We need to talk about mental health care. Mental illness. Emotional distress. Mental distress.
Whatever you want to call it, it has to be the #1 topic for all of us until we’ve arrived at a workable plan that helps those who need mental health care to get it, to get better, and to move on with their lives.
Doubt that this is a public health emergency? You’re a fool, or you live on another planet. Unless you’ve been hiding in a cave since last Thursday, you’ve seen wall to wall coverage of the Sandy Hook Elementary shootings in Newtown, Connecticut that took place on Friday morning. The young man who’s been identified as the shooter, Adam Lanza, has been reported variously as a loner, withdrawn, weird. We’ll never know definitively what made him shoot his way into an elementary school, and kill 20 children along with several teachers, because he also shot himself. And he shot his mother before heading to the school, so we can’t ask her, either.
In the aftermath of Lanza’s actions, there is a rising call for stiffer gun laws to prevent mass shootings from occurring – a great idea, and one that I support. However, there’s a more important step we really need to take, one that carries more weight than gun control when wrestling with the issue of violence in our communities. We must finally recognize that mental illness is part of the human condition, and take steps to make mental health care easily available to anyone who needs it. We also need to make sure that involuntary committal is part of the program, in a way that protects the rights of the individual as well as the rights of the community.
I see the biggest barriers to effective treatment as these:
- Stigma: If you seek mental health services, you’re labeled. I’m not just talking about hearing-voices, full-bore psychotic-break-type help. If you suffer from chronic depression, and seek treatment, you might not get hired the next time you’re in the job market. For families who are struggling to help a kid with emotional issues, this is a double whammy. They lose social connections due to the kid’s behavior, and can wind up having to call the cops on their kid to access real help. And the kid winds up with a juvenile record, or a criminal record if they’re over 18.
- Cost: Even if you’re lucky enough to have good health insurance coverage, it won’t cover much in the way of mental health treatment. This explains why so much of that treatment is based on pharmacology, since insurance covers medication pretty comprehensively. Therapy that isn’t meds-based winds up an out-of-pocket expense for the patient, which prevents many from seeking treatment in the first place, even if they’ve made it past the fear of stigma. Spend thousands, get a permanent social stigma. That sure sounds like a win, right?
- Access: Figuring out where to go for help isn’t easy. If you have a fever, or a broken leg, it’s easy to figure out where to go to get treated. If you’re dealing with mental-distress symptoms, how do you manage those symptoms and navigate your way to effective treatment? Geography can dictate access, and many states have slashed mental-health services as budgets have been squeezed in the recession. Unless, of course, your family calls the cops on you. Then you can get help courtesy of the jail/prison system, which is now the biggest dispenser of mental health services in the US.
If we don’t talk about this as a critical public health issue, NOW, we’ll be wringing our hands over another mass shooting soon. Sure, let’s make high-capacity mags illegal. But we need to talk about mental health, too.