Here we are again, talking about another unspeakable and terrible tragedy involving a mass shooting when Elliott Rodger killed six people and himself, using a gun, a knife and his BMW as weapons. He was 22. There have been 154 school shooting since Columbine, with 37 in 2014 (so far). This came all to close to home when a few months ago, one student was killed at Purdue and we thought it "could never happen here". Elliott Rodger was being treated for mental illness, and his family new his state of mind was deteriorating and he was getting worse when one of his therapists called the family to check on his well being. Was he taking his medication? As an adult he couldn't be forced to be compliant with his treatment plan. Police actually checked on him and found him to be compliant and "meek and polite" and not fitting the criteria for needing involuntary commitment. Rodger even wrote in his journal that he was concerned he had been found out and he wouldn't be able to exact revenge on his victims because he would be in jail. He had legally purchased all of his guns and ammunition, passing the background check. So what went wrong? Should someone with a mental illness be committed involuntarily? If law enforcement had felt Elliott Rodger didn't meet the criteria for involuntary commitment but still sensed something was wrong, could this tragedy have been prevented?
The following is an article from CNN regarding the divide over involuntary mental health treatment, written by Kirk Siegler.
The attacks near the University of California, Santa Barbara, are renewing focus on programs aimed at requiring treatment for people who are mentally ill as a way to prevent mass shootings and other violence.
In California, a 2002 law allows authorities to require outpatient mental health care for people who have been refusing it. Proponents argue that this kind of intervention could prevent violent acts.
But counties within the state have been slow to adopt the legislation, and mental health professionals are divided over its effects.
Do Family And Friends Know Best?
The story behind Laura's Law begins in 2001. In rural Nevada County, near Lake Tahoe, 19-year-old Laura Wilcox was shot and killed by a 41-year-old man with a history of mental illness. He had walked into the county's behavioral health center and opened fire.
Tom Anderson was the county's chief public defender at the time and represented the gunman in court. He recalls that the man's family had tried to alert mental health officials numerous times before the shooting.
"[Officials] were declaiming privacy issues and stuff and wouldn't communicate with the family," Anderson says. "He ... started amassing guns and setting up booby traps around his house, and he had this psychosis of he was going to be attacked any minute."
Now Nevada County's presiding judge, Anderson is also a vocal advocate for Laura's Law, which was passed by the state Legislature in 2002. The law allows counties to compel outpatient treatment for people whose family or friends are concerned about their mental state. It's seen as an intermediate step before someone is forced into inpatient psychiatric care.
Anderson says this tool could be one way to prevent future violent incidents, including mass shootings. And, he says, the patients often respond positively.
"The beauty of the program — the wonderment of it to me — is that roughly about 60 percent of the people that they do outreach to, where they go out to intervene after a person has been referred, voluntarily accept services at that time," he says.
A Question Of Rights
So far, only two California counties — Nevada County and Orange County — have gone forward with implementing Laura's Law. And the state hasn't allocated any funding to it.
The legislation is controversial. There are concerns that involuntary treatment could make mentally ill people vulnerable to civil rights abuses.
"You do have to be conscious that even though these people are mentally ill, they do have rights," says Steve Pitman, board president of the Orange County chapter of the National Alliance on Mental Illness.
"The problem in so many of these cases is that when they're interviewed to see if they meet those kind of threshold requirements, they don't give off any signals of being a danger to themselves or others," Pitman says. "Somebody who's experienced in these kinds of things knows all the right answers to give. They don't want to go to the hospital, so they say all the right things."
That scenario echoes Elliot Rodger's alleged behavior prior to the Santa Barbara incident, in which he allegedly killed six people, then himself.
But Pitman and others are cautious about linking policy changes like Laura's Law too closely to recent mass shootings. For one thing, they say, intervention cases that fall under Laura's Law may take weeks, if not months, to fully implement. And that may be too late.
"I simply don't think that involuntary commitments are going to be an effective tool toward stemming mass shootings," says Jeff Deeney, a social worker in Philadelphia who writes about mental health for The Atlantic.
