We watched in horror this month as a modern-day Valentine’s Day massacre occurred at a Florida high school in Parkland, Fla. As is always the case in hindsight, many signs that might have prevented this tragedy seem to have been missed. And as always, the news programs display messages and share thoughts on why this tragedy occurred. As usual, there is a constant stream of assigning blame and pointing fingers. But if history repeats itself, any honest conversation about the reality of the mental health crisis in this country will continue to fall on deaf ears.
Unless one has experienced the horror of a serious mental illness firsthand, it is difficult to comprehend what happens when loved ones try to get help for a family member or friend in crisis. This becomes even more difficult for individuals who are between 18 to 25, which is often “prime time” for the first actual manifestation of a mental disorder in young adults who may have been looked upon as “awkward” or “socially challenged,” or were labeled with “behavioral issues” or “disciplinary problems” as a child.
Even with good private insurance, it is very difficult to find appropriate mental health care for patients in crisis. Waiting lists are long for psychiatrists that accept insurance, and those who are private-pay charge upward of $350 per hour — and even then the specialist often won’t effectively treat patients who are acutely ill. Often, the mentally unhealthy patient is often completely detached from reality and unaware of the fact that they are in need of treatment. If the patient is over the age of 18, there is little to no medical information that can be shared with the parent or guardian, unless the patient expressly agrees that it can be shared. Oftentimes, young people this age are away from home, at college or living on their own for the first time, so parents may not be aware of any changes in behavior or mindset of their children until a full-blown emergency occurs.
If the patient somehow finds a way to an emergency room during a crisis, it’s still no guarantee of getting the proper help. Often the patient has used drugs during or leading up to the crisis, which can effectively pour gasoline on an already smoldering fire of mental illness. The patient may become violent or resist the efforts of those trying to help. Because these patients are dangerous and disruptive to those around them, they often go from emergency room to jail cell without any treatment at all, as a precaution to protect other patients and caregivers.
It is very difficult for family or friends to intervene by admitting a loved one to a specialty mental health treatment facility involuntarily. The facility cannot detain the patient if they do not give consent to being evaluated and treated, unless the family member or friend can prove that the patient is a danger to either themself or others.
If the patient is admitted involuntarily, they can discharge themselves after only 72 hours of observation. If the clinic or facility is overcrowded (as most are) and short-staffed (as most are), in some cases it could be nearly impossible to receive the necessary care to address a severe mental health crisis. A good outcome truly depends on a perfect timing of symptom emergence, caregiver initiative and the right clinician who not only has the interest but the authority to properly diagnose, stabilize and treat the patient.
Once a patient is finally evaluated, treated and stabilized enough to be released, they often find adjusting to everyday life difficult. In a best-case scenario, they are able to return to their normal routine. However, the lifelong necessity of taking medication, and the frequent mental health checkups and ongoing counseling can be a source of stress for the patience, especially if they lack a sufficient support system. For example, even with access to health care, according to local officials the shooter in the Parkland tragedy had previously been treated for mental illness by a local facility for nearly a year. He, unfortunately, had stopped attending his appointments a few months before taking 17 lives.
As a society, it’s time to face up to the elephant in the room. What has changed in the past couple of generations? Is easy access to violent video games the cause? Has the virtual reality numbed the emotional response to the idea of mass gun violence? Or, is giving more medication earlier in life, while brains are still developing, the cause? Are the 24-hour news cycles that show graphic violence and rage nonstop adding to the problem? Is the addiction to screens — be they televisions, computers, game consoles and mobile phones — partly to blame?
The need for increased study into the correlation among all these variables and the seemingly growing prevalence of young adults who are disenfranchised, angry or mentally unstable is critical. Personally, my sense is that there is some sort of correlation — the only question is whether we will be able to affect change in mental health care and limit exposure to these elements that have become such pillars (unstable as they may be) of convenience in our daily lives.
About the author: Kelly Warren Moore has sold clinical research and development software solutions to the pharmaceutical and biotech industries for the past several years. She previously spent 20 years in business development for the pharmaceutical research and development field, focusing on multistudy, global clinical programs. She has a Bachelor of Arts degree in economics from the University of Texas at Austin. Any opinions expressed in this article are strictly her own and are not meant to represent those of any employer, client or organization with whom she is affiliated.