Crowdsourcing a Mental Health Policy

Tuesday, December 18, 2012 - 03:28 PM

Doctor, Stethescope, Health (Flickr: Bryan Warman)

The tragedy in Newtown has raised questions about the state of mental health treatment in the U.S., especially among children. How should our mental health policy change?

This morning on the Brian Lehrer ShowNadine Kaslow, psychologist, professor and vice chair at Emory University, and president-elect designate of the American Psychological Association, and Steve Coe, CEO of Community Access, Inc., explained the difficulty in treating mental illness in children, and what changes to policy could make it easier.

We asked for your thoughts about how we should change the way we deal with mental illness in this country. Here's some of the highlights of what you told us:

On Facebook, Bonnie says: "Brian, I wish someone would address the fact that these horrible killings are the work of men/boys... Should we be looking at the way our male children are raised, who their role models are, what they are filling their heads with...?"

Calling into the Brian Lehrer Show, Candida says: "I think that we have to be looking at much bigger and broader developmental and mental health support in schools stating very young. I work with a lot of preschoolers who have problems with regulating themselves"

Carol adds that keeping those who need it under care is a challenge: "When there’s a permanent disability, there’s nothing that is mandated for that person to stay in treatment—to get any treatment. They can refuse treatment, yet they’re getting government money because they can’t function in society."

On Twitter, Ina suggests we look for more clues as to what affects early childhood experience can have on the brain.

From our online comments, Amy from Manhattan says: "How can we work to destigmatize mental illnesses? If people weren't ashamed to have a mental illness or to have a mentally ill family member, they'd be more likely to feel that's it's OK to look for help"

Mark draws comparisons between the U.S. and Cuba, where he says he toured mental health facilities as part of a delegation of nurses: "The mentally ill appear to be more included in Cuban society. I think that much of the inclusion and more humane treatment that we observed is a phenomenon of Cuban culture and the influence of the extended family and community there. Unfortunately, we concluded that this was a foundation of humane treatment that could not be imported into the United States without major societal changes."

Rivka, who describes herself as a clinical social worker, says: "A 'diagnosis' of Asperger's or ADHD or intermittent explosive disorder can't be used to explain away the violence. What parents, schools, even school mental health personnel often don't either notice or understand are the deeper feelings within the troubled individual."


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Comments [16]

Bob Joerger from Rutherford NJ

During this segment, it was suggested by one of your guests that every child should have a yearly mental evaluation just as they see a pediatrician for a yearly physical checkup. It was also noted that this notion had several drawbacks: expense, inconvenience, mental health stigma, etc.

I propose that mental health screening be incorporated in the standard yearly visit to the pediatrician. A few age appropriate questions asked in the protective environment of the physicians' office could help early detection of potential problems; cost would be minimal; inconvenience would be avoided through integrating mental health screening with an existing doctor's visit.

CE courses for pediatricians to teach the basics of mental health screening could easily be developed. A child should be referred for more extensive evaluation when indicated. The integration of mental health screening with yearly physicals may help decrease the stigma of addressing mental health issues.

Dec. 21 2012 12:24 PM
jordana from maplewood, nj

Have you mentioned that most of these shooters are men and boys. SHould we discuss how we are raising are males?

Dec. 19 2012 11:34 AM

What if the cure is the problem? Our daughter is on several anti-anxiety medications and we worry about the interaction of the drugs and what effects, both short and long-term, that the actual reduction in anxiety might be. She was on Prozac as a very young girl. Leaving a restaurant one day she reached over and grabbed a french fry off a stranger's plate... not normal. This from a girl who was so socially shy she did not speak or do a thing in the first two years of school. Maybe non-medicated anxiety prevents some bad behavior. We're anxious to hear toxicology reports from the Newtown shooter.

