Mental Health is Dangerous Lacking in the USA
How long will be keep our heads in the sand regarding the delivery of services to the mentally ill in the United States? The devestating killings at Virginia Tech in April 2007 painfully brought to the surface how we have failed those who desperately need help.
We need public education to encourage individuals to go for help when they recognize feeling out–of-control or in a situation where they need counseling, support and advice. Some problems are chemical imbalances and often medications can reduce symptoms or stabilize the individual, if the person takes the medication. They don't always take them because the medications have such uncomfortable side effects that the patient believes that the disease is easier to cope with than the drugs.
Other problems are situational and don't need to be medicated but brought to the surface, worked out and resolved. The best way to do this is through "talk therapy." There are many modalities that effectively work to educate and empower people to stop repeated patterns of destructive and self-deprecating behaviors. Childhood trauma caused from molestation is one example. There is no drug to resolve the damage done and continuing negative effects on adult relationships like trust issues, guilt, shame and sexual confusion and dysfunction. These issues need to be resolved by other means.
Medicating such a wound just exacerbates the dilemma and doesn't resolve or heal the wound. Neither does behavior modification.
Grief is similar issue. Typically it isn't pathological, yet it hurts like hell for a long time. Medication isn't recommended. Grief is best resolved by talking about it with a trained therapist who works and understands bereavement. Knowing what to expect, the hot spots and the time frame is empowering. Just knowing that the immediate pain will heal itself is part of the healing process.
Historically, we as a nation have attached a stigma of shame on the individual suffering from a mental problem and on the family. I know because in 1956 my father was diagnosed with bipolar disorder and rather than go to a hospital and inflict shame on his family and himself he killed himself at 45 years old.
In the 1960's we began systematically to empty out all our mental hospital. Often they were less than ideal, but rather than reform them we dumped the patients onto the street. Most homeless people have serious mental health problems and so do most inmates in jail. The mentally ill have no safe place to go to get shelter and treatment they need. There are few long-term beds available. Half way houses substitute as a safe place to be housed, but they are rarely safe. Most of the population in prison need counseling and therapy to turn their lives around to reduce to high recidivism rate.
Then in the 1990's the Health Maintaince Organizations (HMO's) appeared on the reimbursement stage and embraced short-term therapy with an emphasis on behavioral modification and limited psychotherapy to six or on occasion twelve sessions. Sessions necessary to complete effective therapy must be approved by the HMO responsible for service delivery. This was the death knoll to effective therapy for the severely mentally ill.
Behavior modification is basically a band-aid type of therapy believing if you change your thoughts you heal any pain or problems from old wounds. Just sweep it under the carpet and it will fade away. short term therapy works for minor problems but ignores and fails the needs of the severely mentally ill who need long term therapy. The most seriously disturbed patients may take months just to establish trust in their therapist before they even reveal what happened to them.
States don't have enough money to adequately fund Community Mental Health Programs. Many people fall between the cracks even when identified and mandated to get out patient therapy. Mental health practioners are overloaded, overwhelmed and underpaid. It is a job with high burn out and high turn over. In community mental health agencies patients may be shuffeled from one therapist to another and must start all over with someone new adding to their problems.
Private insurance limits the number of visits they will pay for through reimbursement and co-payments. They closely monitor the number of visits, that are regulated by HMO staff. A mental health professional literally has to beg for additional visits when deemed necessary. Additionally the HMO tells the practitioner what they will pay and it is rarely his or her regular fees, always less.
Mental health must become a higher priority in this country to prevent innocent people from becoming victims. All of society is responsible for this tragedy. We must demand more education, better treatment and prevention strategies to avoid similar incidents in the future.
This is a broken system and needs to be fixed. Now!
About the Author
This article was written by Nancy O'Connor Ph.D.. She worked as a Psychotherapist for 23 years and was the Director of the Grief and Loss Center in Tucson, Arizona for 12 years . She is the author of the best selling book Letting Go With Love: The Grieving Process and How to Grow Up When You're grown Up: Achieving Balance in Adulthood. How To Talk To Your Doctor. Her books may be reviewed and purchased at http://www.lamariposapress.com
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