"I think what we don't have that people want so desperately is the program that stops nonviolent non-offenders from committing their first violent crime because of a mental illness," he says.
Deeney wants to see the conversation shift away from involuntary treatment programs like Laura's Law and toward preventive measures at high schools and college campuses.
For those of us who work in mental health and substance abuse related fields, it can seem sometimes that despite our best efforts, rates of substance abuse and mental illness are overwhelming. But as we know, change takes time and we may not see immediate results of our efforts. But take heart! This newly released report from SAMHSA indicates that we are making progress, especially with our young people. We still have a lot of work to do, but our efforts to prevent and reduce substance abuse are paying off in healthier kids, adults, and communities. Read the brief synopsis of the report below or go to http://www.samhsa.gov for the full report.
"The nation has a long way to go in battling mental health and substance abuse problems, but a new compilation of nationwide and state-by-state trends shows some signs of progress.
For example, fewer teens are smoking and fewer teens and young adults are abusing prescription painkillers, according to a report released Friday by the Substance Abuse and Mental Health Services Administration (SAMHSA).
The report, called the National Behavioral Health Barometer, gathers together data from Medicare and from previously released surveys conducted by SAMHSA, the Centers for Disease Control and Prevention and the National Institute on Drug Abuse. Separate state barometer reports also are available at the SAMHSA website. The reports provide snapshots that will be updated as new trends evolve, the agency says.
Some highlights from the 32-page national report:
• 6.6% of teens smoked cigarettes in 2012, down from 9.2% in 2008
• 8.7% of teens and 9.8% of young adults abused prescription painkillers in 2011, down from 9.2% of teens and 12% of young adults in 2007.
• 9.5% of teens used any illicit drug in 2012, about the same as in 2008.
• 9.1% of teens suffered from major depression in 2012, up from 8.3% in 2008. Only a third got treatment in both 2008 and 2012.
• 62.9% of adults with serious mental illness got any mental health treatment in 2012, about the same as in 2008.
• 1.25 million people were enrolled in substance use treatment in a single-day count conducted in 2012, up from 1.19 million in 2008."
Long-awaited improvements in insurance coverage for mental conditions and addictions are expected to become more widely available this year as a result of two major steps that the Obama administration has taken.
The president’s signature Affordable Care Act includes mental health care and substance abuse treatment among its 10 “essential” benefits, which means plans sold on the public health care exchanges must include coverage.
In addition, rules to fully carry out an older law — the Mental Health Parity and Addiction Equity Act of 2008 — were issued in November, after a long delay. The parity law says that when health insurance plans provide coverage for mental ailments, it must be comparable to coverage for physical ailments. For instance, plans cannot set higher deductibles or charge higher co-payments for mental health visits than for medical visits, and cannot set more restrictive limits on the number of visits allowed.
The new parity rules apply to most health plans and are effective beginning July 1, although many plans will not have to comply until January of next year.
While many plans are already complying with certain aspects of parity, the final rules fill in gaps about how the law must be applied, advocates say. For instance, plans cannot limit mental health care to a specific geographic region, if they do not do so for physical illnesses. And the rules clarify that the law also applies to “intermediate” treatment options for mental health and addiction disorders, like residential treatment or intensive outpatient therapy.
Insurance plans also must be consistent when deciding whether treatment for physical or mental ailments is medically necessary, and they cannot make getting prior-approval for inpatient mental health treatment more difficult than that for admission to an acute care hospital, said Andrew Sperling, director of federal legislative advocacy at the National Alliance on Mental Illness. They must also let patients and doctors know what criteria are used to make those decisions, which can be helpful if coverage is denied and a patient wants to file an appeal.
In the past, when health plans offered mental health coverage, it was often at less generous levels than benefits for medical care, said Debbie Plotnick, senior director of state policy at Mental Health America, an advocacy group. “All these discriminatory practices kept people from getting mental health care, and they are no longer allowed under the parity law,” she said.
