Is Mental Health Care to Blame for School Shootings?
Part 4: What do we do?
Richard J. Keyworth saw mental health issues in crisis situations as a first responder.
“I am a retired Firefighter who spent more than 3 decades on
the streets dealing with people of all types. When the government got
involved in Mental Health and decided that many of these people should be
mainstreamed and not institutionalized we saw a dramatic increase in
abnormal behaviors. Many who were supposed to be on medication, would just
stop taking their meds and then we had situations.”
The withdrawal syndrome effect of “crazy” behaviour happening after quitting psychiatric drugs is a well-documented effect. An increase in homicidal and suicidal thoughts and behaviors while on certain classes of psychiatric drugs is also well-documented, and appears on the standard side-effect warnings one gets from the pharmacy. These effects are clearly caused by the drugs, just as it says on the drug’s packaging. To the general public, though, it may appear that the illness is to blame rather than the drugs. That perception benefits the pharmaceutical companies that make these drugs, because the very side effects and withdrawal effects caused by the drugs convince the public that the drugs are necessary. It sets up the very worst kind of vicious circle, because even when the patients themselves notice what happens when they are on the drugs or in withdrawal from the drugs and resolve to remain drug-free, the law in many states allows institutions and their employees who financially benefit from the drugs to force the drugs on the unwilling.
Chad Dion Lassiter, MSW, is President of Black Men at Penn at the University of Pennsylvania School of Social Policy & Practice. He says:
“The blame is manifold with regards to the manner in which we treat
those who have mental health challenges. The stigma and the gross
generalizations that emerge from society along with feelings of
‘otherness’ from those that are directly impacted by a mental health
diagnoses is deeply rooted and extremely problematic. We should not
blame the illness, but can equally blame those errors in diagnostic
assessment, the lack of mental health funding and research, a flawed
health care system and a society that stigmatizes and has a love affair
with guns and violence. We must do the hard and difficult work of
addressing the crisis in mental health from a policy, educational and
The currently prevailing theory behind psychiatric drugs is the neurotransmitter theory. This theory holds that a chemical imbalance is the cause of mental illness. Psychiatric drugs are designed to change brain chemistry by either blocking or enhancing the effects of the natural neurotransmitters generated by the brain. This theory is taught as if it were proven fact from the beginning of a mental health professional’s college education. It’s even propagandized to the public on TV ads. However, the evidence in favor of the theory is correlative, not causative. High and low levels of specific neurotransmitters correlate with specific emotional states. This is hardly surprising, given the function of neurotransmitters, which is to transmit messages within the brain. The function of SSRIs, Selective Serotonin Reuptake Inhibitors, is just as its name implies, to alter serotonin levels in the brain. The drug is designed to do that because a specific level of serotonin was found to be associated with depression and other conditions.
Noticing that a high level of internet traffic on a shopping website corresponds with Christmas doesn’t mean that if one blocks that website’s traffic one stops Christmas. The logical fallacy is obvious, but that is precisely how modern pharmaceutical-based psychiatry thinks about neurotransmitters. Treating mental illness by blocking neurotransmitters is literally killing the messenger.
The story of killing the messenger is a very old story about a king in the days when messages came only via people. It was not only before the internet, but before the post office. Say a messenger comes before the king and says, “There is war, your majesty! Foreign troops are marching on your border.” Instead of dispatching his army to fight the invaders, the king kills the messenger. That might make him feel better in the short run, but it’s not going to help with his real problem.
Our mental health system pushes these drugs and discourages the talk therapy that has actually been proven to help people cope with the crises and life events that cause depression, anxiety, post-traumatic stress, and other emotions. The economics are clear: pharmaceuticals are manufactured, and therefore benefit from economies of scale, while talk therapy is one-off like hand craftsmanship. Modern economies prefer the big business economy of scale to the small business of craftsmanship. Modern economies reward big business with money. Money buys influence. Influence makes law. The law says drugs are good and must be used. To extend the metaphor, if the king decides to stop shooting the messenger, someone gets to tie him down and shoot the messenger for him. It’s obvious why this is ineffective at curing mental illness.
