yarn painting,day of the dead

Two years of shooting violence!

The dramatic episodes of kids shooting kids in public schools, continues to demand attention, and resists one cause explana- tions. Everything every expert says about violence is true, but not sufficient, nor necessary causes for the violence observed. The explanation least often mentioned, and which provides the most motivation for violence is untreated mental illness.

Today, US communities have inherited 30 years of inadequate care. When clients were first identified as problem kids or teens, they were either not treated, or seen by professionals with minimal training in mental health. Instead they were examined by gatekeepers such as guidance teachers, public assistance case- workers, probation officers, and religious personnel. This hap- pened with Klebold and Harris (of Littleton fame) in the year before their shooting demise.

In the old "bughouse days", patients received a diagnosis, a ward assignment and were then monitored for physical health, but attention to the sources of psychological distress received minimal attention. In the old days this was due to lack of knowl- edge. In more recent times it is a default to chemical treatment. The public knows better, but lacks the will to address these needs.

In the tranquilizer era, initiated by Governor Reagan, mental patients were returned to the community and given a free choice. Many of them ended up on the streets, self medicating with street drugs, and the ones who engaged in violent acts were incarcerated as felons.

All inmates are managed as cognitively competent aggressive criminals, with maximum use of hardware and threat of force by well trained correctional officers. A very small proportion of the budget is spent on mental health, and most of that for psy- chiatric medications. Paradoxically, The Department of Correc- tions is one of the largest employers of clinical psychologists, who are asked to bring their skills to bear in humane behavior change, possibly matched only by chaplains.

This is happening in state prisons, which now house 1.85 million inmates. 15-35% are known to be mentally ill, and receive psychi- atric medications. The balance are various degrees and kinds of substance dependence victims, with institutional remission; waiting to get drunk when they hit the streets.

In the rest of America there has been thirty years of underfund- ing for mental health services. We are looking at a generation of psychologically impaired people who have gone on to create a second generation of dysfunctional families. Their untreated children are in the process of creating a third generation of mentally ill people.

The ones who continue to suffer, either without treatment, or

despite medication, and superficial talk by other providers of care, continue their problem behavior, again and again, but in spiraling cycles of increased deviation and violence. Untreated or inadequate treatment of problem behavior leaves a sore to fester. The problems continue, in different forms, but increased intensity of distress and resistance to conventional treatment.

Our society is willing to try anything for these problem people except psychological treatment and or psychiatric medications. The resources mental health professionals offer are greater knowledge, and depth of understanding. They offer more extensive training for better diagnoses, and the skills to counsel people with mixed emotions.

To do this mental health professionals must take time to wait, to observe, and look for moments of truth, in which to find the opening that creates a tangible piece of wisdom for the person in trouble; something which makes them try a resource they haven't tried before; take prescribed medications, abstain from street substances, go to church, go home, and listen to their mother. This may sound more poetic, than practical, but psychologists are the only profession paid to listen, and that once they put something together they command enough respect for the patient to cooperate. This respect is earned, by accepting and listening attitudes.

One classic example of listening and paying attention is the process known as the dual diagnosis patient; one who is treated for a mood disorder while continuing to take marijuana, alcohol or muscle relaxants. This creates iatrogenic symptoms that are ephemeral, and where usually effective medications make things worse or do nothing. The failure here is to notice that chemical dependency must be treated first before a reliable psychiatric diagnosis is possible. Only after a significant period of sub- stance abstinence can psychiatric medication become effective.

Knowledge is power, and the mental health professional has a profounder knowledge about paradoxical behavior than any other profession. As victims, families and society look around for help, they will eventually try anything, even a psychologist. And that is the prevailing attitude which exists with most physi- cians and consumers. The future of violence in the US is contin- gent upon providing treatment for unrecognized mentally ill. Unfortunately, this usually happens after other interventions have failed. The community has to hit bottom, before mental health is given a chance.