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For forty-eight hours and more I've watched diary after diary stream by, some thoughtful, some ranting, most* about the need for better gun control. No one in their right mind would argue that reinstating the ban on assault weapons and banning certain types of ammunition and mandating background checks at gun shows are not steps in the right direction. This diary isn't about gun control. It's about the severe lack of mental health services in this country of ours.

This diary is also not about autism. Autistic kids are NOT inherently more violent than the rest of us. If you disagree, please go write your own diary about it.

KosAbility is a community diary series posted at 5 PM ET every Sunday by volunteer diarists. This is a gathering place for people who are living with disabilities, who love someone with a disability, or who want to know more about the issues surrounding this topic. There are two parts to each diary. First, a volunteer diarist will offer their specific knowledge and insight about a topic they know intimately. Then, readers are invited to comment on what they've read and/or ask general questions about disabilities, share something they've learned, tell bad jokes, post photos, or rage about the unfairness of their situation. Our only rule is to be kind; trolls will be spayed or neutered.

People who arm themselves and set out to kill as many people as they can do not "snap" or transform into killers overnight. Someone always knows how troubled they are. There are family members or friends or teachers or co-workers who step forward after the fact and say, "I knew he was in a downward spiral." Sadly, past efforts to get help for these killers were rarely successful. Counseling and treatment are expensive, poorly covered by even the best health insurance policies, and limited in scope.

I urge you to read I Am Adam Lanza's Mother, posted this morning on Gawker.com by Liza Long, for a first person account of how difficult it is to get help for a violent child. You may not agree with her decision to not file charges against her 13-year-old son, but you'll have a better idea of why the mentally ill are filling our prisons instead of our broken healthcare system.

Except, of course, for the ones whose mental illness isn't addressed until it's too late.

We're pretty good around here about making noise. Please, while you're doing everything you can to force enactment of better gun control legislation, spare some time to make noise about our national lack of mental health coverage.

If we fail, more states will do what Colorado has done: allow virtually anyone to carry concealed weapons virtually anywhere. I don't have all the right answers, but I'm smart enough to know that is not the solution!

Please join me in the comments for a polite discussion of what might be done.

*For another, better, diary on this topic, read Stuart Heady's post from this morning.

NOTE: Today's scheduled diarist, CyberLady1, and I got our signals crossed. Her wonderful diary is currently in Community Spotlight and, with your help, could earn the Rescued to Recommended tag. Please read and recommend!

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  •  To write for KosAbility, reply to the tip jar. (99+ / 0-)

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    Nurse Kelley (KelleyRN2) is the moderator of KosAbility’s diaries and maintains the schedule. If you’d like to sign up for an open Sunday, reply to this comment, send me a private message, or email me at KelleyRN2[at]gmail[dot]com.

    The content of the KosAbility diaries is important to many folk who depend on the exchange of information and ideas about their struggles with real life-changing conditions. The moderators of these diaries will not tolerate rude, disruptive, off topic, and/or threadjacking behavior. If in doubt, read our mission statement in the diary.

    "Do your little bit of good where you are; it is those little bits of good put together that overwhelm the world." ~ Desmond Tutu

    by KelleyRN2 on Sun Dec 16, 2012 at 11:43:09 AM PST

    •  Rec'd to the 10th power! (8+ / 0-)

      I find it so frustrating from the perspective of patient, provider and citizen that we as a society can't manage to protect the mental health of our citizens. As with any other disabling illness, emotional and mental conditions make it harder to make a living, resulting in a cycle wherein people are constantly underserved and/or in a lot of debt. How does this make sense? It doesn't, except in a worldview where behavior is a matter of pulling yourself up by the bootstraps and your circumstances are a reflection of God's favor or the lack thereof.
      Wow- like so many others here I keep reading my own words and realizing how worked up I am and how this energy just keeps going. Hope we channel it into something very positive. I might like to write for KosAbility at some point, but I think it best to lurk for a bit first.
      Many thanks and blessings to you dear Nurse Kelley!

      Stay fired up: now is the time to focus on downticket change! #Forward

      by emidesu on Sun Dec 16, 2012 at 05:46:29 PM PST

      [ Parent ]

  •  Even if you have good health insurance ( and (53+ / 0-)

    many of us do not), the coverage for mental health problems is very limited. We emptied out the in-patient treatment centers decades ago. We adopted a model for community treatment, but it seems clear that it is not working. Many folks simply refuse treatment, even though they may be dangers to themselves and to society. No parent want to press charges against a son or daughter just to get the child the treatment that s/he needs. Broken mental health care is just another piece of a broken health care system.

    And we still stigmatize mental illness.

  •  I've known three killers. (25+ / 0-)

    One, an acquaintance, was a domestic abuser who killed his wife and went to prison for ten years.

    One was a person who I think it is fair to say people who knew him thought a little weird but not dangerous who was convicted of his part in the contract murder of a mother and her child. He died on death row in Florida.

    And I was fairly close friends with Jay Handel, the man from Vancouver Island who burned down his house with his six kids in it. Jay had exhibited anger issues over the previous few years, but I don't think any of us who knew him, even those who knew him well, would have ever believed he would have killed his kids, even him, until the day he did. Were we blind to the increasing nature of his anger, seeing the gentleman we had known and loved for years? Perhaps, but I do believe that the day he set the fire something snapped within him.

                      Just my two overwhelmingly sad cents,
                                       Heather

    Torture is ALWAYS wrong, no matter who is inflicting it on whom.

    by Chacounne on Sun Dec 16, 2012 at 02:17:24 PM PST

  •  I am a strong believer in universal health care (23+ / 0-)

    for both physical and mental health. I agree universal health care would help a lot with other society problems.

    As a member of Courtesy Kos, I am dedicated to civility and respect for all kossacks, regardless of their opinions, affiliations, or cliques.

    by joedemocrat on Sun Dec 16, 2012 at 02:18:17 PM PST

  •  An appropriate response to (20+ / 0-)

    this national disgrace involves both improved health care for people with psychological/neurological disorders and severe restrictions on the culture of guns and violence. As you correctly pointed out, nobody suddenly gets out of bed one morning and just out of the blue says I think I'd like to go kill a bunch of people today.

    These kind of incidents arise out of a complex context of individual pathology that takes root in an environment that provides support for violence. We don't know much about Adam Lanza's personal pathology, but we do know that he was raised in a family that appears to have made a fetish over guns. The two are not unrelated.