Is a paradigm shift coming in the mental health care professions? Only a very few mental illnesses have ever been proven to have a genetic link. These include the oldest and most basic of mental health labels, such as schizophrenia. A genetic link implies inborn abnormality, and that in turn implies that brain chemistry might be a legitimate place to look for a cause, and therefore also for a cure. However, both the new DSM and the past few editions include thousands of mental health labels that have no physical tie at all, and are widespread in the population. Mental health labels define in the DSM define what diagnoses insurance companies must pay to treat, either with drugs or with therapy or both. Nearly everyone fits the criteria for at least one diagnosis in at least one part of their lives. Because drugs are economy of scale products, they are cheaper than therapy, and therefore both insurance companies and government programs prefer drugs. That does not mean they the best treatment for the patient, however. It leads to scenarios in which a would-be consumer of mental health services tells the doctor, “I have nightmares about the war,” and the doctor says, “You have a chemical imbalance, here is a pill, come back next year for another prescription.” There is clearly a disconnect between what people need and what the mental health care system has to offer. It is obvious that pharmaceutical-only treatment may be good for insurance companies but it is bad for patients, and ultimately, for society at large.
Mental health experts see a need to improve the system. Experts offered various solutions to the problem of mental health as it relates to school shootings.
Steven B. Gordon is Executive Director of Behavior Therapy Associates, on the faculty at the Graduate School of Applied and Professional Psychology at Rutgers University for over 25 years, and Adjunct Associate Professor in the Department of Psychiatry, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School. He says, “It is critical that schools and mental health professionals identify students who have ‘social-emotional learning’ difficulties. The saddest part of these stories is when we learn that the perpetrators were already known to educators and others as needing help.”
“After a person is identified as needing help, the next step is to provide targeted interventions that will address these social learning deficits such as articulating the problem; identifying their own emotions; specifying a desired outcome; exploring, evaluating and implementing solutions that will work; and finally, deriving satisfaction from the outcome. Young people need not only to have alternatives to violence and aggression, they need a skill set.”
Dr. Bradley Kaye is Scholarly Editor at Edwin Mellen Press. He says, “We need more community based mental health options in this country. I think that many people suffering from mental illnesses find that their anger leaves them in complete isolation, without any friends, and often alienated from family. The solution is something along the lines of The Icarus Project, whose goal is to build alliances and friendships in a way where people can express their emotions in a supportive community, by making friends. We need more support groups, and free therapies like that. Hospitalization is not the only answer.”
“I think that mental health care should use a template like Alcoholics Anonymous. For instance, one thing AA does that can be transferred to mental health support groups is firstly using sponsors who remain anonymous. AA provides a sponsor, or has you choose a sponsor, someone who is also a recovering alcoholic who serves as a counselor of sorts. The recovering alcoholic can call them at any time and the sponsor listens, talks them through the crisis. I think that this could serve as a free way get help from people who have gone through a suicidal period in their lives and can tell the person that the feelings are only temporary. It helps.”
“The Quakers used to do provide a more communal based approach back in the 19th century. Things like volunteering with soup kitchens, realizing that God (or perhaps evolution) naturally provides us with curative capacities, and that mental health involves taking care of the sick person and loving them unconditionally, listening to their angry outbursts without judging, and being a rock for them.”
Nancy B. Irwin is a therapist and clinical hypnotist. She says:
“1. As a mental health professional, I certainly believe there is more
we can do. I have treated young men who were extremely rageful and riddled
with hatred and self-hatred. I would not be surprised at all if I saw them
on the news one night, having perpetrated a heinous crime. However, there
is only so much we therapists can do; if a patient leaves treatment, we
cannot “stalk” them or call their parents and warn them that we believe they
are at risk. I believe this could be helpful, yet our confidentiality
requirements at this point in time prevent us from that. Unless they state
a target, a method, and there is specific, serious intent (Tarasoff), my
hands are tied.
“2. While I am not a fan of guns myself, and believe that better
backgrounds checks should be in effect and no assault weapons should be
owned by private citizens, guns do not kill people; people do. A deranged
person will find another weapon (bombs, fire, knives, poison, etc.).
“3. Perhaps the easier answer will be for “busybodies” to warn parents
and teachers if they see a person who is unduly isolated, angry,
hate-filled. If it takes a village to raise a child, it takes a village to
protect us all.”