Still, consumers will have to take time to understand details of their health coverage, so they can raise questions if they think their plans do not follow the rules, said Carol McDaid, a lobbyist specializing in behavioral health issues. “Consumers have to know what their rights and benefits are,” she said.
Expanding insurance coverage does not necessarily mean everyone who needs care can easily find it. Many office-based psychiatrists, for instance, do not accept insurance, partly because reimbursement for services has been inadequate. A study published in December in the journal JAMA Psychiatry found that only about half of psychiatrists accept private insurance.
It’s also still unclear just how the parity rules apply to some coverage under Medicaid, the federal-state health plan for low-income people; further guidance is expected on that, advocates say. (The parity law does not apply to Medicare, the federal health plan for people 65 and older. But payment for psychological services under Medicare is now comparable to that for medical services, under the requirements of a different law.)
Here are some questions to consider:
■ What should I look for when evaluating a plan’s mental-health benefits?
Advocates say one of the most important features to consider is a plan’s network of mental health professionals. Check to see if providers are in your area; otherwise, you may pay higher fees for seeing an out-of-network therapist.Advertising
■ What if my health plan is unfairly restricting mental health benefits, or has denied my claim?
The Parity Implementation Coalition, formed to promote compliance with the law, offers a tool kit to help you file an appeal, at parityispersonal.org. Steps beyond an appeal with your insurer depend on what type of plan you have. For instance, private companies that buy insurance for their employees, rather than paying claims directly, are considered “insured” and generally are regulated by state insurance departments. But if your company is “self-funded” and pays health claims directly, your appeal most likely would be handled by the federal Labor Department. Coverage through state or local governments, meanwhile, may be regulated by the federal Health and Human Services Department. If you don’t know what kind of plan you have, call your plan administrator and ask.
■ What if I can’t find a therapist who accepts my insurance?
Contact your county behavioral health department, which coordinates mental health care and can help you find affordable treatment. The federal Substance Abuse and Mental Health Services Administration also offers a service locater, samhsa.gov/treatment/index.aspx on its website.
Last time you had a bad cold, you likely had less energy than usual. You lay around and didn't have any enthusiasm for your usual activities. After it dragged on for a day or two, a sense of helplessness probably set in. It was hard to remember what feeling good felt like or how you could ever bound off the couch again.
In short, for a few days, you probably felt a lot like someone with depression.
And increasingly, scientists think it's no coincidence that a mental illness feels like a physical one.
A growing body of research on conditions from bipolar disorder to schizophrenia to depression is starting to suggest a tighter link than was previously realized between ailments of the mind and body. Activation of the immune system seems to play a crucial role in both.
"We just didn't understand how much of a role the immune system plays in how we think and feel and act," says Andrew Miller, a professor of psychiatry at Emory University. "An overactive immune system or when there's something going on in the immune system, it can have consequences on the brain."
An immune response, including inflammation, new research suggests, may help explain why:
• Brain conditions such as multiple sclerosis, Parkinson's and Alzheimer's disease all affect mood;
• About one in four people hospitalized with schizophrenia had a urinary tract infection when admitted to the hospital;
• Mothers with auto-immune conditions such as lupus are more likely to have a child on the autism spectrum;
• People with higher rates of inflammation are more likely to show signs of depression than those with healthy immune function. A study in mice presented earlier this month at the Society for Neuroscience's annual convention showed that the immune changes came before the emotional ones.
"One of the things we need to stop thinking is that mental health is just a disorder of the brain," says researcher Georgia Hodes, of the Icahn Medical Institute at Mount Sinai Hospital, who conducted the mouse study. "There's plenty of evidence in a number of different mental illnesses that they have components to them that relate to the entire body."
Merely adding inflammation to their thinking has helped neuroscientists cast a broader net when searching for causes of and possible treatments for mental illness, mood disorders and neurodevelopmental conditions such as autism, researchers say.