  •  One thing that we have to stress is that these (22+ / 0-)

    violent killers are not animals or monsters, they are human beings.

    Human beings commit these violent acts, and thus we should hopefully treat them that way before they move to violence.

    The lack of health care, and our society's love for violence provide overwhelming motivation for violence with little chance to abate it. It is no different in these cases than the young gang members in Englewood, Chicago that clearly have PTSD.

    "If you don't sin, then Jesus died for nothing!" (on a sign at a Mardi Gras parade in New Orleans)

    by ranger995 on Sun Dec 16, 2012 at 02:18:31 PM PST

  •  I've had a few jobs in mental health (21+ / 0-)

    There's never enough money, or time, or staff.

    Lots of people dealing with homelessness.

    It's a mess.

    The old Cherokee simply replied, "The one you feed."

    by teacherjon on Sun Dec 16, 2012 at 02:19:10 PM PST

  •  Paying attention to mental health does (18+ / 0-)

    make a difference. It even makes a difference for violent, defiant children.

    We are too much talk in this country -- and nobody wants anything that they think they have to open their wallets for. The free market will provide everything we need, right? These shootings are just a market adjustment, then.

    I do not want to live in a society where mass murders are accepted because a couple of special interest groups stop productive discussion with their red herrings, straw men, and polarizing rhetoric.

    Thank you Kelley. I hope there is a lot of productive discussion -- and a lot of change. And as much as we need to address firearm issues, none of that will help unless we address mental health first.

    Breathe in. Breathe out. Forget this, and attaining enlightenment will be the least of your problems.

    by rb137 on Sun Dec 16, 2012 at 02:21:01 PM PST

    •  Thanks for your valued input, rb. (12+ / 0-)

      These are hard questions with no easy, facile answers. Everyone should feel invested in discussing them.

      "Do your little bit of good where you are; it is those little bits of good put together that overwhelm the world." ~ Desmond Tutu

      by KelleyRN2 on Sun Dec 16, 2012 at 02:45:23 PM PST

      [ Parent ]

      •  This is going to be a fantastically (8+ / 0-)

        unpopular comment, but here it is:

        Both poles of the gun control fight stop necessary discussion. All or nothing isn't within the realm of reality -- it's just simple. Our problems aren't simple. The first thing we need to do is embrace their complexity.

        Political rhetoric cannot embrace complexity, because complexity can't fit on a bumper sticker. That is the reason we need to address the emptiness of our political speech. Sure, everyone has a right to say empty, destructive things -- but we don't have to let those things destroy innocent people.

        What was the revenue gained by the firearm industry when the NRA convinced "the base" that Obama was going to take their guns? The NRA isn't much but a functionary that increases sales for gun companies, and makes sure that those sales continue.

        That said, firearms availablity is part of the problem -- but it really is only one part. Focusing on this purely via increasing gun control laws will not stop these crimes. We need to talk about legal infrastructure, but all of the laws in the world won't help if we don't address our deeper issues as a society.

        Breathe in. Breathe out. Forget this, and attaining enlightenment will be the least of your problems.

        by rb137 on Sun Dec 16, 2012 at 03:05:35 PM PST

        [ Parent ]

        •  (((((((((((((((((((((((((rb))))))))))))))))))))))) (9+ / 0-)

          Seems to me, there are four problems that need to looked at a discussed and worked on/changed, at the same time:

          1) gun availability
          2) mental health services
          3) anti-poverty activities
          4) cultural issues like violent video games and emotional emptiness and things like that

                                   Just my two cents,
                                        Love and Hugs,
                                             Heather

          Torture is ALWAYS wrong, no matter who is inflicting it on whom.

          by Chacounne on Sun Dec 16, 2012 at 04:42:20 PM PST

          [ Parent ]

  •  I am not at all sure what can be done (19+ / 0-)

    On the one hand, psychologists, psychiatrists et al have an awful record of predicting violent behavior; there are many studies that show this. This is true even for people who are IN treatment on a regular basis.

    While, after such a tragedy, we can always find signs that the person who committed the acts was disturbed, we do not know how many people who do NOT ever commit such acts have similar signs of disturbance. I would bet it is very high. We run a substantial risk of further stigmatizing the very people we wish to help.

    However, this is a different issue from preventing violent behavior. It is almost impossible to study prevention of violence, because it is almost impossible to say what someone would have done if he/she had/hadn't been in therapy.  And it is almost impossible to form control groups because we have such poor understanding of who acts on violent urges.

    I can say, for example, that I think that, had I not been in therapy in my teens, I would have committed suicide. But I can't know for sure. And what would I use as a control group? Doing an experiment - randomly assigning troubled people to get or not get therapy - would be immoral and unethical.

    Can we make therapy more available? We can. How much can we do? I am not sure. Will it help? Probably.

    How could we do this?

    What if the various societies that license psychiatrists, psychologists and social workers promoted or even required pro bono services?  (Many therapists have sliding scales; I don't know how many offer them for free).

    If we had more counselors in schools, that might help. But it would probably have to be a lot more. The proportion of adolescents who qualify as "troubled" under any reasonable definition is huge.

  •  One thing we could do is better treatment of (17+ / 0-)

    PTSD.

    The reason this is do-able is that (often but not always) it is known who suffers from this; e.g. soldiers returning from a war.

    My own PTSD regards a former boss - one of the most brilliant and gentlest men I've known.  He was in WWII on the front lines. After his return, he one day picked up his wife, held her upside down and dropped her on her head. Then he left, not knowing if she survived. He never did anything remotely like that before or since.

  •  even good insurance (14+ / 0-)

    is making mental health care hard.  "EAP" crap.  hard to get into.  limited treatments.  pills first.  

    many policies have NONE right now.  

    schools cut back on counseling.  

    and mental health care for the uninsured ? i'l lol, but i'd rather cry.  

    Ted Kennedy: “The work goes on, the cause endures, the hope still lives, and the dream shall never die…”

    by jlms qkw on Sun Dec 16, 2012 at 02:34:24 PM PST

  •  Great diary... (12+ / 0-)

    All weekend long, I've been trying to wrap my head around the idea that the Republicans have been simultaneously saying that these massacres are due to mentally ill people (not guns!) AND then slashing any and all programs that could help. Don't a lot of middle class families rely on Medicaid for treating a family member who has mental illness? But the Republicans want to take away Medicaid and replace it with um, what, jail?

