Slipping Through the Cracks

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The issue of mental health care is one of the most ongoing, divisive, troubling topics in our country today. Included in that issue is the question of how it relates to gun control. But let’s start with the basics.

In several articles regarding studies done on mental health issues in this country in 2016, this startling fact comes to light: One in five people in this country suffer from some sort of mental illness. That means in 2016, there were 44.7 million people with some sort of affliction. Here are some of those mental health issues that are recognized: Autism, Major Depression, PTSD, Bipolar, OCD, Schizophrenia, Suicide, Eating Disorders, ADHD, and Personality Disorders. Substance Abuse and Mental Health Services states that out of that number, 9.3 million have serious issues and that most of them start at the age of 18 and move upward. Also, states that didn’t expand Medicaid under Obamacare, refused service to about 4 million people due to lack of insurance.

So, what is contributing to this problem? In corresponding with Dr. Julio Busciolano, PsyD he and his associates at the Partial Hospitalization Mental Health Program feel that the stigma or attitude towards mental health is a major roadblock. Cultural, religious, and family perceptions are at the forefront because of a lack of compassion and understanding. Of course, there is also the fact that those afflicted with mental health issues often feel that they don’t need help and are “strong enough” to combat this on their own. It’s what society has taught people over the years … that one must be “strong,” “no talking of such feelings,” or “forget it and move on,” that anything less is an admission of failure as a person when the opposite is the reality.

One of the major setbacks in correcting this is money, or more to the point, the lack thereof. Without proper financing, there are far too few professionals, causing burnout because of the hours worked, and paperwork required as some of the reasons. Also, the lack of resources and access to mental health professionals is worse than those for other types of doctors. Limited resources mean fewer outpatient programs, with our youth being primarily affected. It’s a Catch-22 with cost leading to financial distress, leading to more mental distress, leading to more financial stress … money spent, debt acquired, followed by financial hardships.

There is the option of Involuntary Commitment. In Florida, a state representative, Maxine Baker (1963-1972) sponsored a bill enabling involuntary admittance for mental health issues. This was titled the Florida Mental Health Act of 1971 but is commonly referred to as the Baker Act. To Baker Act, a judge, law enforcement official, doctor, or mental health professional must deem the individual to have a “substantial likelihood that without care or treatment, the person will cause severe bodily harm to themselves or others, in the near future.” One cannot be committed because of past behavior or actions and alcohol or drug abuse may not be considered but only a mental instability. However, after 72 hours (or before, depending on the circumstances) the patient will be released.

How does all this relate to gun control? It seems the sound byte of the day is that with better mental health background checks, gun control via the ability to buy a gun, will limit the sales of firearms. However, after doing research, it seems almost all our states have some sort of provision in their laws that say (and I’m paraphrasing) “if anyone is found to have had mental health issues of any sort, they will be prohibited from purchasing a firearm.” However, anyone that has had a problem will not list it on the application and health records aren’t allowed to be entered into national databases due to doctor/patient confidentiality, so there is no reliable way to detect such issues. Also, were we to be able to have mental health professionals doing exams, how would we know where they stand on gun control?

So, what are the answers? The bottom line, as I see it, is that some help is better than none. If, by getting someone in to counseling, getting them some sort of medication to balance them, giving them some time sort out emotions, showing them there are people who care and want to help, we may give them the chance to restore their lives to some semblance of normalcy, which is far better than what they had been living. Dr. Renae Lapin, a local psychologist, said: “stress is a major contributor to mental health problems and that our youth are being affected in far greater numbers these days.” Lapin said that research based on studies has shown there are several other ways that may help besides counseling. Some of these ways are nutrition, exercise, good sleep habits, and focusing on the positives in our lives.

One place that offers this type of program is the 9 Muses Art Center of The Mental Health Association of Southeast Florida. Dr. Julie Bruno, PsyD, feels there is a need for more long-term facilities for those with chronic mental illnesses. Insurance needs to be revamped to allow the ability to get into those facilities, state or private, and receive the proper medication. With all of that, many of those falling through the cracks might not.

The truth is, they aren’t cracks they are gaping chasms. Mental health isn’t considered a priority at the same level as general health. The money isn’t there to allow for proper help, the law doesn’t allow an indefinite commitment. Those who are committed (short term), may not really want help or recognize their need for such. What to do? First, we need to address this issue with our government officials. If enough people speak out, maybe a change can take place. Second, we all need to be more aware of those around us and pay attention to changes in personality or habits, no matter how small. If you see changes that alarm you, act on them by talking to the person. Hopefully, you can convince the person to seek help voluntarily. If not, then with the right circumstances, you can do it yourself. Just know that it is likely going to be a short-term solution, but any step forward is better than one going back.

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