Friday, February 19, 2010

Beyond Politics: Mental Health

By now, you're all aware that one Joseph Andrew Stack flew a plane into the Austin IRS office, after setting his house on fire and leaving behind a lengthy anti-government screed. And around the blogosphere there's extensive speculation about the "politics" behind the act. Was he a "tea partier" or a "terrorist"? Can we use him to score political points? The same dynamic occurred after the Alabama university shootings, the Ft. Hood shooting, and pretty much every other case of senseless violence in recent years.

But I'm seeing this from a very different perspective. For my newer readers, a bit of background: I was a mental health counselor for about 15 years, working primarily with extremely disturbed and violent individuals. A lot of my work focused on violence prevention, anger management, and suicide prevention (which are usually intertwined), so I'm inclined to look at incidents like this in a different light.

The general narrative when something like this happens is that the person "snapped", and they "snapped" because of "XYZ". It's a narrative that completely misses the actual problem. Almost every time, after further investigation, others reveal that the person had been "increasingly withdrawn", "acting strangely", "expressing paranoia or delusional", or exhibiting other behavioral changes prior to committing the violent act. Signs that, in hindsight, the person was about to snap.

Which brings me to a greatly under-reported problem: our current mental health treatment system is in shambles. Clinics are grossly under-funded, counselors are overburdened with huge caseloads, and treatment rarely goes beyond prescription medications. Counseling often isn't covered by insurance, and only rarely available to the uninsured.

Here's a simple exercise: imagine that someone close to you, a friend or family member (or even acquaintance or coworker), began exhibiting symptoms that had you worried that they might be about to do something extreme (even merely suicidal). Where would you turn? Assuming that you could get the person to agree to "get help"(involuntary treatment is a whole separate issue, so I'm not addressing it in this post), is there any real treatment available? Unless the person is fairly well off, the answer is probably "no". Community mental health centers are grossly under-resourced and overburdened, and are generally limited to crisis intervention, not prevention.

While better treatment won't eliminate all acts of senseless violence (human behavior is not an exact science), could some of these be prevented? I believe so. In the wake of the Virginia Tech shootings, what few mental health records that were released revealed that the shooter exhibited multiple warning signs, but that the treatment was woefully inadequate. A prescription for an anti-depressant, but no follow up counseling. And a lot of dead innocent people.

Sadly, incidents like this are going to continue to occur. Nothing is being done in the current system to prevent them. Regardless of the politics of the person who "snaps".


Demeur said...

That is something I have contended for quite some time. It started when Raygun opened the doors to mental health facilities and let most of them out. Wouldn't want to have to pay taxes to treat these people.
Sadly we'll be seeing much more of this as time goes on. I'm loosing count of the murder suicides up here.

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