Letter writer: Appropriate mental health care can protect community — but it is expensive

Graphic by Lori Deaton

I would like to have an open and honest dialogue on community mental health and mass killings by people with mental health problems, but when will that actually happen? I am a retired community mental health therapist with over 25 years of experience in the community and private psychiatric hospitals so [I] have some knowledge in the area.

I laugh when I hear, following another mass killing, that we need to [have] a public dialogue, because I know that it will not happen; we just salve ourselves with this platitude. If we had an honest dialogue, we would conclude that appropriate mental health care for even the most severely ill could drastically reduce the instances of these events. But there is a cost, and that is where this discussion always ends. As a society, we refuse to pay the price for adequate services in proven models of treatment; in fact, mental health care is often the first to be cut when we cut budgets. We are cheapskates, and a few dead people every couple of weeks is apparently not enough of a price to make us open our pocketbooks.

For individuals with the most significant illnesses, treatment must be intensive and that is expensive. Treatment MUST include the newest, most appropriate, proven medications, and they are expensive. It must include monitoring of the individual on an ongoing basis, and that is expensive. Treatment must address issues of desocialization, isolation, stigma, housing and community integration, and that is expensive. We must use appropriate treatment methods (evidence-based practices) on the appropriate populations and not add on other populations in an effort to reduce the per-consumer cost. We must allow therapists latitude to use their judgment and specific skill sets to assist consumers in their recovery.

We also have to understand that intensive treatment means some smaller caseloads and get away from the notion that we can set “managed care” rates and time limitations on the most severely impaired if we are to have any hope of returning them to the community functioning. We must have modern, adequate and available inpatient hospitals and treatments for individuals in need of periods away from the public. We need a public willing to employ these people as part of their recovery. We must know that consumers can recover, relapse and recover again and be there to support them. All of this is expensive, but we are currently unwilling to pay the necessary price for adequate care that could offer some additional protection to our communities. If we continue to be unwilling to pay, we will be facing a never-ending string of biweekly killings that in many cases could have been avoided.

Mental health professionals know that we can make progress against these illnesses, but the fact is that it is expensive, and as a society, we don’t seem to want to invest in appropriate treatment. And until we are willing to provide adequate funding and professionals to provide these intensive services, we are simply doomed to see ongoing images of police standing around outside a theater or school with blue lights flashing, and the bewildered-looking announcer wondering about the root causes of another unthinkable act.

— Michael E. Beech
Asheville

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2 thoughts on “Letter writer: Appropriate mental health care can protect community — but it is expensive

  1. Jordan Mitchell

    Well put. And let’s not forget, it’s not only these terrible tragedies that could be reduced with adequate mental health care, but a wide variety of other social problems we lament daily. Homelessness, domestic violence, child sexual abuse, all the way up to corporate scandals – all have roots at least partially embedded in deep mental health issues.

    But you’re right, we’re not going to pony up – I think that’s been well established.

  2. A pleasure to see someone with experience comment so thoroughly and with authority. You have told the truth, and the fact that few have commented is a further indication of the complacency of the majority on this subject. It reinforces your points perfectly.

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