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The Decades Long Mental Health Crisis in America

Our health affects one another.  Whether it is because you can carry a disease or illness that can transfer to another person or vice versa in every day circumstances, or whether you work in a field where your health might affect the health and well being of others (e.i. food service), or whether you are in a field where being physically unwell might cause you to increase the risk to others’ lives such as being an airline pilot or truck driver.

Add to this the myriad ways that our health affects our lives and the lives of those around us… and then multiply that by adding our mental health.

The mental healthcare system in the US has been in crisis for decades and apparently this has worsened by a lack of investment, attention, and evolution in the field of psychology/mental health and the systems used to provide care as well as continuing education to support the evolution of these systems,… but it also has worsened during the financial crisis as states faced tight budgets.

Consider that not only has poor mental health played a role in the recent tragedy in Connecticut taking the lives of so many very young children but it plays a role in homelessness, unemployment, and in need for state and federal aid.

And then add the cultural stigma that looks at mental illness or those that do pursue mental health as a weakness, a taboo, or a character flaw. 

We are in a mental health crisis in this country.  Pretending that the recent tragedy would be prevented just by passing new gun laws is naïve.  We know better but it seems easier to do that, than to address mental illness in this country.

From the Nami site:

“State Mental Health Cuts: A National Crisis

The recent tragic shooting of Congresswoman Gabrielle Giffords and the killing of six innocent citizens in Arizona focused national attention on the state of the public mental health system in Arizona and other states. Many asked how a tragedy like this could happen again, with chilling references to Virginia Tech. How did Jared Loughner fall through the cracks when the signs of a serious psychiatric crisis seemed so clear?

For NAMI, the National Alliance on Mental Illness, what happened in Tucson is all too familiar. Even during the best of economic times, youth and adults living with mental illness struggle to access essential mental health services and supports. Services are often unavailable or inaccessible for those who need them the most.

One in 17 people in America lives with a serious mental illnesses such as schizophrenia, major depression, or bipolar disorder.1 About one in 10 children live with a serious mental disorder.2

In recent years, the worst recession in the U.S. since the Great Depression has dramatically impacted an already inadequate public mental health system. From 2009 to 2011, massive cuts to non-Medicaid state mental health spending totaled nearly $1.6 billion dollars. And, deeper cuts are projected in 2011 and 2012. States have cut vital services for tens of thousands of youth and adults living with the most serious mental illness. These services include community and hospital based psychiatric care, housing and access to medications.”

(http://www.nami.org/ContentManagement/ContentDisplay.cfm?ContentFileID=126233)

I was trying to think of where I had seen ‘any’ leadership on this issue.  Rosalynn Carter who wrote her book  ‘Within Our Reach, Ending The Mental Health Crisis’ was the only public person I could find.

From a Q&A she did recently in Time Magazine:

‘You write that in the U.S. more lives are lost to suicide than homicide. Is there more that could be done in the field of suicide prevention?

Absolutely. One hundred people commit suicide every day in our country. 10 are children. The mental health system has failed them. Look at depression, which is one of the easiest [mental health] problems to treat. If you look at suicides, most of them are connected to depression. And the mental health system just fails them. It's so sad. We know what to do. We just don't do it. And the stigma contributes to that because people don't go to see a mental health professional because they don't want to be labeled as mentally ill. ‘

Here is the link to this great Q&A: http://www.time.com/time/health/article/0,8599,1987385,00.html

There is the added problem that what is offered by our mental healthcare system when care is provided is often very inadequate as there has been too little investment and attention to support the system in evolving and attracting quality people and innovation in techniques and treatment other than through medications to a great extent.

For me what I will focus in the wake of the CT tragedy is that we are in the midst of a very long and very much ignored mental health crisis in the US.  It reveals itself in our politics, and every aspect of our lives.  We are all connected and we affect each other constantly.  We cannot afford to pretend that this tragedy was just about the need for better gun laws (as much as I would be happy to have those).  We must demand attention to mental health and fight to remove the stigma and shame from having and seeking to treat mental illness. 

If we care about each other and our children, if we want to leave the world better than we found it, we must address the mental health crisis that has too long been allowed to fester.

For a tiny bit of good news in this area here is another quote from the Q&A with Rosalynn Carter:

"Now that you've mentioned the political, what are the ramifications of the new health care law.

It's very, very helpful. The basic health plan includes mental health and substance abuse services. So that's really good. It makes mental health professionals — and training mental health professionals — a priority. I'm really pleased. It doesn't do everything that I would like it to do but it's a great step forward."

 

 

NAMI is a very interesting site. At one point they linked to a documentary on three young people living with Schizophrenia, and it was fascinating. One of the guys lived on and off with his mom and it seemed like a draining and potentially dangerous situation. I haven't been able to find the documentary again, though.

Yes I had my own experience with this and I could easily see myself or my daughter having been killed if the person ever had access to a gun.

Addressing the mental illness issue means a lot of money needs to be spent at a time when all people are talking about is cutting the budget of everything.  At some point people need to acknowledge that if they do everything they can to prevent the next Newtown, they will need to give more in taxes.  Got to put the money where the mouth is. 

Around the beginning of the 90s, I worked in the mental health field helping transition primarily schizophrenics from the state hospital to less restrictive environments.  Interesting work to say the least. 

It about that time that the cut backs in my state really took hold.  Some of the case managers I knew who were working with clients who not in any institutional setting (many of them homeless) had as many as 45 people on the case load.  Considering it sometimes took a single day just to locate one client (since many were homeless), they were lucky to meet with their clients once a month for maybe a hour. 

And that was just the beginning as fewer and fewer dollars were allocated to deal with the problem.

I agree that a lot of money/resources need to be allocated to this but if we want to be honest about what is behind so many of our societies challenges, including the recent tragedy in CT, it is essential that we stop ignoring the reality of just how negligent, outdated, and stretched thin our mental health care systems are.  We truly are in an extreme mental health crisis that has worsened over decades. 

i can't remember his name, but there was a guy on fox news a few days ago who put it best.  yes fox news. and his blame went on who? the insurance companies.  they didn't want to pay for the people who had the expertise to diagnose potential shooters.  no they would only pay for interns who couldn't tell a sociopath from a hole in the wall.

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