And this mind-immune system connection might help explain why mental health treatments don't work for some people. Perhaps, researchers now think, those people would be better off with approaches that target their immune systems rather than their brain chemicals.
For those with schizophrenia and urinary tract infections, for instance, acute psychotic symptoms often improve after a few days on antibiotics, according to Brian Miller, an assistant professor of psychiatry at Georgia Regents University in Augusta, who is studying the connection between the conditions. This isn't to suggest that all people with schizophrenia should be on antibiotics, Miller says, but patients with both might get as much or more relief from antibiotics as antipsychotics.
Other studies show that the level of an inflammatory protein called interleukin 6 may help predict someone's emotional state. Manipulating the levels of this protein changes behavior on depression and anxiety tests in mice, says Larry Swanson, a neuroscientist at the University of Southern California, and immediate past president of the Society for Neuroscience.
Researchers are still working out the connection between the immune system and autism, says Judy Van de Water, an immunologist at the MIND Institute at the University of California-Davis. There is some indication, she says, that the people with autism who have the most behavioral problems, such as irritability and hyperactivity, also show the highest levels of inflammation. She says she hopes that better understanding the role of inflammation in autism will lead to treatments.
The immune system's role might also fit into the "second-hit" idea of mental illness, where two or more factors, such as genetics, immune challenges and, say, a hit to the head, combine to cause brain problems. That may explain why traumatic brain injuries often lead to depression, says Jonathan Godbout, a neuroscientist and associate professor at the Institute for Behavioral Medicine Research at The Ohio State University Wexner Medical Center.
A serious infection during pregnancy or early in life might make someone more vulnerable to problems later, says Godbout. "It's like a priming or sensitization. There are secondary triggers that can reactivate something and make it worse."
What is clear, says Andrew Miller of Emory, is that the body and mind both influence one another. "It's a two-way street — what happens psychologically can affect you physiologically and then feed back and affect you psychologically. The brain and immune system — their interactions are quite meaningful for health and illness."
The immune system and the brain may be connected in ways that scientists have not previously realized.(Photo: Photo Disc)
Tips for keeping down inflammation, which might help promote good mental health:
• Keep stress to manageable levels (inflammation probably causes stress and stress can cause inflammation; both are bad for the body and the brain.)
• Maintain a healthy weight (excess fat leads to inflammation).
• Get adequate sleep — 7½ to eight hours a night, on average.
• Avoid serious infections while pregnant and in early childhood.
• There is a little evidence that anti-inflammatory drugs, including aspirin, might help improve mood, though that research is very preliminary and these drugs are probably not strong enough to treat full-blown illnesses, say researchers.
Brown University student Okezie Nwoka experienced his first manic episode in the fall of his junior year.
After being hospitalized for a week, Nwoka spoke to administrators about remaining on campus to complete the semester.
"I was convinced very strongly to take a medical leave," said Nwoka, who had been president of his class. "I thought about it and decided I could take the medical leave and still graduate on time."
When Nwoka tried to return the next semester, his application for readmission was rejected.
"They said I had to be away at least a year," Nwoka said. "The rejection letters — it's almost like a slap in the heart."
While most universities offer support for students with mental health conditions, some who have taken psychological leave have found the process of returning to school difficult or impossible.
Brown's official medical leave policy mandates that a leave — for either physical or mental health — "is expected to last two full semesters."
Mental health problems are common on college campuses: Suicide is the second leading cause of death among college-age students, and a 2011 American College Health Association–National College Health Assessment survey found that 30% of undergraduates reported experiencing serious depression during their college careers.
Brown University's director of psychological services, Sherri Nelson, did not reply to an e-mail seeking comment. The former director, Belinda Johnson, has responded in the past to criticisms of the policy.
"The situation that arises is that as an institution we are trying to support students," Johnson said in an interview in 2010 interview with The Brown Daily Herald.
"Let us, as staff with experience, help you out."