Donna Mae DePola is a recognized leader in the field of Substance Abuse and Substance Abuse Education. She says, “We as human beings want answers to things that there are no answers for. But there can be some suggestions. Training the parents on warning signs of violence, substance abuse or even mental health. Education from their local providers of these services. Hot lines for people where they can be referred. Also talking to children, teens and young adults about trusting certain people about what to do if you hear another student or friend threaten anyone of harm.”
Some practical ideas that could be applied in addition to reform of the health care system come from other types of experts.
Alvin Doylean runs a campus of The Y.A.L.E. School for youth with behavioral and mental health challenges. Al suggests, “Reconsider the building itself. At school entrances and exits –remove all glass doors, and consider a ‘lock box’ entrance with bullet proof glass. This will allow secretary to lock and hold the offender in the room until the police arrive. All schools should have cameras on each entrance and exit.”
Oliver McGee, author of Jumping the Aisle: How I Became a Black Republican in the Age of Obama, says that schools have a “fundamental ‘duty of care’” to protect the safety of children. Among other things, he advocates repealing Gun Free School Zone laws so that armed staff could protect schools just like armed staff protect airports.
Paul Komarek is the author of Defying Mental Illness: Finding Recovery with Community Resources and Family Support. He says, “Fortunately, ordinary people can do something about what happens as a person breaks down. The path is the same for suicide as it is for violence. The only difference is what happens at the end.
“We can interrupt the disruptive path, but we have to be able to pick up on
the clues, and we must be willing to have a safe face-to-face talk with the
person who is in trouble. Suicide prevention training is readily available
everywhere, often for free. It takes an hour or two.”
Nancy S Buck, PhD of Peaceful Parenting Inc is a developmental psychologist, expert in children’s motivation and behavior and an educational consultant who has worked in schools all over the world including Newtown School district, and blogs for Psychology Today. She says, “Almost every person in the US and beyond over the age of 5 knows all the steps necessary to get into and maintain good physical health. That doesn’t mean all people do it, but at least they have the knowledge. But what about good mental and emotional health? Do we even know what it is? Unfortunately in this country mental health really means the absence of mental illness. But it is so much more.
“I’m advocating solutions that go beyond the immediate solution of gun control, improved and immediate long term help with mental illness. All of these things are important. But if we could start addressing, teaching and advocating good mental health for all, including from kindergarten and all ages beyond, people can learn to be responsible for their own good mental and emotional health.
“Good mental health begins with good, healthy, satisfying, connected relationships. Ask school professionals today who the children are that are at risk in their schools and everyone knows the answer, including the other students. The child who can’t get along, who has no friends, who is isolated and often in trouble for discipline problems as well as academic learning is the child who may grow to become another mass murderer These children are not succeeding in school and grow up to be people who are not succeeding in life. That does not mean they all turn to guns and mass murder as their solution, but some do. And we all know that now, today, this very minute. Help and attempts at solving this child’s problem is offered. But for most it does not help or succeed.
“We need to first adequately and simply define good mental and emotional health. We need to teach people how to attain this goal. And we need to put mental health counselors in our schools to work with children and professionals to achieve these results. Professional educators are just that, experts in education, not mental health. And yet every school in this country is dealing with children who are struggling. Private schools have the luxury of eventually asking these tough students to please leave. But even there professional educators are struggling with these students before they exit.”
What to do, of course, is related to what one thinks is the cause. There is at least some proof that a bad economy is partially to blame. Alan Hall of the Socionomics Institute says, “We have observed that secular bear markets (periods of sideways-to-negative stock price movement) also tend to worsen aggregate mental and physical health outcomes, causing health care systems to simultaneously face the opposing aspects of an increased need for health services in the face of an increased call for budget cuts. We have also noted a correlation in the U.S. between multiple shooting casualties and societal trends as reflected in the stock market. We think all these manifestations arise from the same unconscious source: social mood. We think if you want a single cause to blame, it’s the long-term negative social mood trend that has been in force since the year 2000. If more public health officials were aware of socionomic causality, they might anticipate periods of heightened risk, put more effort and resources into public health and perhaps prevent some of these tragedies.”