    How long can they refuse to do anything about the guns and refuse to supply any funds to treat mental illness!?!?!?!

    It is possible to read the history of this country as one long struggle to extend the liberties established in our Constitution to everyone in America. -- Molly Ivins

    by theKgirls on Sun Dec 16, 2012 at 02:35:57 PM PST

  •  i see a 3-fold idea: (15+ / 0-)

    1. gun & ammo controls
    2. mental health stuff
    3. conflict training, starting in kindergarten.  

    Ted Kennedy: “The work goes on, the cause endures, the hope still lives, and the dream shall never die…”

    by jlms qkw on Sun Dec 16, 2012 at 02:38:31 PM PST

  •  The mental health aspect (7+ / 0-)

    is important, but something of a red herring in this case, imo. From what I've been reading, the Lanzas were well-off enough to afford mental health care had they wanted it. They lived in a 4000 sq. foot house in an affluent suburb of NYC. A Glock and other automatic weapons are not cheap. They cost hundreds of dollars a piece.

    The problem with "mental "illness as opposed to "physical" illness (I see them both as intertwined, hence the quotation marks) is that with mental illness, the system with which one perceives one is ill is the affected system. If a person has intense stomach pain, fever, vomiting, etc. so on, it is pretty clear something is wrong and s/he will go for help. With mental illness, often the person does not believe him/herself to be ill. What does one do then?  Involuntary commitment? That isn't always possible before something horrible happens. Which is why this incident has convinced me the only way to prevent future shootings is to concentrate on the well regulated part of "well regulated militia" in the Bill of Rights. They didn't have Glocks and "cop killer" bullets in the 18th century.

    Also, there is a diary on the rec list postulating that the use of psychotropic drugs in children is to blame. Perhaps.  We need to be having this discussion and other discussions on the nature of mental health itself. What is mentally healthy?  Is there an objective way to measure it? When and how do we intervene?  What if someone doesn't want help or counseling, etc. doesn't work?  

  •  two comments: (8+ / 0-)

    yes, it's a terrible story, and I feel for that woman and thank her for telling her story, and of course, our society has myriad failures when it comes to mental health, but NO, goddamnit, the author Liza Long is NOT "Adam Lanza's Mother," because, unlike Nancy Lanza, she did not keep a lethal arsenal of weapons in her home that her disturbed son could get at. As demonstrated by the fact that the shooter DID get at them.

    Liza Long took the sharp objects away from Michael.

    A report today has the mother recently confiding to a friend her worries about the shooter because he was now burning himself with a lighter. Self-injury. And still she didn't get the guns out of the goddamned house?

    second comment: yes, of course, we need to re-fund a compassionate mental health system, with confinement institutions for people and children who need to be confined, but the Lanza family had plenty of money to pay for private care in this particular case.

    •  This isn't about the Lanza family specifically. (7+ / 0-)

      It's too early to know which reports we've seen about them are true, and which are pure bullshit. (Remember how the cable shows said for hours that she taught at that school? Good grief - how hard was that to fact check?)

      The Sandy Hook killings are history and cannot be changed by dissecting what we perceive to have been wrong within one family dynamic. My interest is in finding ways to prevent some of the future kilings that are sure to occur.

      "Do your little bit of good where you are; it is those little bits of good put together that overwhelm the world." ~ Desmond Tutu

      by KelleyRN2 on Sun Dec 16, 2012 at 03:27:53 PM PST

      [ Parent ]

      •  My comment is not about "one family dynamic" (2+ / 0-)
        Recommended by:
        FloridaSNMOM, Chi

        And how can we find ways to prevent future killings if we don't discuss why they happened?

        Although this is the first I've seen of it here, I'd already seen this piece posted and recommended often on Facebook this afternoon, in some cases by anti-gun-control acquaintances who earlier were posting links about how reprehensible it was to "politicize" the massacre by discussing gun control, or society norms regarding keeping a lethal arsenal in your house.

        My point contrasting the actions of one mother to another is an important one, in my own opinion.

        yes, reporting has been hasty, as always these days, but some things we can know for sure. He did it with her guns. employment history? not only hard, but impossible to confirm what people are telling you when the office where those records are kept is a crime scene.

  •  I seem to live in a state (6+ / 0-)

    of perpetual outrage over healthcare.  Mental, physical, stigmatization.  Lack of access, affordability, coverage.  Good diary.  Wish I had something to add.

  •  There's one thing I agree with gun advocates on. (10+ / 0-)

    We need to do something to stop this shit from happening, and I'm willing to try providing more and better mental health services as a part of the solution.

    My local radio station runs ads from a pro-mental health group. They have good ads up, saying things like, "If your friend told you she had diabetes, would you become afraid that she'd be violent? ... Then why would you be afraid when your friend tells you she has a mental illness?" and "Mental illness, what a difference a friend makes."

    If we're going to seriously address mental illness in this country, then we need a major educational campaign to go along with it to (a) notify people of what services are available and (b) de-stigmatize people with mental illness. Mental illness is just as much an illness as physical diseases are. I've been lucky that when I needed therapy, I've gotten it through my university and my local mental health center. But a lot of people won't, because they either don't recognize it or think it's a "weakness" to get help.

    I can't imagine how screwed up I'd be if I hadn't gotten help for my PTSD after my roommate abused his wife in front of me. And no, it didn't make me violent. It made me afraid, hyper-focused, and very head-fogged.

  •  It is very complicated, my own family being a case (14+ / 0-)

    in point.  Twenty one years ago on the 30th of this month my 33 year old brother committed suicide using my Dad's rifle.  He went to the beach, put his headphones on, put the rifle in his mouth and pulled the trigger.

    Dad had that rifle before he and Mom married in 1946.  He originally hunted with it and when he stopped doing that it sat empty in a bedroom closet.

    My brother, who suffered drug and alcohol addiction was a mental health worker who was ultimately fired from his job.  Mom and Dad struggled with all of this and how to help.  Twice we as a family had my brother committed, trying to get him some much needed help.  There were many other things we as a family did, we loved Matt dearly.  Since he was of age we couldn't make any of it stick.

