because he can no longer wait for them to die to get his inheritance. But to kill a stranger for no particular reason other they are in the class room the killer decided to invade that day, is baffling and frightening. And, most importantly, it is a mental health concern. If there is a way to stop these men before they snap, then we should try to identify them and prevent them from moving forward with their mad plans.

This obviously means that the present mental health system is failing to stop mass killers. The painful truth is American mental health is almost exclusively reactive — we wait until someone breaks before addressing mental health issues. Then we collect the pieces and, if there is enough of a person still there, we work on putting them together again.

A reactive mental health approach is never going to stop mass killers. We would have to take a proactive approach to mental health something are system is in no way prepared to do. Our legal system and our mental health care system would need to be overhauled considerably in order to stop these young men before they begin to shoot. We would have to be able to assess people, take control of their lives and let them know their future freedom is contingent on them changing their behavior. In order to do this, we would also need a place to house our potential killers, drugs and therapy to help change their behavior, and professionals to take on this task of managing the person’s mental health.

This is an enormous and costly task. But, given the array of mental health issues our country face besides mass killings — drug abuse, alcoholism, homelessness, spousal abuse to name a few, the cost would be worth it in numerous ways — less time off from work, less suicide, less emergency room visits, less homeless people in public spaces and, of course, less mass killings.

Therein lies the problem. Money. We are always looking at the costs of doing something right and saying it is too expansive. We can’t afford it. Imagine all the money that Ulvade cost — all of the police resources, emergency room resources, an entire school suddenly unusable, grief stricken parents unable to work, tearing school down because nobody wants to use it, building a new school to replace the torn down school, health care for the wounded who survived, the funeral expenses, and the psychiatric care for the teachers, students and parents. Some Republicans are advocating “hardening” of the schools in order to make it more difficult for mass killers to attack. This would mean that every school in the United States would have to be physically altered. Think of all of those costs and then figure the costs of better mental health care and see which would be cheaper.

The important thing here is that some Republicans are identifying mass killings as a mental health problem. If they are identifying this as a problem, they also need to provide a mental health solution. They can’t say that mental health is a problem and do nothing about it. They are on the hook for at least a discussion of how to get better mental health so these killings don’t happen. Perhaps we can get better mental health care for everyone in the process. It may not be the answer some of us are looking for but something worthwhile could potentially come out of this.

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I am willing to bite. It doesn’t take a lot of effort for me to believe that anyone willing to go into a school (or store or movie theater or church or any place where large number of people congregate) and shoot strangers has a mental health issue. Republicans are keen on saying it isn’t the gun that is the problem but the person shooting the gun. OK. Fine. What is the mental health solution then?

It gets irritating to hear this response when that person is also unwilling to provide any details on how to make it easier for people to get mental health treatment. Speaking as someone who has been using mental health for some thirty years, I can tell you it isn’t easy. First you absolutely have to have insurance or money. If you don’t have either, you need to apply for some form of assistance — which, unless you are destitute, can be difficult to qualify for. Then, if you do have insurance, there is finding a health care professional that takes your insurance. Sometimes they do, sometimes they don’t. Sometimes if they do, they only take a limited number of patients who use your insurance. It takes a bit of an effort to come up with a mental health professional to treat you.

Now image yourself in a healthcare crisis having to jump through all these hoops before you can get help. A struggling person is given another struggle to deal with. So, then, how are you going to make make mental health easier to get and less expensive. Oh, and this will cost money. Who exactly is going to pay?

Then there is getting the young man to mental health care. Men are notoriously bad about seeking mental health. They see a stigma associated with it. This means someone is going to have to get scared enough to turn them in or try to convince them to get help. This is where things get hairy. How do you balance the rights of the man with the fears of parents or teachers or friends? Do we have laws that make it even possible? Laws will have to be looked at and changed. What do we do with the young men who are truly dangerous? Do we have institutions to house these young men? And, the all important question, who exactly is going to pay for the process of evaluation and institutionalization? Because you know all this is going to cost money.

When you say it is a mental health problem and offer no way to make mental health more accessible and cheaper, your response is unserious. You are letting yourself off the hook. Mad men are the problem, not guns. OK, so what are you going to do about the mad men? The present system has obviously failed us and needs to be improved in order to catch them. And, by the way, it is going to cost money.

Which, if you ask me, is the real problem here. Republicans can throw that out mental health as a solution after every mass shooting because they are betting that no one will ever call them on how this is done. Which says a lot about both the Republicans and what they think about the American public.