A lot of people are talking about gun control today. And they should be. The problem is, without changing the basic infrastructure of our society's mental health care system, even the most stringent gun laws will not be able to stop this kind of violence.
I want to talk about that.
My husband and I both have Master's degrees in mental health. I work as a Speech Therapist. Before Maze became disabled, he worked in sales. Let me tell you why. After spending three years and over twenty thousand dollars on our advanced degrees, we were offered jobs in the field that paid an average of 18,500$ a year, with minimal or no benefits.
I took one of those jobs, because when I graduated we were newly married and didn't have a child yet. I worked 10 hours a day, and was physically attacked twice, once resulting in a broken foot. We were chronically understaffed, and turn over was rampant. This was a for profit agency. I left the field, went back to graduate school for Speech Therapy, and never looked back.
When Maze graduated, we knew he could not work for so little money. Despite glowing recommendations from all his supervisors and professors, he never took a job in the field he loved.
During his internship however, he worked for a year in emergency mental health care. This is the kind of place where the homeless guy you see mumbling to himself and peeing in garbage cans is sent. While Maze interned there, he worked with dozens of people who had zero access to any kind of health care, let alone mental health. They were given medications to stabilize all kinds of diagnoses, from major depression (he worked with multiple suicide attempt patients, all of whom had made seriously deadly attempts multiple times) to psychosis (one of his patients had plans and means to kill the President; the Secret Service actually brought this guy in, and told the head of Maze's department to 'lose him in the system' for a while). None of them had the ability or means to continue their meds once they were discharged. Emergency Mental Health is meant to be a bridge, but for most of these people, it went nowhere. Maze can recount at least four stories that ended in the patient's eventual death. One ended with a patient killing his family in another state.
But even if someone *has* the means, it doesn't guarantee access. Good mental health care can be difficult or impossible to find even in the best of circumstances. Years ago, my sister and her now ex-husband adopted a child from Poland. Their daughter had a traumatic past that makes me sick just to think about. They knew from the outset she would need a lot of help, and they had plenty of money to provide it. What they couldn't find were skilled practitioners. Most medical insurance doesn't cover intensive counseling, or inpatient care that is not for addiction. Relying on private pay clients is iffy, so many therapists opt to treat only "the worried well"- you and me, having a bad day. If they were to take on truly troubled families, the odds of getting paid are much lower. Inpatient facilities, which require a large, highly trained staff and a huge amount of malpractice insurance are few and far between. Their daughter went to at least 10 different therapists, and 5 different therapeutic schools during the five years she lived with them. All the schools closed. All of the therapists either stopped receiving needed additional funding from the state and so stopped practicing, or stopped being able to afford to practice for other reasons. Along the way, their daughter pushed my father down a flight of stairs, set fire to my sister's house, tried to kill my sister with a knife, and attempted suicide multiple times. She is currently in jail, for prostitution and drug dealing.
America is very fond of putting our mentally ill in jails. Jails are cheaper and easier to build than mental health care systems, and our culture loves to think we are tough on crime. And maybe we are, and maybe that's good. But the number of mentally ill inmates in our prison system has *quadrupled* in the last decade, and the criminal justice system is in no way adequately prepared to treat these people. About 20% of offenders are classified as mentally ill. It's easy to argue that anyone who commits a certain type of crime is 'crazy' - nobody shoots up a roomful of Kindergardeners if they're in their right mind. But what if we got to these people *before* they started shooting? What if this guy's mother had options *other* than arming herself with a handgun that would ultimately be used against her? What if some of the men and women currently imprisoned in America could have been productive members of society if they were provided the right kind of medication management, counseling, life strategies and skills? What if we have failed millions of people, simply because they have a kind of illness we are too proud, or too ashamed, to even talk about?
Without my anti-depressants, I would be dead. I am not ashamed to say that, any more than Maze would be ashamed to say that without his insulin, he would have been dead. But there is still a stigma attached to mental and emotional disabilities, still a sense of weakness or not trying hard enough. And there should not be. If someone is truly depressed, or has compulsive thoughts, or delusions, or paranoid fantasies, the only thing that will work for them is the highly skilled care of a medical practitioner. Full stop, the end. And if we do *not* provide access to this kind of care, the same way we do for other kinds of diseases, then we will continue to see a rise in both suicide and violence against others.
I say this as someone who has needed, and benefited from, quality mental health services and as someone who works in the field of health care. I say this as someone who works for the number one rated non-profit health care agency in the country- and whose top rated benefits currently include a mental health care option so ****ing LOUSY that I pay privately and out of pocket for every service we have ever required other than medication. That's right, I work for an agency that provides health insurance AND care, and even I can't get access to decent, timely, mental health services.
Our system is obviously and heinously broken. Now is not only the time to have this discussion. Now is the time to fix it: Contact your employer or insurance agency, tell them you want good mental health services as an option. Contact the
National Alliance for the Mentally Ill, ask them how you can help spread awareness or donate time or money. Contact
Mental Health America and ask for the contact number of your local affiliate. Call your legislator, and tell them not to sacrifice Medicare/Medicaid, and the already limited mental health services they provide to the fiscal cliff. Donate to the Veterans Administration, so they can provide mental health care to our veterans, many of whom are still returning home with PTSD, head injuries, and addictions. Donate time, money, or blankets to your local mission, regardless of your (or their) religious affiliation- oftentimes, they are the only thing standing between a homeless, mentally ill individual and the streets. Talk about mental illness. Talk about treatment options for mental illness. Don't stop. Thank you.