    Matt ultimately returned home with my folks, after he lost his job he couldn't keep his apartment.  Mom fed him wonderful meals and Dad broke out the rifle and took him target shooting for some father/son time.

    You know what happened having read my opening paragraph.  Misguided, stupid thinking on Dad's part provided the tool for suicide.  Yet Dad never once saw it coming.  Denial?  I still don't know and Dad never once said before he died in July.  But as I read many comments about how Adam Lanza's mom could be so stupid as to take him target shooting I cannot help but draw the parallel to my own family.  The difference being that Matt killed himself, literally, and his loved ones figuratively, but didn't harm innocent people beyond that.

    I could say so much more about the folks in his field, his co-workers who knew the state he was in and who looked the other way, about doctors he saw who also knew and didn't pursue ways beyond the normal to help him.  I don't blame them for one minute and yet think all of us were complicit.  Not because we didn't care and try, each in the best way we knew how, but because nothing was working and we didn't know how to work together, much less who all of "us" were who might have joined together somehow to find a way to help Matt that could have worked.

    I'm not sure if this makes sense, I hope it does.  I'm trying to say there is no black nor is there white, each person and his or her problem is unique and there is no "making a care plan" for the majority of human beings in any of these cases.

    I offer no solution here, I realize that, but share a bit of what it is like for families and loved ones who come at these terrible needs and crises from their own perspective without help to join the threads into solid fabric.

    Andy's two-timin' tail run off wiff mah sig line!

    by nannyboz on Sun Dec 16, 2012 at 03:13:53 PM PST

    •  ((((((((((((((nannyboz)))))))))))))))))))))))))))) (8+ / 0-)

      I am so sorry for your loss, and for all you have been through.

                           Love and Hugs,
                                 Heather

      Torture is ALWAYS wrong, no matter who is inflicting it on whom.

      by Chacounne on Sun Dec 16, 2012 at 03:18:50 PM PST

      [ Parent ]

      •  Thank you Heather. I didn't say this to garner (7+ / 0-)

        sympathy but rather to illustrate how many layers there are in any given situation.  My quandary is how do we solve this?  I don't know and feel so inadequate having lived it.  Oh, I could make bullet points of what to do but how in the world does one get all the others involved to agree and work together?  Unfortunately there seem to be way more questions than answers.

        Andy's two-timin' tail run off wiff mah sig line!

        by nannyboz on Sun Dec 16, 2012 at 03:23:54 PM PST

        [ Parent ]

        •  Oh, I know you didn't do it to garner sympathy. (6+ / 0-)

          I needed to respond to your heart. It seems to me, especially lately, that North American society is broken, in part, because we don't respond to each other's hearts.

          Yes, many more complicated questions than answers. And it becomes even more complicated with our aging population where even more of those with serious mental health issues of various kinds are left in limbo because their parents and siblings have become incapacitated or died.

                                    Hugs,
                                    Heather

          Torture is ALWAYS wrong, no matter who is inflicting it on whom.

          by Chacounne on Sun Dec 16, 2012 at 03:33:55 PM PST

          [ Parent ]

    •  I'm so sorry, nannyboz. (9+ / 0-)

      The crazy-making thing about our current system of care is that even when help is available, there is no way to force an adult to avail themselves of care, unless they are determined to be an imminent danger to themselves or to others. Even in those cases, the holds are for only a few days.

      I read one comment this weekend that gives me hope: the commenter has a family member with schizophrenia, and that member - like so many suffering with that horrible disease - was non-compliant with her meds. I don't know what happened to bring about the arrangement, but the family member now gets an injection every two weeks and, if she doesn't show up for it, a social worker finds her and brings her in. Her choices, iirc, are to have the injections or be committed. Two years into this arrangement, the patient has a full-time job and no longer skips injections.

      I know, I know. Meds don't fix everything. Still, it was the first I'd read of a system that is successfully addressing non-compliance. Baby steps!

      "Do your little bit of good where you are; it is those little bits of good put together that overwhelm the world." ~ Desmond Tutu

      by KelleyRN2 on Sun Dec 16, 2012 at 03:41:22 PM PST

      [ Parent ]

      •  Baby steps are the first steps! Whatever works! (5+ / 0-)

        Matt's situation was 21 years ago, this was not something offered to our family then.  Thank the powers that be for whatever progress there is.  Having lost my brother in no way lessens my hope for others coming after him getting meaningful help.  I'm glad you told me about this, it lets me know there is some measure of progress.

        Andy's two-timin' tail run off wiff mah sig line!

        by nannyboz on Sun Dec 16, 2012 at 03:47:37 PM PST

        [ Parent ]

  •  Lord Almighty, this is important and thank you (10+ / 0-)

    for writing this.

    It must be handled in a multi-pronged fashion. Anything else is short-sighted.

    And I wrote a comment here which I feel is important toward addressing my perspective about what it is that's wrong with our mental health services right now: a lack of affordable, comprehensive, accessible coverage for those truly in need of more than band-aid solutions, for those facing major delusional disorders, dating back to the Reagan era has left more mentally disturbed kids at home where they simply cannot receive the kind of care they could before. That care was certainly flawed. But it should be reconsidered and reconceived, because at least it was effective and humane to provide in-depth treatment for people with violence or delusions rather than a six week prescription for Prozac and a "see you later" without aftercare.

    I think anyone who has seen certain forms of mental illness up close will understand that we need more care for people who cannot care for themselves easily on an outpatient basis.

    Also, I feel like our society has gone into total denial about how severe some peoples' mental disorders are due to our economic lack of solutions and our desire to not impede on peoples' rights, failing to understand when someone presents a real danger to society or themselves.

    My original post is here and explains my perspective in more depth:

    http://www.dailykos.com/...

    Tipped & Rec'd.

    Click the ♥ to join us on the Black Kos front porch to review news & views written from a black pov - everyone is welcome.

    by mahakali overdrive on Sun Dec 16, 2012 at 03:31:18 PM PST

  •  The safety net is broken for at-risk kids (13+ / 0-)

    I teach in an "alternative" high school. Many of our students have "learning differences" and there are extensive systems to help them through their classes--extra time, extra tutoring, special help of all kinds. Then they graduate, become adults, and there is no longer a safety net in place for most of them. They are left to struggle on their own, and figure life out for themselves.

