Mental health care shouldn't be reactive

Following the Sandy Hook shooting, our country finally seems to be having some serious conversations about modern mental health treatment. One constant refrain has been that we don’t have nearly enough resources for everyone in need. It seems that in many recent violent incidents, someone knew that the perpetrator was unwell. Their friends and family tried to intervene only to be stonewalled by a lack of options, especially for adults who resist treatment.

What does “lack of resources” mean in Minnesota? After the well-intentioned Community Mental Health Act of 1963 (which shuttered large hospitals in favor of community-based treatment), Minnesota went from 6,000 residential treatment beds for mental health to 600. Anyone seeking treatment for a loved one can tell you how hard it is to secure one of these beds, even when someone is in danger of hurting himself or others (and intensive residential treatment isn't covered by Medicaid).

Non-residential services haven’t been able to fill these treatment gaps, either. Nearly every social-service agency in the state has struggled over these past several years to meet growing community needs in the face of declining revenue. Mental illness, in particular, can carry a stigma that makes it hard to evoke public sympathy and public support.

In lieu of mental health care, we have homelessness and incarceration. 55 percent of homeless adults in Minnesota report having a serious mental illness. (That was in 2009; the shelter at which I work has seen a significant rise recently.) Hennepin County estimates that 25-30 percent of jail inmates have a mental health condition. It comes as no surprise that neither shelters nor jail can effectively treat mental illness. In fact, these stressful and unstable conditions often have the opposite effect.

As much as mass shootings break my heart, I am also saddened for the rest of these suffering folks. Most of our neighbors suffering from mental illness will not ever be on the news. They’re not going to inflict horrific violence upon their family or the public. But they are suffering all the same, and they don’t have to be. Most mental illness can be treated; most people with a diagnosis enjoy a normal life. We all have family, friends, co-workers, or classmates who have had mental health needs at some point. Perhaps we ourselves have benefited from counseling or medication. We have no reason to be frightened of mental illness. We have every reason to push for better mental health care.