Wednesday, December 19, 2012

In tragedy's wake, a call for comprehensive mental health policies

Alexis Skoufalos
Associate Dean for Continuing Professional Education
For months now, we have heard the drumbeat of the Mayan prophecy for 2012…the apocalypse, the end of civilization as we know it.  Who could have ever expected that it would arrive a week ahead of schedule, in a small, quiet Connecticut town?

To a person, we have experienced a mixture of overpowering emotions – sorrow, grief, outrage and anger – at the heart-wrenching horror that occurred at Sandy Hook Elementary School on the morning of December 14. 

As a nation, we appear to have reached the limit of our ability to stomach this type of violence, now that it has been visited so cruelly upon the youngest and most innocent among us.  Across the political spectrum, there is commitment to make whatever changes necessary to prevent similar incidents in the future.

The effort to enact more restrictive gun laws, or limit access to assault weapons and extended capacity ammunition, while noble, is short-sighted and will only address part of the problem. 

The root cause of last week’s tragedy lies in the failure of our health system to provide proper supports and services for those who suffer from mental illness.  The perpetrator of this unspeakable event was himself a victim; a victim of a broken system that does not provide proper treatment for people with mental health issues and personality disorders.  Individuals with mental illness are a chronically underserved special population, even when they have plentiful financial resources and insurance coverage.

According to news accounts, Adam Lanza suffered from Asperger’s syndrome in addition to other neurological and personality disorders.  Because this young man had no intellectual disabilities – in fact, he has been described as ‘brilliant’ – the supports he received to address his developmental disorder (that allowed him to function in mainstream society) ceased once he left the school system.
By itself, Asperger’s is a complex disorder, presenting a bit differently in each individual.  The supports needed for a sufferer to be successful are seemingly minor –– but they can make the difference between a person who is productive and successful and one who is troubled, broken, and destructive.

Once one leaves the special education cocoon, the structured framework of mandatory counseling and behavioral support services is gone.  Functional supports that help someone understand the appropriate conversational responses, how to structure one’s time and work, manage stress and engage socially with peers disappear…to say nothing of badly needed employment coaching and vocational rehabilitation.
The healthcare system does a good job in managing acute illness, a fair job in dealing with chronic conditions, and a miserable job in health promotion and wellness.  Particularly for those with complex personality disorders and serious mental illness, mental health services are poorly managed and difficult to access…if they are available at all.  For those without insurance coverage, all bets are off.

We must work together to develop comprehensive policies and services to address the mental health crisis that plagues this country, or the body count will continue to increase while we shake our heads, wring our hands and cry over the littlest angels.