    If a 20 year old is not functioning well, it is up to him/her to get help. The parent cannot do it. It's a difficult situation. We need to figure out a better transition for the vulnerable young.

    Thank you for writing about this.

    •  Sixty Minutes is just coming on here. (3+ / 0-)

      As I understand it, they have new information about the family dynamics - should be interesting. You're absolutely right, when kids age out of the school system they lose a huge safety net.

      Thank you for choosing teaching as a profession.

      "Do your little bit of good where you are; it is those little bits of good put together that overwhelm the world." ~ Desmond Tutu

      by KelleyRN2 on Sun Dec 16, 2012 at 05:05:47 PM PST

      [ Parent ]

  •  It's not just a matter (13+ / 0-)

    of getting treatment, either.  If you get a diagnosis and treatment, you now have a pre-existing condition.  My OCD was cause to be turned down for other health insurance.  I tried going off the meds that had made me functional for a year in order to qualify for coverage, but it wasn't enough - they wanted to know your history for five years back....

    There is NO way for this problem to be addressed in any health care model that includes for profit insurance agencies.  It can't happen.

    Justice For Will Will spent his brief, courageous life fighting for the rights we all take for granted. Please share his story to support the fight!

    by KibbutzAmiad on Sun Dec 16, 2012 at 03:34:29 PM PST

  •  we need to undo reagan's mess (10+ / 0-)

    first is de-stigmatizing mental health. Reagan tossed the issue and people with mental health issues out the door and onto the streets.

    "It is in the shelter of each other that people live." Irish Proverb

    by Patriot Daily News Clearinghouse on Sun Dec 16, 2012 at 03:50:38 PM PST

  •  Exactly why we need, our lives depend on it, (5+ / 0-)

    Medicare for all.

  •  In the specific case of Lanza, this is new (7+ / 0-)

    This is the first report that his mother realized he was worsening in the week before he killed himself:

    http://www.nydailynews.com/...

    She said, according to this friend, that she was getting help for him. Clearly, even with money, she didn't choose to -- or was not able to -- provide safe, comprehensive care for him outside of her home. I find that really telling. It speaks of stigma, perhaps, or her own belief that she was able to handle this on her own.

    The burning himself is noted by two previous people, one a former teacher of his, and is typical of schizoid personality disorder -- which is sometimes a misdiagnosis for early schizophrenics who haven't displayed all symptoms yet.

    I wanted to draw your attention to this article because it sheds light on one parent trying to make hard decisions about care but still unable to for some reason. It may have involved consent due to his age, or else it may have involved stigma. Both seemed applicable to the conversation here.

    Tragic. Far better, more thorough care was clearly needed.

    Click the ♥ to join us on the Black Kos front porch to review news & views written from a black pov - everyone is welcome.

    by mahakali overdrive on Sun Dec 16, 2012 at 04:00:04 PM PST

  •  Thanks, KellyRN2 (9+ / 0-)

    I happen to know something about this subject because my brother became psychotic for the first time in high school, back around 1969.

    I think the problem is that there isn't much general knowledge around and you can't find professionals who really have the grasp of it that you would wish.  It takes a long time before what the reality is actually becomes understood.  

    The first thing that one wants to do is to argue with mental illness.  Perhaps there are just some wrong assumptions that cause these behaviors.  

    You want to try and placate it.  For this reason, my parents indulged him in support of both smoking, which they knew was not good, and obtaining a pistol for target practice.  

    This sort of thing apparently worked for a while, or seemed to.  But at one point, I came home from college for a visit and my father asked me to quietly remove the pistol.  I packed it into my bags.  Nothing was ever said.  

    The problem with really serious mental illness such as bipolar disease or schizophrenia, stems from the core fact that, as advanced as science may be in general, our basic understanding of mental illness is very little progressed from the days of Sigmund Freud.  

    The tendency to throw pharmaceuticals at the problem is really due to frustration that anything else will work.  

    My brother died a couple of years ago, of liver cancer.  It went untreated for a while because he thought that the doctor and a nurse who were talking about an MRI test, were actually talking about castration.  So he hoofed it out of there and refused treatment.  

    He was 56 when he passed away, having made it one year longer than the average life span for bipolar sufferers.  The MHMR system seemed to be capable of pretty good chronic care maintenance.  The funding was primarily Medicaid, with section 8 housing.  Other chronic sufferers in a similar situation wind up getting into arguments with landlords and thrown out of section 8 housing.  They die out in the wooded areas, among the homeless.  

    I think that the whole system is a tragic mess, and this is partly due to the fact that the arguments about budgeting that we go through year after year are not about mental illness.  This is a painful issue and there isn't a consensus about what to do.  It isn't clear that there really are cures or even effective treatments.  

    It isn't very likeable.  If you have ever had to deal with someone who is mentally ill, it is scary.  Arguments about what is going on or what to do are in a nightmare dreamscape in which alien agents are on earth doing business with super secret government operations that watch certain people because they know they know.  This gets confirmed on late night talk radio and it bleeds over into network TV which is insanely violent.  

    It is really a nasty situation.  It is no wonder that, in the days and weeks after the next really shocking shooting incident involving someone mentally ill, the issue goes away.  

    I think progressives, who should be the vanguard on this, are really afraid of mental illness.  I think people given to using their intellects and who have an imagination are a bit vulnerable to turning away from the word "crazy" and the stigma associated with it.  

    An enlightened perspective, one based on our best educations, however, would be that with better funding and more enlightened handling of people who are at risk, we could be making progress.  

    Instead we are making jokes about zombies.  Probably whistling past the graveyard of our fears.

    hope that the idiots who have no constructive and creative solutions but only look to tear down will not win the day.

    by Stuart Heady on Sun Dec 16, 2012 at 04:05:32 PM PST

  •  Thanks, Nurse Kelly (6+ / 0-)

    I saw that article, and it's a really good insight into the life of a mother living with a mentally ill child.  He's so bright--I hope he gets the good counselling he needs, so he can pursue a good course of academics and learn to channel his rage in constructive ways.

  •  jailing the mentally ill is like throwback to (5+ / 0-)

    bdlam

    yes, sure lets jail the mentally ill. costs more too!

    fact does not require fiction for balance (proudly a DFH)

    by mollyd on Sun Dec 16, 2012 at 04:21:01 PM PST

  •  I just got up from a nap and found this. (5+ / 0-)

    In response to Peter, upthread, I have spent the last forty years of my life as a student of violence and violent behavior.  Actually, it goes back further than that.  I was five the first time I saw the body of someone who had died a violent death.  I was ten the first time I actually saw someone die a violent death.  I have lost track of the number of dead, and sometimes mutilated, bodies I have seen.  They all affect me.