Motivational speaker Janet Pfeiffer blames mass shootings on the moral decay of America, and a culture that glorifies violence. “Only when love for all becomes the standard measure of a life well lived will we defeat hatred, destruction, and evil.”
Dr. Carly Stewart, the medical expert at Money Crashers, says, “It really is a tough call as to how any meaningful change can be put in place to prevent what happened last week in Connecticut. However, we as the collective American people can do plenty to ensure a shooting like that never occurs again. We can take more personal responsibility as far as the number and type of weapons in our households. We can also make sure that any dangerous weapons are kept locked up and out of reach of other household members. We can also step up and make sure that any relatives or friends who seem like they’re troubled and may need professional assistance are pointed in the right direction. This can be tough to do without potentially offending someone, but isn’t speaking up and preventing a possible tragedy worth the risk of hurting someone’s feelings?”
What to do must also include how to help those whose lives were affected by violence, not just how to prevent the next incident. Dr. Fredrick Capaldi of Outreach Concern, a non-profit school-based counseling agency, offers these steps to held children who have been exposed to violence.
“What can we do to help children cope with traumatic events:
Reassurance and support are key. However, it’s important that whoever is providing this information is able to model this behavior when speaking with the child versus being overwhelmed by the event itself. It’s important to let children express how they feel about what they witnessed or heard, validating and explaining that it’s normal and reasonable to be frightened and have questions when a crisis or traumatic event occurs. It’s also extremely important to point out that the environments the children go to, home, school, etc are safe places and parents, teachers and other significant individuals in their lives are there to help, support and listen to them
“There is no set direction, as to how much information is right or wrong, but it should be directly related to the age and maturity of the child and their questions. Again the key is providing useful feedback and security establishing a comfort level and an atmosphere that supports sharing and communicating about what a child’s feeling.
“Realizing children communicate differently is important. Some are direct asking about what they witnessed or heard. However, others communicate more indirect, staying close to parents not wanting to be alone or demonstrating non-verbal clues that indicate their discomfort. Remembering it’s not always what a child says, but oftentimes what they don’t say that’s an indicator of their discomfort. They key is to take the time, recognizing that all children, as well as, adults demonstrate different ways of verbalizing their discomfort.
“Is there a way to cheer up a child after a traumatic event? So much of this has to do with the child, their involvement in the traumatic event, their perception, how they were impacted and how they experience the event as it relates to them. For a parent or other significant adults in a child’s life it’s all about being there for them. Giving them a time to discuss the event and their feelings attached to it. Most of all provide them reassurance and validate their emotions. The parent needs to read their child and what they’re ready to do. But doing simple things, taking walks, spending time together as a family, watch a favorite TV show together. Simple ways to help a child cope and in some cases distance themselves from what they’ve experienced. The key is to reestablish the structure and normalcy in the child’s life, don’t push, be flexible, open and accepting.
“What should an adult do if a child because of a traumatic event becomes depressed, sad, withdrawn or possibly suicidal? If a parent recognizes a constant change in their child, sleep disturbances, a change in eating patterns, anxiety, withdrawal, an unwillingness to attend family events, school, shy’s away from play, is sad, seeking the help of a mental health expert should be the next step.
“After traumatic event should a child be taken to see a trauma counselor or child psychologist? Incorporating professional help is always an option, however, the first question is to assess the emotionally of a child, what did the child see, experience, how much of the crisis was the child a part of, were they directly or indirectly involved? Are they comfortable sharing their experience with their parents or other adults, are they able to get back in their routine, attend school, involve themselves in extracurricular activities easily? Their need to see a professional is all based on their comfort level and their ability to reconnect with their world, demonstrating similar behaviors, as they did prior to the crisis or traumatic event.
“How can you help a child overcome a fear that may result, because of a traumatic event? Once again, security, reassurance, support and the opportunity to communicate about their feelings and emotions related to their experience, this is the first step. Limit the amount of media exposure; be aware of the conversations and information from adult to adult that children are often exposed too. Make a point of reestablishing a routine as soon as possible. Consistency, exercise, sleep, reestablishing the structure with school, and outside activities are all good examples of working through the emotions that are connected to traumatic events. Additionally, reassuring children that the environments they operate in are safe places to go and the people that are connected with them, teachers, family members, other adults in their lives, public safety providers are all there to help and keep them safe.”