Dec. 19 2012 11:27 AM

when you do have insurance is very limited how many sessions you can have per year with psychiatry and mental health. that should be changed should be unlimited. and for the uninsured and those that do not have the public insurance and they are not will see but yet are not for enough to have Medicaid or Medicare something affordable should be available

Dec. 19 2012 11:14 AM
Steven Taylor from Brooklyn

What everyone seems to be avoiding across the media landscape is the fifty-billion-dollar annual sales of psychoactive medications, antidepressants (SSRIs) which were implicated in the Columbine shootings and which, in a survey of reputable international news sources, show up in literally hundreds of cases of bizarre violence since the 1990s. The FDA notes that SSRIs are the #2 and #3 prescription meds associated with violent behavioral side effects and the pharmaceutical companies themselves note violent behavior as a possible side effect. The media problem is one that Chomsky points out. There are thousands of mentions of this in individual news reports, but down at the bottom of the column. It only makes sense when you search multiple newspapers. Gun control is needed, but what about medication control? Are the news outlets avoiding confronting big pharma?

Dec. 19 2012 10:37 AM
Arlene Mehlman from NYC

One of my regrets in life is my part in desinstitutionalization. I was young and idealistic and did not understand the problem as comprehensively as I think I do now. Instead of doing away with Psychiatric Hospitals because of the abuse or poor conditions that prevailed in several of the hospitals, we should have insured that the Psychiatric Hospitals adhered to the same standards that our hospitals, nursing homes and other medical facilities must adhere to. I am convinced that Psychiatric Hospitals can be the most humanistic place for the mentally ill. It is a place where people who need medications (and often cannot be trusted to monitor their medications) are supervised (causing both the patient and others fewer problems and stress) and, therefore, more stabilized and healthier. Our mental health population is an extremely lonely existence. Psychiatric hospitals provide a community for people. In the long run, psychiatric hospitals would probably be more cost effective than the present system or lack of system.

We have cut out health education, a course if taught properly deals with topics such as bullying, stress, anxiety, friendships, relationships, parenting, i.e., loving our children, parenting, sex education, nutrition, importance of exercise and wanting to be healthy mentally, physically and spiritually, self confidence, learning how to become your own best friend. I could go on and on as to the benefits and importance of health education as well as physical education, art and music which nurture our children's minds and spirit. The investment in after school centers as we used to have where teachers knew the kids and the kids had a place to hang out under supervision is a very cost effective program.

I grew up in the projects. My family loved living in the Glenwood Projects in Brooklyn. My father would call me from Leisure World in Laguna Beach where he and my mother retired and say "wasn't that the best time of our lives"; and it was. Happy to talk about my thoughts on the projects.

Last but not least, I do not allow my college students to e-mail me. I give them my telephone number and they can call me 24 hrs a day, 7 days a week. The violence in our media combined with technology which allows people to communicate cut off from human contact is producing people who are cut off from their feelings, a recipe for disaster.

Dec. 19 2012 01:03 AM
Michael Villacres from Queens, NY

Because of this and so many other tragedies, I am calling for an Empire State, NYC, and all other localities; Commission on the State of our Mentally Ill and System. What is the current state of the NY Mental Health Care System? What are we doing right and wrong? What should we keep and what should we stop and change? Budgeting, is the current budget underfunded? By how much? How much more does it need? What do our mentally ill need? What are the roles for the cities, towns, villages, counties, etc; in administrating the programs and outreach? What does the private sector, charities, etc; say has and has not worked in giving their care? What are their dealings with NY State government and local agencies; regarding funding, information and other help? What would the agencies, charities, etc; the mentally ill, and their families, all to have to say that they are being “supported” by each other? These are some of the questions awaiting answers. Good day.

Dec. 18 2012 08:35 PM
Michael Villacres from Queens, NY

About 14 years ago a mentally ill man pushed an innocent woman onto the subway tracks in mid-town, killing her, in order to get the help he wasn’t getting from the NY State Mental Health System.
NYTimes story about the attack-
NYTimes story about him and the system-

Dec. 18 2012 08:35 PM
Michael Villacres from Queens, NY

Next, we need national and state and or local town halls to hear and have the mentally ill, with their families, to say what challenges they face socially, professionally, economically, etc; and what solutions they think would work. Finally, at the federal level, fund current and make more necessary programs, by way of the US Department of Health and Human Services, that will help the state or local governments with their mental health programs. For the state/local/territories levels to maintain their mental health agencies, programs and funding. Seek federal funding for outreach, counseling, treatment, research, etc. This is at least a start.

Dec. 18 2012 08:29 PM
Michael Villacres from Queens, NY

I recommend first, a comprehensive education campaign for both the American public and the mental health community. For the community to better understand the public when communicating to them to be understood. The American Public, who do not have medical training or experience, need to know more about conditions, symptoms, interacting with, and being sensitive to both the mentally ill and their families; because we don’t know we just don’t know. This includes first responders, politicians, teachers, etc.

Dec. 18 2012 08:27 PM
Michael Villacres from Queens, NY

“Whack-job, nut-jobs.” I don’t want people to think that I’m crazy. Don’t fire that person, she or he might come back and kill us all. Don’t get her or him angry. It’s always the quiet ones. I talk to myself because I am thinking out loud. He/she is talking out loud they’re definitely crazy! Get away from my child, you Whacko!” These are all examples of stereotypes and insults that people have said about the mentally ill. This stigma has got to go. As long as there is this fear, persecution, and stigma the country will switch subway cars, cross the street, to avoid “the problem” instead of facing it and reaching a solution, which is what all of us deserve. Thank you.

Dec. 18 2012 08:26 PM
Michael Villacres from Queens, NY

People are afraid that if they act “crazy” they will be treated like another “crazy person.” This fear has got to go. Anyone can have or know someone who has a mental illness. It could be your coworker, cousin, spouse, your proud veteran daughter, or even yourself. This fear of weakness, isolation, or of “what’s wrong with you” fuels the fear that mental illness will ruining your or your loved ones’ life. He may lose his job, or that promotion she has been waiting for, or have all those conversations stop when you walk down the hallway and then be about your “gossip-fueled case of depression” after you’ve walked on. While this does not happen everywhere or by everyone in America, this pain of loneliness and lack of understanding shows the status quo as a chasm between healing & understanding and fear & ignorance.

Dec. 18 2012 08:26 PM
Michael Villacres from Queens, NY

What turns me off from listening is when PhD.s, Master Degrees, counselors, or other “experts” are on the media talk shows and say: “let’s not call ‘them crazy’ we prefer ‘mentally ill, special needs’, etc.” They seem to think as if these terms are going to be used because non-MD citizens will understand why we should use them. These terms don’t work because of the reality that I and the rest of the public see and hear from the media, reports about the “20 children killed, 10 dead, 14 wounded, 18 ‘gunned-down ' shot, killed, by a ‘crazed’ gunman, a mad man, in a massacre, shooting, bloodbath;” over and over and over again from different mass shootings and numerous stations,websites and tweets. This is how we are “informed” about the mentally ill. Not from stories that educate us about their conditions, challenges from trying to “fit-in” to our world, research into treatments and or medications to help them live.

Dec. 18 2012 08:25 PM
Michael Villacres from Queens, NY

We have to deal with the stigma of mental illness. This is the biggest problem with the public dealing with the mentally ill., it has been this stigma that prevents the general American public from reaching out, listening, and helping those whose “conditions” lie in the mind.

Dec. 18 2012 08:23 PM
Barbara Dolensek

Nadine Kaslow, who holds several important positions in the psychotherapy field, said firmly on the Brian Lehrer show this morning that there is absolutely no connection between violent crime and Asperger's. If it is true, as reported, that the Newtown massacre was committed by Adam Lanza, who apparently had Asperger's, doesn't that count as a connection? Obviously, most individuals with a degree of Asperger's do not commit such crimes, but why does this one not count in her book?

The media have turned this tragedy into a circus and a political push for gun control (which would have had no effect on this particular crime), but I think the real culprit is our violence-loving culture and our determination to make these criminals into anti-heroes.

Dec. 18 2012 06:05 PM
Robert Moore

The wide and growing use of organized gang stalking pushes many people over the mental cliff as was done to Jiverly Wong and Gloria Naylor two victimized New Yorkers.
Legislation to make Organized Stalking Illegal Is An Absolute Necessity!

Dec. 18 2012 04:37 PM

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