    Most mental health professionals, and I include both psychologists and psychiatrists, would not recognize a potentially dangerous patient if they were hit in the butt with a bass fiddle by one.  I have taught a graduate level course on thanatology (the study of death and dying).  I have a seven hour lecture I give on suicide.  Did you know there is a percentage of diagnosable mentally ill people who have MMPI-2 profiles completely within the normal range?

    I am far better than the average psychologist or psychiatrist when it comes to identifying who might or might not be dangerous, but even so, I have made some horrendous misses.  This is not easy.  Where I have been most useful is talking people out of killing themselves or others.  I know of several insurance adjusters who would be pushing up daisies if I had not talked the patient out of killing them for refusing to pay claims.

    The general who wins the battle makes many calculations in his temple before the battle is fought. The general who loses makes but few calculations beforehand. - Sun Tzu

    by Otteray Scribe on Sun Dec 16, 2012 at 05:17:23 PM PST

    •  Thanks for this, OS (5+ / 0-)

      What do you think of a suggestion made above that we teach conflict resolution and/or anger management in our schools, beginning in kindergarten? Useful or not?

      "Do your little bit of good where you are; it is those little bits of good put together that overwhelm the world." ~ Desmond Tutu

      by KelleyRN2 on Sun Dec 16, 2012 at 05:22:42 PM PST

      [ Parent ]

    •  But what about one who was burning himself? (6+ / 0-)

      Adam Lanza was reported now to have spent the week burning himself intentionally. That could lead to a 5150 hold. Plus, we don't know if he'd been previously violent although school officials have said he had violent outbursts in school which caused his mom to have to come pick him up; she wound up home schooling him. Also, his mother was concerned though that he was worsening according to a friend who she talked with that week.

      I know you cannot always tell in advance if someone will be prone to violence. But if someone has schizophrenia (I'm really focused on this, and schizoid personality disorder, based on reports of his flat affect and inability to feel pain, which is highly unusual other than in schizoid personality disorder and sometimes schizophrenics), they're more prone to violence and need careful monitoring.

      I've known a high, high number of people who committed suicide, I think because of how I grew up and with what crowd. I don't want to talk publicly about it too much. One expressed violent thoughts and this is, I think, why he killed himself: to avoid harming anyone else.

      My stepmother and friend is a psychologist and yes, has suicides sometimes.

      This is sort of a rambling response, sorry. I do feel that if someone is known to be violent or a risk to themselves or others, we need some better social protocols. Did you see the diary here earlier from someone in Portland with a friend who was armed and dangerous and the guy didn't know what to even do? Neither did I, really. How do we find help for people with clear signs? With my friend, I tried and found nothing. I called the police, his former probation officer, his family, his former doctors, and no one could help, and a few weeks later, he was hanging from a rope.

      I loved that guy with my whole heart. It devastated me. He called me for help. He had very specific things he asked for, including help moving, which I couldn't fully help with, and talking with his ex-wife, which I did. I haven't made peace with this yet, sorry to ramble...

      Click the ♥ to join us on the Black Kos front porch to review news & views written from a black pov - everyone is welcome.

      by mahakali overdrive on Sun Dec 16, 2012 at 05:39:35 PM PST

      [ Parent ]

      •  That was probably TMI (5+ / 0-)

        Sorry. I try to avoid that. But when it comes to talking about mental illness and death, I've been around it a lot, especially for someone of my age.

        Click the ♥ to join us on the Black Kos front porch to review news & views written from a black pov - everyone is welcome.

        by mahakali overdrive on Sun Dec 16, 2012 at 05:45:37 PM PST

        [ Parent ]

      •  Self injury is a wild card. (5+ / 0-)

        Autistics in particular are prone to self injury, and at younger ages we see a lot of head banging.  I remember one case where the head banging was so severe, he detached both retinas and became blind.  

        Cutting is more prevalent than burning.  Also, I am aware of persons who become almost addicted to body piercings and tattoos.  When one starts digging in the personality, we find the pain gives them momentary relief from inner pain.  Pain sensations release endorphins, which act as an antidepressant.  The kid in CT was supposed to have an anesthesia to pain, so I don't know what to make of the burning.  That is so far out on the tail of the statistical curve as to be regarded as an outlier.  

        The general who wins the battle makes many calculations in his temple before the battle is fought. The general who loses makes but few calculations beforehand. - Sun Tzu

        by Otteray Scribe on Sun Dec 16, 2012 at 05:58:37 PM PST

        [ Parent ]

  •  My granddaughter says (4+ / 0-)

    that watching Lt. Joe Kenda on TV is kind of spooky, because she says it is like listening to me, except she says he does not have my dark sense of humor.  

    The general who wins the battle makes many calculations in his temple before the battle is fought. The general who loses makes but few calculations beforehand. - Sun Tzu

    by Otteray Scribe on Sun Dec 16, 2012 at 05:21:04 PM PST

  •  In this country we don't even want to talk about (2+ / 0-)
    Recommended by:
    FloridaSNMOM, second alto

    our mental health. Even though we all have mental health issues to deal with at some points in our lives we try to pretend that we are always fine.  And we pathologize normal behavior (sexual kinks and identities) while pretending that pathological thinking (extreme paranoia for example) are normal.

    "Even a man who is pure in heart and says his prayers by night may become a wolf when the wolfbane blooms and the autumn moon is bright" Curt Siodmak

    by Wisdumb on Sun Dec 16, 2012 at 05:23:04 PM PST

  •  Excellent diary (6+ / 0-)

    I almost agree with everything you said. Health issues, and particularly mental health issues, are difficult to see, even by very close friends and family members. In the days of the television show "all in the family" I remember my great uncles saying which great uncle reminded them of Archie Bunker. They all had a little bit of Archie in them.

    Many years ago I took a course in group dynamics with 12 people in my group. We met every day all day for two weeks. At the end of one session a member of the group had a heart attack. Only one member of the group recognize the heart attack and rushed the victim to the hospital. The rest of us including the teacher had gotten up and left.