While Brown University does occasionally make exceptions, Nwoka took several mandated medical leaves over the course of his education. He graduated from Brown five semesters late, in December 2012.
After six months of leave, Nwoka was required to start repaying his student loans, while his family struggled with a "ridiculous amount" of medical expenses. He tried to transfer to Howard University in Washington, D.C., which did not accept the majority of his credits.
One of the administrators, he claims, told him: "You should consider yourself lucky because Brown's better than other schools. At least you're not getting kicked out of Brown."
Medical leaves and the law
"I think universities do want to work with students to help them succeed," said civil rights attorney Karen Bower, who specializes disability discrimination cases in higher education. "There may be some sincere belief that in their experience, students need time to deal with emerging mental health problems."
Bower has litigated several cases involving undergraduate mental health, including a high-profile 2005 case at George Washington University.
The plaintiff, Jordan Nott, was a straight-A GW freshman. After his close friend and hallmate committed suicide in 2004, Nott sought treatment for depression from the University Counseling Center, according to court documents.
Under the influence of the prescription sleeping pill Ambien, Nott experienced suicidal thoughts. He told his roommate, who accompanied him to George Washington University Hospital.
Within 12 hours of his psychiatric hospitalization, Nott received a disciplinary letter barring his return to campus that semester. The university subsequently leveled disciplinary charges against Nott.
"He was charged with violation of the school code of conduct, which prohibited self-harm," said Bower. "He chose to withdraw from the school and matriculate elsewhere."
"I think GW would acknowledge that they mishandled the Jordan Nott situation and overreacted in ways that were less than helpful," said Dr. Victor Schwartz, medical director of the Jed Foundation, a leading college mental health organization.
"My sense is there's a tremendous variation among colleges and universities and how they handle these situations," said Ira Burnim, legal director of the D.C. Bazelon Center for Mental Health Law. "Some do a really good job; some deal with it in just a frighteningly, appallingly prejudicial way."
The Bazelon Center recently filed a discrimination complaint with the United States Department Office for Civil Rights against Princeton University.
The complaint claims that an undisclosed Princeton student was coerced to withdraw "voluntarily" from the university, which imposed "onerous and intrusive" conditions for his return.
"I was astounded to learn that Princeton has a mandatory one-year (medical leave)," Burnim said. "The law is clear — you can't deny people readmission if they meet the essential academic and behavioral standards of the school."
He claims policies that treat mental health leaves differently than physical health leaves are in violation of the American with Disabilities Act andSection 504 of the Rehabilitation Act, which forbids organizations from "excluding or denying individuals with disabilities an equal opportunity to receive program benefits and services."
"It's unfair, and illegal," said Burnim of the year-long requirement. "It's obviously not helpful to mental health."
Princeton officials declined to comment for this story.
"The policy needs to be clear and well-defined enough to be helpful for students and their families so they understand the parameters of the leave," said Schwartz. "At the same time, the policy needs to be flexible … the decision-making needs to be driven by some sense of medical necessity."
Schwartz said that some psychiatric problems—like "medication mismanagement"— can be treated within three or four weeks, and do not require year-long leaves. For other conditions, like eating disorders, longer treatments may be necessary.
"The student might be doing great academically but be in acute physical danger," said Schwartz. "The schools might use the leave of absence as leverage to get treatment. It can save people's lives."
Schwartz advocates equal policy for psychiatric and physical health leaves.
Jake Baggott, executive director of the University of Alabama-Birmingham's Student Health and Wellness Center, does not believe mental and physical health conditions can always be treated equally.
Baggott says he spoke as an administrator with almost 30 years of experience with campus wellness, not on behalf of UAB.
"I think that each condition, each situation, needs to be considered on its own merits," Baggott said. "It wouldn't be easy to compare the two ... I think it would be problematic to come up with one policy that applies to everyone the same. I'm going to be hesitant to be critical of anybody's particular practice."
Veronica Bland, 19, is a sophomore at Elon University who suffers from depression. Four years ago, while attending the Brooks School in Massachusetts, she overdosed in a suicide attempt.
