Many words have been spoken about the tragic and remarkable events that began in Tucson some weeks ago. I say tragic for obvious reasons, but remarkable, too, in that Americans, starting with the thousands gathered at the memorial service in Tucson, found a way amid tragedy to honor to dead, cheer the living, and commit to taking a new and higher road in our pursuit of the common good.
All too often in public and political debate, phrases about “what we leave to our children and grandchildren” are often used as a warning-to ourselves or to opponents-that posterity will look upon and judge what we have done or failed to do.
At the memorial service in Tucson, President Obama invoked the name of the youngest victim, Christina Taylor Green, to suggest that in the case of her death, the judgment of posterity came early. She, a recently elected member of her school's student council, died while waiting to meet her Congresswoman, missing her chance to see an America worthy of her hopes and dreams. “I want us to live up to her expectations. I want our democracy to be as good as she imagined it,” said the President.
In coming years, our field is challenged with those expectations. What will we leave to today's nine-year-olds? How will they judge us when they are 30 years old, having passed through the years when they are at greatest risk for the onset of mental illness? In how many of them will illness be prevented? In how many will it be treated effectively in its earliest stages? In how many will it spiral, without adequate intervention and care, into social isolation, unemployment, and poverty, or, in the rare case, even violence? How many of them, or their communities, will have the knowledge and resources to prevent such illness, or to consistently help struggling friends and neighbors to access appropriate treatment?
Now is the time to consider these questions, along with the lessons to be learned from yet another tragedy. Among the best lessons and ideas I've heard are these:
1) “We must look at mental health as a public health issue and give it the attention and resources it deserves,” says David Shern, PhD, CEO of Mental Health America, in a recent editorial. He adds that, “Owing to … the ‘rescue’ focused systems of care in the United States, we are missing important opportunities …” Shern joins many in arguing that prevention can succeed with more early screening and treatment, since half of those with mental health problems experience them by age 14, but get no treatment until age 24.
2) Linda Rosenberg, CEO of The National Council, observes that, “Often after incidents like this, people who knew the accused ask themselves what they could have done …. [N]ow there is a way for people to take action and possibly prevent such tragedies …. Mental Health First Aid is a novel, evidence-based public education program that teaches average people how to assess a situation, select and implement appropriate interventions, and help a person in crisis or developing the signs and symptoms of mental illness. It equips people to provide initial help until appropriate professional, peer, or family support can be engaged.”
3) Commenting on the $18 billion in “Prevention and Wellness” funds contained in healthcare reform legislation, Benjamin Druss, MD, Rollins School of Public Health, Emory University, says: “I hate to say it, but if you could fund only one thing in healthcare reform, that is the thing. It's the only thing that promises to change the orientation of our healthcare system.” He is one of many who recognize that prevention is critical to reducing the occurrence of serious mental illness and other chronic health problems and to closing the 25-year gap in life expectancy for those who suffer from it. He warns, however, that these prevention funds could be a target for short-sighted budget cutters in Congress.
Dennis G. Grantham, Editor-in-Chief See also