    After I graduated college I dated a girl and became quite close to her. Eventually I learned that she had suffered a nervous breakdown and had been treated at a psychiatric hospital for schizophrenia. If I had not been told then I would never have known of her mental illness.

    Years later I dated a woman with three daughters. We started to live together. I realized that one of her daughters was mentally ill and consulted a close friend of mine who had a doctorate in clinical psychology. He recommended a psychiatrist and when the daughter was seen by the psychiatrist he hospitalized her immediately for mental illness. She suffered from extreme OCD.

    My point is there are times when one can recognize others have an illness and there are times when it may be very difficult to recognize an illness in others. Close family members may not want to see the illness. Other people may be all too willing to see an illness where none exists.

    I am very wary of believing someone who claims they saw mental illness after a catastrophic incident has occurred and say that they saw the mental illness before the incident occurred.

    I believe many people including myself can benefit from counseling with a trained counselor. Unfortunately, our society denigrates counseling.

    Practice tolerance, kindness and charity.

    by LWelsch on Sun Dec 16, 2012 at 06:00:22 PM PST

    •  Larry Welsch! OMG, you're back! (5+ / 0-)

      I can't tell you how many times I've checked your comments to see if you'd reappeared. Now I see your recent diary about being gone, and the health issues, and I'm so sorry you went through all that.

      We lost ulookarmless while you were gone. That was brutal, personally. It's good to see that someone I feared was with CJ has returned to the fold. Welcome home!

      "Do your little bit of good where you are; it is those little bits of good put together that overwhelm the world." ~ Desmond Tutu

      by KelleyRN2 on Sun Dec 16, 2012 at 07:44:56 PM PST

      [ Parent ]

    •  Welcome home Larry!! (2+ / 0-)
      Recommended by:
      KelleyRN2, FloridaSNMOM

      It's good to 'see' ya.

      Feliz Navidad, Joyeux Noel, Happy Hannukah, Merry Kwanza, Cheerful Boxing Day, Joyous Festivus, an Enlightened Bodhi Day, and Cheery Winter Solstice and Yule celebration.

      by khloemi on Mon Dec 17, 2012 at 01:57:55 AM PST

      [ Parent ]

  •  Thank you for this. (6+ / 0-)

    I raised a child with severe mental illness.  It was the most painful, hopeless, helpless and traumatic experience of my lifetime.  I realized when he was very, very young that something was dreadfully wrong.  I spent several years frantically trying to get him the help he needed.  I did not want my child hurt, nor any other to be hurt by my child.  There simply were no resources to turn to.

    Out patient therapy and medication only bought us some time, but he continued to deteriorate.  It was like living in a war zone trying to protect both my  children; one from himself and the other from her brother.  The school didn't even take me seriously, despite the warnings from his psychiatrist, until he attempted to strangle a classmate without warning or provocation.  Only then would they place him in a special class with more supervision.

    After an agonizing and lengthy struggle, where I was so worn down, I once wondered if death were not preferable for him and myself, he finally found the help he needed.  The only hospital in this part of the country capable of helping him  had a 2 1/2 year waiting list, but due to the severity of our situation, made a bed available to him even after I admitted that our insurance could not come close to covering the charges.

    My child was 10 years and 7 months old the day he was finally admitted to a psychiatric hospital for the intensive treatment he required.  In approximately one month, his insurance hit the lifetime cap and he was in a facility that charged $1,000 per day for the bed, plus medication and therapy.   It would be two years before he was stable enough to return home and resume outpatient therapy.  

    That was 1988,  the hospital is no longer there and I know of no other that offers the services they did.  My child is an adult now and leading a good, productive life, but only because that hospital chose to accept him when it did.  My mind wrenches away from thoughts of what would have happened without that intervention, possibilities too awful to consider for more than a moment.  And I often contemplate the fact that the hospital only had 12 beds in the pediatric unit and many were turned away because there weren't enough resources.  They were not so fortunate and did not get the care that led to him having a functional adulthood.  And I wonder what happened to all those less fortunate sons and daughters.

    This country has got to do one hell of a lot better when it comes to mental illness and until it does, until we do better, we are going to continue to pay a very high price for that neglect.

    You are my brother, my sister.

    by RoCali on Sun Dec 16, 2012 at 06:32:50 PM PST

    •  I'm (almost) speechless, RoCali. (5+ / 0-)

      You could have written a much better diary than I did; you said more in this comment than I did in several paragraphs.

      THANK YOU for sharing your story. I would love to know what your son's inpatient therapy did for him to give him his life back, but that's the nosey nurse in me. I do know, from a relative's experiences in the 80's, how scarce pediatric beds are, and I can only imagine, as a mother myself, what kind of hell you went through during those dark years. I wish you and your family nothing but peace and fair skies for the remainder of your lives.

      "Do your little bit of good where you are; it is those little bits of good put together that overwhelm the world." ~ Desmond Tutu

      by KelleyRN2 on Sun Dec 16, 2012 at 07:57:15 PM PST

      [ Parent ]

      •  Kelly, you are Gracious and Kind (3+ / 0-)

        I felt guilty about such a long comment and yet, it barely skimmed the surface.  I would be more than happy to answer any questions you have.  Truthfully, that would be easier now than it would have been during that time.  I confess, I still get emotional about it and have sometimes felt emotions akin to PTSD.  For several years, we lived continually on the edge of the abyss.  

        There were 12 tales of pain and struggle tied to those 12 pediatric beds.  The patients were aged 5 to 12 and each was there because of severe mental health issues.  All had a documented history of violent episodes.  A few of them were never expected to leave institutional care.  

        I learned some harsh and painful truths while we were associated with the mental health system in general and that hospital in particular.  It was then that I first realized how profoundly we as a society have failed our children.  

        You are my brother, my sister.

        by RoCali on Sun Dec 16, 2012 at 08:54:01 PM PST

        [ Parent ]

        •  I'd like to see you write about all this. (1+ / 0-)
          Recommended by:
          FloridaSNMOM

          What it's really like to need, search for, and afford mental health care for a child. You don't have to violate your son's privacy any more than you have here, because the story I'd like to see told is your story, a parent's story. What is it like to realize your precious child is mentally ill? What steps did you go through before knowing long-term institutionalization was the only answer? What effect did the experiences have on your marriage, if you were married, and what was the impact on your other child? What do you think would have happened if you hadn't found a hospital willing to take him? What was life like after he was released? Was it smooth sailing, or were there serious setbacks?