"I immediately realized I couldn't do this to my family or my friends," Bland said. "I went and told a girl who lived on my hall. I was immediately brought to the hospital by the faculty member on duty that night."
While Bland was hospitalized, Brooks School made the decision to withdraw Bland without her knowledge — or her parents'.
"I guess they came to the conclusion, the deans and the president of the school, that I was dangerous to the community," Bland said. The school banned her from campus, even to visit friends.
In contrast, Elon has been accommodating to her needs.
"I don't think I could have asked for a better school. They would never involuntarily kick me out or put me on medical leave," Bland said.
Bland believes a network of university support is crucial in preventing other suicide attempts.
"It almost felt to me at the time, what was the point of getting help," says Bland of her expulsion. "I was just going to be kicked out anyway. The second time I attempted, I didn't really reach out."
"You didn't have to leave school in order to recover," said Bower, who also represents Bland. They are considering pursuing litigation. "Once you get the right people around you, recovery is that much better."
"Colleges need to accept that this isn't our fault," Bland said. "I will always be scarred by what happened. I will think about it for the rest of my life and how much it affected my recovery."
Cara Newlon is a senior at Brown University.
OCtober 23rd marked the 50th Anniversary of President John F Kennedy's Key Community Mental Health Act. We have made great progress since 1963 but we still have some work to do. But JFK's Act set a course for person centered care, better access to diagnosis and treatment, and access to medications. Read about his historic act here
BOSTON (AP) — Vice President Joe Biden planned to join Health and Human Services Secretary Kathleen Sebelius and former U.S. Rep. Patrick Kennedy for a forum on policies that affect people with mental illness, intellectual disabilities or addiction.
The two-day event marks the 50th anniversary of President John F. Kennedy's signing of the Community Mental Health Act. The legislation, the last signed by Kennedy before his assassination, helped transform the way people with mental illness are treated and cared for in the United States.
Chelsea Clinton and Chicago Bears wide receiver Brandon Marshall, who's been treated for a personality disorder, also plan to attend the opening night gala.
Biden, Sebelius and Marshall are expected to speak at the event.
Clinton, vice chair of the Clinton Foundation, will moderate a conference panel on public health and community approaches to addressing behavioral health disorders.
Patrick, the late president's nephew and a longtime mental health advocate, said he hopes the forum will help remove the stigma surrounding mental illness.
The Wednesday night gala will be followed by a daylong conference Thursday at the Westin Copley Place in Boston.
The forum also will include a discussion of the importance of stemming suicide among veterans and improving mental health care for a generation of veterans returning from a decade of war.
The law signed by Kennedy in 1963 aimed to build mental health centers accessible to all Americans so that those with mental illnesses could be treated while working and living at home, rather than being kept in state institutions that sometimes were neglectful or abusive.
Recent deadly mass shootings, including at the Washington Navy Yard and a Colorado movie theater, have been perpetrated by men who were apparently not being adequately treated for serious mental illnesses.
Those tragedies have renewed public attention on the mental health system and areas where Kennedy's hopes for the treatment and care of those with mental illness were never realized.
ELKHART, Ind. – A local study funded by the National Institute for Mental Health may increase the quality of life for Latino youth living in Elkhart County.
Dr. Irene P.K. Park, assistant research professor of psychiatry at Indiana University School of Medicine South Bend and the leader of the study, said she wants to look at ways that Latino children and their families may experience discrimination, especially when it comes to mental health care.
“One of the key stressors when it comes to adapting to a new country is that of discrimination,” Park told The Elkhart Truth. “When a Latino individual is trying to seek (mental health) services, there may be different barriers. The care provider may not know about their culture of origin, and there may be a language barrier or different cultural values.”
Park added, “We hope that clinicians and practitioners can use the data (from the study) to better treat Latino youth.”
