What needs to change?
Each day, thousands of young people contending with a mental illness wake up and go quietly about their lives. They attend school, go to work, and enjoy time with friends. They are engaged, productive, relational – and managing their illness. Some days or weeks may be better than others, but like other young people contending with a health issue, such as congenital heart disease, type 2 diabetes, or asthma, they seek treatment and learn how to live with it.
Unlike children struggling with these other possible health issues, a young person in a mental health crisis can draw attention to mental illness in a dramatic way. The recent violence in California is an example. It was a heartbreaking event for the families and friends of the victims, and others who were injured. It also revealed the challenges the perpetrator’s family had to face dealing with their child’s mental illness.
It also brought an unwelcome spotlight onto all young adults affected by mental illness— the majority of whom would never engage in a violent action. What remains to be seen is if the ripple effect of this serious event deters young people from getting the help they might need for fear of being identified in the same way.
Another possibility is that it will it open a door to treatment for children and adolescents who are struggling with an illness they don’t understand.
One thing is certain. The event creates a new outcry for change in the mental health system.
In light of tragedies such as this one, the question always comes back to, “What can be done?” As providers, we know some of the struggles experienced by families to get help: lack of insurance, too few providers, lack of beds, and lack of awareness. How do these things get solved? What needs to change?
There are different opinions on the best way forward. Some, as reported in the Washington Post, propose:
- detection and early intervention in the school setting,
- more consistent screenings in primary care settings to compensate for the lack of mental health physicians,
- and the promotion of intensive, youth friendly mental health services to help kids with serious conditions.
Another opinion, covered in The Guardian, calls for changes in the delivery system. They recommend creating:
- single points of access (24-hour hotline for referral, evaluation to treatment),
- service coordination and facilitators to help patients and their families navigate the system,
- a broad offering of community based services to meet a variety of needs (from individual, group, family therapy to substance abuse treatment to medication),
- more access to crisis and inpatient services to divert people from the ER (or jail) by filling the gap in number of beds,
- and a stable funding system.
Closer to home, we asked medical professionals in Bexar County what they thought would be the most beneficial initiative for children with mental health problems in our area. Multiple answers were given by the 190 respondents. Here are the responses in order of preference:
- Increase the availability of outpatient clinical services (83% of respondents)
- Create a regional psychiatric emergency service for children (65% of respondents)
- Increase the number of psychiatric inpatient beds (36% of respondents)
What do you think? What needs to change to provide the mental health care one in five of our children need? We’d like to hear from you. Email us here.