          Like that. If you decide to do it, take all the time you like to write it, then kosmail me or email me and we'll publish it as a KosAbility Special.

          It's a critically important story ....

          "Do your little bit of good where you are; it is those little bits of good put together that overwhelm the world." ~ Desmond Tutu

          by KelleyRN2 on Sun Dec 16, 2012 at 09:26:30 PM PST

          [ Parent ]

          •  It's not a pretty tale. (2+ / 0-)
            Recommended by:
            KelleyRN2, FloridaSNMOM

            I would have to explain some pretty raw stuff for anyone to truly understand.  I try to be quite  careful about revealing too much identifying information, such as the name of the facility or doctors.  They were intensely scrupulous about protecting the identity of the patients, due to the stigma attached to mental illness and related privacy concerns.  I respected their efforts and continue to do so. It is also a long tale, covering many years.

            If you feel it might be helpful, I will do it.  No one, and I do mean NO ONE, should have to go through that.  The illness itself is devastating and overwhelming for a family to cope with.  To have to battle the system and the lack of a functioning system on top of battling the illness itself is just about more than a mere mortal can take.  If laying out that ugliness and exposing that pain could in any way provide some resource or solace to ease that burden for another, I will do it.  I owe that.

            You are my brother, my sister.

            by RoCali on Sun Dec 16, 2012 at 09:54:19 PM PST

            [ Parent ]

            •  I do think it would be helpful. (1+ / 0-)
              Recommended by:
              FloridaSNMOM

              People seem to think everything will be juuust fine if we can change the gun laws. That's so simplistic it makes me tear my hair out! Why don't  you think about it overnight (or for a day or two) and, if you're still willing, let's talk. You know a truth about American mental health care that needs to be told.

              "Do your little bit of good where you are; it is those little bits of good put together that overwhelm the world." ~ Desmond Tutu

              by KelleyRN2 on Sun Dec 16, 2012 at 10:01:29 PM PST

              [ Parent ]

    •  This is exactly what I fear is happening (4+ / 0-)

      because of stories like yours, which match the experiences I've seen as well.

      And my insurance also listed it at 1K per day after three days and only one hospitalization, so it sounds like a serious gap in our care.

      I'm sorry for all that you went through with your child.

      Click the ♥ to join us on the Black Kos front porch to review news & views written from a black pov - everyone is welcome.

      by mahakali overdrive on Sun Dec 16, 2012 at 08:50:10 PM PST

      [ Parent ]

      •  Thank you.. (4+ / 0-)

        I don't think enough people fear what is happening, frankly.  Too many people have no real understanding of the realities and complexities of the problem.  Mental health insurance coverage is an absolute joke when faced with the real-world costs.  Of course, first you have to find a facility... then you have to worry about paying for it.  And what other option do you have, really?  

        The first few weeks were filled with testing, some of the highest costs of treatment.  He hadn't been there too many weeks and I saw the first statement with a total over $250,000, knowing the insurance was spent.  I had a moment of hysteria, folded it into a paper airplane and laughed as I cast it.  I knew, without treatment, my child was utterly lost and I knew with equal certitude that I could not afford that treatment.

        In a sense, we got lucky.  The hospital took pity on us.  At the time, I was spending over $700 per month on medication for him so they asked that I pay that to them as long as he was in the facility.  When the insurance ran out, mostly due to the admittance testing to get his base results, they asked me to sign him up for Medi-Cal.  When he was ultimately released, they wrote off the enormous balance due out of a charity account they had, explaining it was limited and reserved for only the most desperate and needy cases.  Whatever guilt I had at "hogging" their limited available charity was overwhelmed by my relief that my child would have a chance at a healthy life.  Yes, we got very, very lucky.

        You are my brother, my sister.

        by RoCali on Sun Dec 16, 2012 at 09:05:33 PM PST

        [ Parent ]

        •  You should diary on this if it's not (3+ / 0-)

          too personal. It might help raise some peoples' understanding of exactly how prohibitive it is to find mental health treatment in the U.S. It's almost impossible to find it in any long-term or meaningful sense; I know. But many don't. So you could educate them about this if it weren't too painful for you to diary on.

          My personal hunch is that a lot of the kids involved in the recent mass murders had problems profound enough that they should have been in-patient until stabilized, but that the vast majority of their parents had the resources. I feel that many were given light-weight antidepressants for major mental disorders because no one could afford that kind of in-patient care -- which was pretty standard in the past, although it was also a lot scarier and in need of its own reforms -- and the cost to society was unspeakable as a consequence of this all.

          Again, you are strong. You've lived through a lot. Your hospital was kind to you as well. I hope everything is good now and that your child is living more functionally.

          My many blessings to you all.

          Click the ♥ to join us on the Black Kos front porch to review news & views written from a black pov - everyone is welcome.

          by mahakali overdrive on Sun Dec 16, 2012 at 09:24:53 PM PST

          [ Parent ]

  •  I've been trying to come up with the words to (4+ / 0-)

    discuss the issues of mental health in this country.  I can only say that this "People who arm themselves and set out to kill as many people as they can do not "snap" or transform into killers overnight." is very true and is making it difficult for me to effectively communicate.

    I seem to be in a low spot.  It could be SAD.  It could be the vitamin D deficiency. It could be PMS stuff.  It could be general anxiety about the upcoming family gathering for Christmas.  It could be general anxiety about financial security.  It could be all the crap going on in Congress and my reading about it.....  who the hell knows.  Three weeks ago would have been my parents 50th wedding anniversary.  I'm having some warning bells go off about work - that someone is going to try to throw me under the bus, or somehow discredit me.

    •  That's a lot of heaviness, nchristine. (2+ / 0-)
      Recommended by:
      nchristine, FloridaSNMOM

      If it's SAD, plan to celebrate on Friday, the end of shortening days. In about six weeks we'll really notice the lengthening of the days.

      Hang on, Honey. You're one of the survivors, a woman with an inner strength.

      "Do your little bit of good where you are; it is those little bits of good put together that overwhelm the world." ~ Desmond Tutu

      by KelleyRN2 on Sun Dec 16, 2012 at 09:31:53 PM PST

      [ Parent ]

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