The recent shooting at a Parkland, Florida high school which left 17 people dead, has sparked a lot of outrage and debate about preventing these types of incidents. Some call for stricter gun control and universal background checks while others suggest arming teachers and other school staff with guns. Both the liberals and conservatives have strong opinions on the issue of school safety and gun control in an effort to prevent another tragic incident like what happened at Marjory Stoneman Douglas High school. However as someone who lives on the autism spectrum, I feel there is an important element that is missing from the discussion as well as media coverage in terms of reducing mass violence across the United States. It is about reforming our mental health system as well as our societal attitudes against people who have developmental disabilities and mental illnesses. Before I go on writing in depth on why these factors are important, I want to make clear that I do agree we need more regulation on guns in this country. I support universal background checks and believe that individuals who have a history of violent outbursts or who have suicidal tendencies should not be permitted to own a gun.
There is no question that mental health care in America needs serious reform. This is apparent in the number of homeless people (most with serious mental illnesses) I see on the streets in places like Downtown Los Angeles or the Venice beach boardwalk. Some end up in prisons and other places that are not equipped in addressing their mental health needs. This is the result of patients of being released from the hospital prematurely (due to overcrowding) with no action plan in place. After leaving the hospital, individuals with serious mental illnesses are left on their own wondering the streets if they have no family or other people around to support them. The amount of homeless people with serious mental illnesses are the results of deinstitutionalization from the community mental health act signed by president John F. Kennedy in 1963. The intent of this act was a good one since some of these institutions for those with mental illnesses were rife with abuse and neglect. It focused on the need for community based mental health support. The problem lies in the fact that we haven't followed through on establishing more community based mental and behavioral health supports. We also closed mental institutions too soon without gradually transitoning patients out into the community. The consequence of closing down hospitals and lack of psychiatric beds, leaves many individuals with serious mental illnesses and their families without adequate resources.
Going back to the point I made in my last paragraph of families having no resources when they are facing a crisis, we need to follow through with the Community Mental Health act in establishing more behavioral health centers that provides comprehensive supports to these individuals. We also need to have a more comprehensive treatment and behavioral support plan when an individual is in crises. This one article mentions that states have been cutting hospital beds at an alarming rate. This leaves the family with either few or no options for psychiatric care when their loved one is a threat to themselves or others.
When the individual has a developmental disability along with mental health issues, finding adequate help becomes more complicated as some of the psychiatric facilities and other resources are not properly trained on developmental disabilities. In this scholarly paper conducted by the University of Denver, there is disconnect between mental health system, developmental disability services as well as with primary care doctors. In other words, research has highlighted the negative consquences such as law enforcement being called or being placed in a hospital in which staff are not adequately trained in dealing with developmental disabilities when there is disconnect between the different departments that cater to both developmental disabilities and mental health. Oftentimes, individuals who are dually diagnosed are discharged from the hospital with no follow up services to prevent future crises or episodes. I feel there needs to be a more proactive plan for individuals with developmental disabilities with co-occurring mental health issue when they are experiencing a mental health crisis as well as preventing future incidents from taking place.
Picking up on the point that we need to take a more proactive approach in our mental health system, I heard of an approach via a John Oliver clip on youtube called assertive community treatment. This intensive approach does much more then just periodic visits with the psychiatrist that last 45 minutes to an hour. It is an intensive individualized approach in which services are delivered directly to the patient and provides assistance with everything from employment to finding housing etc. It's structure is equivalent to supported living and supported employment models that are already available to individuals with developmental disabilities. I feel like a service design that will do whatever it takes to keep the patient integrated in the community as much as possible will be more effective at preventing frequent hospitalizations of those with mental health challenges.
Then comes the confidentiality laws when an individual turns 18 and how parents and other family members feel powerless in helping their loved ones with either a mental illness or developmental condition. Sometimes the laws that are meant to protect the privacy of an individual with mental illness and/or developmental disabilities can prevent important key people (parents, professionals etc.) and offices from intervening if problems arise. There is a way around it in regards of signing a waiver that allows key people in the person's life to have access to personal information as well as being allowed to exchange information with offices or resources that cater to those with disabilities (doctors offices, counseling, college disability centers) ea about a particular individual. I have firsthand experience of how these laws that are suppose to protect my privacy can at the same time be very burdensome and contribute to me feeling isolated. When I turned 18 and moved onto college, the disability center were not allowed to communicate with my parents and other key people because of those privacy laws. Even the disability center were not allowed to communicate with my professors and other campus resources (e.g. the student psychological services) about my disability even though I am registered with their office. The disconnect between various offices on the college level contributed to unnecessary heartache and also increased the sense of isolation I felt at college. These laws creates a sense of disconnectedness between different agencies and offices as well as people such as therapists and parents. Therefore, it can prevent them from effectively helping a person with a mental illness or other disabilities. This the Catch-22 of many privacy laws that are meant to protect the dignity of those with disabilities and mental health challenges. There has to be a better system of communication between different individuals and agencies for those adults who are not under a conservatorship. I feel like these privacy laws don't take into account the importance of a team approach by making sure that anyone who helps a client or individual with disabilities is on the same page.
Lastly, we need to change our societal attitudes of how we deal with those with disabilities and mental health conditions . This is the first part that needs to happen if we want to come up with effective supports for those who mentally ill or have disabilites. There still seems to be a negative view of people with disabilities as burdens or that they are "crazy" and "violent." This is evident in the media depictions on linking violence with mental illness and other conditions. This leads to stigmatization and alienation of those who are not able-bodied and have brains with different wiring. This is why mentally ill patients are discarded on the streets because society does not see value in them and wants nothing to do with them. Americans think that it is the fault of the person with the disability for all the challenges they encounter in life. As someone with autism, it is hard living in a society that is rife with ableism (both explicitly and implicitly) and continuously refuses to provide accommodations and supports because it is too inconvenient and burdensome for able bodied people. To live everyday in which you are constantly reminded how much of a "burden" you are can sometimes can be too much to bear for some people. We need to stop marginalizing those with disabilities and start valuing them as human beings with feelings and contributions. Instead, society should have the mindset of how we can lessen the stress that people with various physical, mental and developmental conditions face in their daily lives.
In conclusion, I feel that the solution in reducing the number of incidents of mass violence ad shootings is more than having more effective gun control laws. We need to reform our mental health care and how we deal with those with disabilities and mental health. This involves having deep and uncomfortable conversations about how we are going to fund or reform mental health care systems as well as other disability systems. It should not be a solution of band aid fixes like how we solve other large scale problems in our country. It should well thought out and should involve the insights of those who utilize such services. As I said in the beginning of this post, I believe in tighter regulations of owning weapons. However, the solution to preventing mass violence in this country is multi-fold instead of just one universal solution.
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