Sandy Hook shooting's glare illumines cracks in mental health care (+video)
Though the mental health of Sandy Hook shooter Adam Lanza is unclear, the massacre has spawned extensive discussion on the mental health care system. That could be helpful or harmful.
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About 39 percent of all people who have a diagnosis and are in need of treatment actually get treatment in a given year, says Mr. Fitzpatrick of NAMI. Since the economic challenges in 2009, he adds, $4.35 billion in state general funds has been cut from the mental-health system.Skip to next paragraph
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On the other hand, Fitzpatrick has hopes that the Affordable Care Act will help millions of Americans who currently have no coverage for mental-health services to get such coverage. “That’s a game-changer,” he says.
While little confirmed information is known yet about the role mental illness may have played in the Sandy Hook shooting, having a national conversation about it still makes sense simply based on the patterns from past shootings, says Christopher Ferguson, a professor of psychology and criminal justice at Texas A&M International University in Laredo.
Most past shooters, he says, have certain common traits: a history of antisocial traits or behaviors; some sort of mental-health problem, often psychosis or depression; and a characterization as “injustice collectors” who blame others for problems.
With a tragedy that has captured the national consciousness, Professor Ferguson says, “a big part of the focus has to be on mental health and the inadequacies of our mental-health system.” In the past, he says, people have been reluctant to have tax dollars go toward what they see as “welfare.” “We need to repackage [mental-health services] as less to do with welfare and more to do with public safety,” he says.
Like Torrey, he believes that increasing the ability to commit people who may pose a threat is one option that needs to be explored more – even while he still sees a risk of, essentially, incarcerating people for crimes they haven’t committed. It's key, he says, to have good assessments and to ensure that treatment facilities offer adequate and humane care.
Psychiatrists also emphasize the need, in looking at this case and others, to avoid confusing various forms of mental illness and developmental and personality disorders – and also to realize that there’s no firm line determining when someone is, or isn’t, mentally ill. Moreover, a “diagnosis” is often a somewhat arbitrary process that explains a variety of overlapping conditions.
“It’s very important to make distinctions between the psychotic and the psychopathic, but there can also be people who are neither, and who have developmental and personality disorders that could explain a failure to be empathetic and a failure to act in a lawful way, ” says Frank Ochberg, a clinical professor of psychiatry at Michigan State University in East Lansing and a former associate director of the National Institute of Mental Health. Psychopathic individuals, he says, are those lacking a conscience, while people with psychotic disorders have a hard time distinguishing what’s real for a period of time.
In Lanza’s case, while nothing is known yet, “in due course we may learn that he fit neither,” says Dr. Ochberg. “If we learn that, it will expand our thinking about young men who are potentially dangerous, even though they lack sadistic intent.”