Park and her team, which includes community consultant Gilberto Perez of Goshen-based Bienvenido Community Solutions, hope to study 270 families in Elkhart and St. Joseph counties over a two-year period. They hope to access these families through contacts at local school corporations, churches and community groups. Goshen Community Schools agreed to help Park at its regularly scheduled board meeting Monday, Oct. 14, and Perez said he hopes to meet with Concord and Elkhart schools soon.
“We felt that the first entry point (to find families) should be the schools, because that’s where kids are located,” Perez said Wednesday.
Goshen Schools will provide addresses of Latino students, and Park’s team will send letters asking if the families want to participate in the study.
Park noted at Goshen’s school board meeting on Monday that study participants will be compensated with up to $190 per family. Each child and parent will be screened for depression and anxiety and directed to local services if needed. The focus of the study is on the children, specifically youth ages of 12 to 17.
So why is this study focused on Elkhart and St. Joseph counties?
Park said she chose these northern Indiana counties because a high percentage of the population is Latino, according to U.S. census data.
“St. Joseph County has a more settled Latino population that’s been here for maybe ... three generations,” Park said. “Elkhart County, however, what we saw there in terms of demographics is that the Latino population is one of the new populations. The Latino population in Elkhart has just exploded over the past couple of decades.”
Park added, “For me as a researcher, that contrast was very interesting. Are there differences between the two groups?”
Families involved in the study will go through three interviews, each six months apart. Perez said the first interview will happen at the end of November or the beginning of December. By summer 2014, the team hopes to complete the interviews. Results of the study may be available by September 2015, according to information prepared by Park.
Park’s ultimate goal, she said, is to give a voice to the Latino community, and to change the quality of mental health services they receive.
“I think that this study is groundbreaking, because we are trying to look at this relatively new immigrant population in the area, and examine the sources of risk and resilience that can play a role in their mental health,” Park said.
Assisting in the study are a six-member staff, consultant Waldo Mikels-Carrasco of the University of Notre Dame, and consultant Jennifer Burke Lefever, associate director of the University of Notre Dame Center for Children and Families. Also assisting are senior consultants from Harvard University, Dr. Margarita Alegria and Dr. David Williams, both experts on Latino mental health.
Information from: The Elkhart Truth, http://www.etruth.com
The awful mass killings this month by a delusional shooter at Washington's Navy Yard provoked familiar demands to fix the nation's mental health system. Polls show most Americans believe shoring up the system could help stop the carnage.
If only it were that simple.
There's no question that the nation's mental health system needs improvement. Ask almost any parent who has tried to get help for a severely troubled child. The number of psychiatric beds today is less than one-tenth the 500,000 available in the 1950s, and the overburdened, underfunded system fails to treat millions of people with severe mental illness. They and their advocates have long lacked the clout that gets funding for other diseases. If concern over mass shootings helps propel a fix, good.
But the idea that this will end mass shootings is extremely naive — or politically convenient. "If we leave these homicidal maniacs on the street," NRA Executive Vice President Wayne LaPierre said Sunday on NBC's Meet the Press, "they're going to kill. ... They need to be committed."
Getting Navy Yard shooter Aaron Alexis off the streets surely would have saved lives, but the demands by LaPierre — who obviously wants to deflect attention from new restrictions on guns — are far more difficult to meet than he makes them sound.
For one thing, mental health professionals agree that predicting which person with mental illness will turn into a "homicidal maniac" is difficult or impossible. The overwhelming majority of such people are more dangerous to themselves than to anyone else.
Though estimates vary, Rep. Tim Murphy, R-Pa., a psychologist and an advocate for fixing the mental health system, told Congress recently that there are 11 million people with serious mental illness in the U.S., about 2 million of whom aren't being treated, and that people with mental illness commit a thousand homicides a year. That's frightening. But it's also a rate of only 1 in 11,000 people.
Should 11 million people be locked away to prevent those homicides — or even 2 million?
The idea would prove wildly infeasible, legally impossible and hopelessly expensive.
