Everywhere you look, someone is saying that America’s mental health system is broken. Gun advocates are especially quick to point a finger at the mental health system’s shortcomings as the major cause of gun violence.
Although I, of course, agree that more resources are needed, I find myself becoming defensive whenever such charges are leveled and have started proposing that there be a mental health tax on every gun sold and licensed, just like the casinos are required to kick in money for gambling programs.
I’ve read recent editorials that suggest we need to start to institionalized more people again, while many states are still trying to reduce state hospital populations. This year my state has instituted a clever little twist by which CMHC’s that are unable to place patients, put on the state hospital discharge ready list, quick enough, forfeit funding. Of course one of the main barriers to being able to place patients in a timely fashion is--you guessed it--inadequate funding.
In a recent Huffington Post article entitled Mass Murder: Is There a Mental Health Issue? Michael Friedman, L.M.S.W, who teaches at Columbia University's school of social work, addresses what he refers to as “three questionable assumptions.” I would like to focus on the just the second of these three--the assumption that “These events [mass murders] reflect widespread inadequacies in the mental health system.”
Friedman says that this assumption neglects the progress that has been made over the last fifty and he cites Richard G. Frank and Sherry A. Glied’s 2006 work, Better But Not Well which documents the advances and progress that has been made in the treatment and understanding of mental illnesses, despite it not being what most of us fully desire.
I remember several years ago several writing comprehensive service area plans, in preparation for Joint Commission Accreditation surveys and it was rare to find that we had more than half of the resources required to meet the assessed needs of our communities.
Friedman acknowledges that recent funding cuts have restricted access to services, but maintains the system is not “as terrible as frequently portrayed” and he seems generally optimistic about the impact of healthcare reform and the emphasis on recovery models.
Friedman also addresses other important and related issues such as the difficulty in predicting violence and the challenge of providing behavioral healthcare services that contribute to public safety in a free society.
What do you think? Are we truly broken or perhaps just a little bent?