Mental Health Matters: America’s problem is its absence of mental health care | SierraSun.com

Mental Health Matters: America’s problem is its absence of mental health care

Andy Whyman, MD
Special to the Bonanza

Two New York City policemen were murdered Dec. 20 while sitting in their patrol car. The shooter, one Ismaaiyl Brinsley, was a black man who took his own life minutes later.

Subsequently, the media focused on the seemingly senseless murder of the two officers, and, given the prior police-caused deaths of two unarmed black men, the relationship between the police and black communities.

Noted, but not sufficiently explored, was Mr. Brinsley’s prior life history — 28 years old when he died, Mr. Brinsley was previously arrested some 19 times in Georgia and Ohio and ultimately spent two years in jail from mid 2011 through mid 2013.

According to his mother, he experienced a violent childhood, struggled with mental illness for much of his life and refused family efforts to get him help. He attempted suicide when a younger man, and tried to hang himself a year before his death.

“Whether by accident or design, the hallowing out of mental health services in the past four decades has left millions of the mentally ill to fend for themselves, consigned to a brutal and often unnaturally shortened life of despair, addiction, homelessness and incarceration.”

In a last Facebook post, said to be written shortly before he killed the two policemen and then himself, he said, “I always wanted to be known for doing something right … but my past is stalking me and my present is haunting me.”

His sister was said to remark that the criminal justice system never provided him with mental health care or any other form of rehabilitation.

In a broader context, in 2006 the Bureau of Justice Statistics found that 45 percent of federal prisoners, 56 percent of state prisoners, and 64 percent of local jail inmates suffered from mental-health problems.

Other findings from a 2013 study in Psychiatric Services found that, at a national level, two million people with mental illness go to jail every year.

In a 2010 study, Columbia researchers found that over 60 percent of people in prison suffered from drug addiction before incarceration. Most had mental disorders. In fact, the American Psychiatric Association defines drug addiction as a mental disorder.

Stop and pause over these numbers for a moment; they speak to a criminal justice system which few outsiders can even contemplate, much less understand.

In essence, our prisons and jails have become the largest institutions in America housing the mentally ill. And the vast majority of these people receive either no care or offensively deficient care during their incarceration.

At a local level, Kevin MacMillan, editor of the North Lake Tahoe Bonanza, has written two excellent articles on the problem of substance abuse in the Incline Village community and its schools.

In the initial piece (12/11/14), Mr. MacMillan cited the some 400 arrests or citations for Incline Village related-drug crimes from 2009-2014 and six narcotics-related deaths.

He also noted the admirable recent efforts of local Realtor Edee Campbell, who started a first-of-its kind for this region, Nar-Anon group (a 12-step peer group meeting for anyone dealing with a loved one’s addiction).

The second article (12/25/14) focused on drug problems in local schools. It quoted Katherine Louden, director of counseling, equity, and diversity for the Washoe County School District. who said that, “… substance abuse remains a constant with our youth over time… “ and Leslie Hermann, K-12 principal at Incline public schools, who opined that, “… there’s a drug problem at every high school in the United States.”

Ultimately, both of these revelatory articles raise questions about the sufficiency of professional educational and counseling services to tackle this problem.

So what do these seemingly disparate and unrelated stories have in common?

Whether by accident or design, the hallowing out of mental health services in the past four decades has left millions of the mentally ill to fend for themselves, consigned to a brutal and often unnaturally shortened life of despair, addiction, homelessness and incarceration.

According to the National Institute of Mental Health, neglecting the legitimate needs of the mentally ill costs the nation some $444 billion annually mostly due to lost earning capacity.

Says Ron Honberg at the National Alliance on Mental Illness, “We know what to do. We just don’t do it.”

Proven programs, appropriately funded, would improve the lives of millions of Americans with serious mental disorders. For example, assisted housing providing support services reduces homelessness, and decreases the financially costly time that would otherwise be spent in shelters, hospitals or jail.

Another example: Supported employment programs providing guidance to those with mental disorders have been shown, in multiple studies, to triple the rate of gainful employment.

Yet, according to the Substance Abuse and Mental Health Services Agency, only 2 percent of the mentally ill in an already anemically underfunded public mental health system obtain either of these services.

What we know is that mental illness, to include substance abuse and addiction, is not a lifestyle choice or, for that matter a choice of any sort.

Like the treatment of cancer or heart disease, a non-judgmental caring community of health providers with access to educational and social resources can make a difference in the lives of those with mental disorders.

The fundamental problem in America is absence of access to quality care, or worse, absence of access to any care at all for most everyone except the well to do or those with gold plate insurance coverage.

Rather than squander hundreds of billions of dollars yearly on the failed War on Drugs, the criminalization of drug use, and punishment of the mentally ill, shifting resources to prevention and treatment would offer millions of Americans the promise of a better life.

Encouraging open discussion about the realities of mental illness is a necessary first step. Readjusting our policies to accommodate what we know about mental illness is a struggle worth pursuing.

Incline Village resident Andrew Whyman, MD, is a clinical and forensic psychiatrist. His column focuses on drugs, mental health and substance abuse in an effort to raise better awareness. It appears every other week in the North Lake Tahoe Bonanza and Sierra Sun. He can be reached for comment at adwhyman143@gmail.com.