Until the 1970s, snatching people with symptoms off the street and committing them to an institution was permissible. So was keeping them there, no matter their mental state. But a string of court decisions changed the rules by recognizing that the mentally ill have civil rights, and by requiring strong evidence of imminent danger to themselves or others before they can be committed against their will.
This helps explain why police didn't just lock up the Navy Yard shooter when he told them he was hearing voices about a month and half before his rampage. At that time, he had committed no crime, and he posed no apparent danger.
Reducing gun violence will require much more. Mass shootings get most of the news media attention, but people are killed on purpose and by accident by firearms every day in ways that sensible gun restrictions, such as universal background checks, could lessen.
USA TODAY's editorial opinions are decided by its Editorial Board, separate from the news staff. Most editorials are coupled with an opposing view — a unique USA TODAY feature.
A debate combining gun control, patient privacy and behavioral health is set to heat up again. A proposed rule change from the Department of Health and Human Services that would amend patient privacy protections under HIPAA is headed towards the Federal Register,according to an article in Health Data Management. The goal is to get states to submit more records of individuals prohibited from owning a gun for mental health reasons.
Its one of several executive and Congressional actions announced earlier this year by U.S. President Barack Obama.
The proposals followed the shootings at Sandy Hook Elementary School that left 23 people dead, including 20 children, last year. Although the shooter did not purchase the guns himself, it reawakened the debate over bolstering gun control, background checks and behavioral healththat began in earnest with the Virginia Tech shootings.
The reason for the proposal is that states are not providing much data for these instant background checks. The article cited a 2012 report by the Government Accountability Office indicating that 17 states have submitted less than 10 records of individuals prohibited from owning a gun for mental health reasons.
he National Instant Criminal Background Check System uses several factors to prevent people from buying guns, including felons, convictions for domestic abuse, documented substance abuse problems and people with severe mental health disorders or ruled mentally incompetent.
Leon Rodriguez, director of the HHS Office for Civil Rights tried to alleviate apprehension over the requirements earlier this year. He explained that no information detailing the gun buyer’s behavioral health background would be available to the person conducting the check. They would only see that the person was turned down. He added that the database that contains the behavioral health information does not include electronic health records.
“If an individual is prohibited from purchasing a firearm due to specific mental health reasons as set by law, the following information is submitted to the NICS: (1) basic identifying information about the individual such as name, social security number, and date of birth, (2) the name of the state or federal agency that submitted the information, and (3) a notation on which of the ten prohibited categories is applicable to the individual, which allows the individual to appeal and seek to correct incomplete or inaccurate information.
Several psychological and mental health associations and advocacy groups have come out against the proposal, according to iHealth Beat. They say that it stigmatizes people with mental health problems. They also expressed concern that it could make it less likely they would seek treatment. Many psychiatrists who keep electronic medical records have opted to keep patients’ information and their own notes relating to their patients’ mental health separate from the rest of the medical records. That practice has sparked some debate over whether it undermines patient health. Despite privacy regulations there are instances where identifying data can be traced back to patient records.
The world seems to be full of bad and scary news. Whether it's local violence, theft, or fires in the community where we live, or news of alleged chemical weapons used to kill innocent children half way across the world in Syria, talking to our kids about the world can be difficult. How do parents and other adults explain these scary events while making sure our kids still feel safe? Depending on the age of the child, they may or may not have the capacity to understand and process the information they are seeing and hearing. Some kids, who may be naturally more anxious or sensitive to "bad news", might need to get the information in a different way.
Even if you do your best to shield your kids from seeing horrific images or hearing news stories, it's not always possible to control how they get the information They might hear about school shootings from friends or other adults at school, or they might see the newspaper or news headlines on the internet. Older kids may be more curious or concerned about what's happening in their world, and might seek more information on their own. So, what's the best way to talk about bad or scary news without making your child afraid or anxious?
Dr. Paul Coleman, author of the book "How to Say It To Your Child When Bad Things Happen", offers the following advice for talking to kids about potentially scary news: