Robert E. Simpson Jr.: For safer America, treat mental illness more effectively
AMHERST — As I listen to the national gun control debate following the tragic shootings in Newtown, I know in my heart this is not the right strategy. While I do favor a multi-pronged approach to the problem of violence that includes gun controls, I feel the emphasis should be on providing significantly more resources to the early identification and treatment of those at risk for violence in our communities.
The discussion should center on how our nation will embrace decades-old strategies to end the stigma surrounding mental illness and give the required resources to prevent and treat mental illness. This strategy is not only the most cost effective; it is also the most humane. Our nation must provide leadership in protecting children.
The U.S averages 2,200 child homicides by gun per year. A thousand more die annually by suicide using a gun. Yet as a country we have become strangely inured to these personal tragedies. Perhaps it takes a very public event to make us realize our society has become complacent in protecting our children.
It is far less expensive to promote mental health, implement preventive strategies and treat existing illness than it is to allow stigma to drive us to other solutions that do not target the primary problem.
Mental illnesses are real health conditions that are defined by alterations in thinking, mood or behavior. Psychiatric treatment involves a complex blend of psychology, biology and compassion. It means never giving up on someone struggling for relief from unbearable pain. It requires deciphering when an individual cannot care for him or herself and how to intuit danger and protect others while caring for our children, our communities and ourselves.
In fact, the overall contribution of mental disorders to the total level of violence in society remains exceptionally small. But when it does occur it is highly visible due to stigma and fear.
Yet the general public remains poorly informed about the nature of mental illness, further isolating those with mental illness. Evidence from many sources underscores that social risk factors such as substance abuse, being a victim of violence during childhood, or living in high-crime neighborhoods is more predictive of violence than having a mental illness.
The nation has been admonished now for several decades by governmental reports that for children the promotion of mental health must be tied to strategies that integrate mental health and physical health with a public health design that links families, health care providers and schools in an inclusive and de-stigmatizing approach. Yet in any given year less than one in five children in the U.S. who need mental health care will receive it.
President Obama’s plan, “Now is the Time,” promotes several areas that I think are worthy of support. The first is to clarify state laws around the country that may prohibit physicians and mental health providers from inquiring about safe firearm protections in homes “especially if their patients show signs of certain mental illnesses or if they have a young child or mentally ill family member at home.”
I am well aware of the damaging effects of bullying in school settings and agree with the president that increasing mental health professionals in schools can help enhance a culture of safety and also identify and refer for treatment children at risk for violence toward others.
Building alliances between pediatricians and school personnel in identifying at-risk children and families at an early stage can and does happen in many communities. This requires funding. The president’s findings note: “A report issued by the U.S. Secret Service and the Department of Education after the Columbine shooting found that one of the best things schools can do to reduce violence and bullying is to improve a school’s climate and increase trust and communication between students and staff.”
The president is right when he said, “We are going to need to work on making access to mental health care as easy as access to a gun.”
A key component of such a strategy must include legislation that assures all Americans access to the full range of mental health and addiction services and guarantees adequate funding of treatment services. Our efforts should be focused on delivering on the promise of decades of research and evidence that promoting mental health and treating mental illness is a very effective strategy to reduce violence.
We should embrace the decades of scientific work that underscores that no matter the number of children killed by guns in a given year or in a given event, providing mental health prevention services will help us move away from violence as a solution to conflict and unmet emotional needs and replace it with critically needed professional and personal support for individuals in crisis.
I think this makes good, old-fashioned common sense.
Dr. Robert E. Simpson Jr. of Amherst, the president and chief executive officer of the Brattleboro Retreat, has worked in the field of mental health as a clinician and administrator for more than 40 years.