Friday, December 28, 2012

Mental health services are part of the challenge to stop mass ...

In the numbing aftermath of the Newtown murders, public attention inevitably focused on how to stop future mass shootings. As was clear from President Obama's actions, the two main areas of concern are gun safety and mental health treatment.

Mr. Obama created a task force headed by Vice President Joe Biden to develop proposals to curb gun violence. Part of Mr. Biden's charge, along with steps to keep guns out of the wrong hands, is to find ways to improve access to mental health services.

"We're going to need to work on making access to mental health care at least as easy as access to a gun," said Mr. Obama.

This page supports sensible measures that would make it more difficult for potential killers to get guns, particularly assault-style weapons with high-capacity magazines.

The country should also make a greater investment in mental health services because better screening for mental disorders and more public access to treatment could help a great many people. We should make this investment even though, experts say, it is not a magic pill for identifying potential mass murderers.

Loners

Many of the mass shooters, nearly all male, are loners, oddballs, outcasts. But as many as half of mass shooters, by one survey, don't display symptoms of mental illness. They may have a grudge against the workplace or the world, they may be lost in violent video games, but such is the state of countless people.

It is hard, even for psychiatrists, to predict which ones will reach the point where they arm themselves and head for work, a school, mall or theater for a personal Armageddon.

Also, a large majority of people who are diagnosed with serious mental illness are not violent, and if they do act out, they are far more likely to hurt themselves than others.

Plus, the authorities cannot take people into custody merely on the suspicion that they may be pathological. They must be a danger to themselves or others or have a grave disability to be committed, and they have the right to appeal. One thing the Connecticut legislature can do is to give doctors the authority to mandate outpatient treatment for potentially dangerous people.

Intervention

What might have made a difference with Adam Lanza? He appeared to former classmates as odd, and he was home-schooled for a time because his mother "was not satisfied" with his schooling, a relative said. That could have been the time for intervention.

Paul Gionfriddo, a former Connecticut state legislator who has written movingly of his own son's struggles, proposes behavioral health screenings for every child, and state mediation for every special education student who is removed for behavioral reasons for five or more days.

For most people, however, access to mental health treatment tends to be available only if they can pay for it.

Connecticut, for example, closed two of its three public mental hospitals decades ago with the promise that services would be transferred to community settings. That promise has been only partly realized, as evidenced by the fact that the largest provider of mental health services in the state is the prison system.

It's reasonable to suppose that better access to community services, particularly in cities where the stress of poverty and its related pathologies add to the challenge of living, would help people get on with their lives and not end up needing prison services.

Additional funding of research, by public and private sources, should also be part of a mental health program.

The state should move toward better screening and prevention in tandem with other efforts. Gun violence is a multi-layered issue whose solutions should include sensible gun-control measures, a closer look at school security and an examination of the effects of violent video games and films.

In Newtown, 12-year-old Max Goldstein has started a movement asking kids to dump their violent video games. There, Mr. Biden, is a start.

Source: http://www.courant.com/news/opinion/editorials/hc-ed-newtown-mental-health-20121226,0,7978142.story

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