The importance of addressing mental health early

From Safe Start Center Director Elena Cohen

The impact of the tragedy in Colorado is felt across the Aurora community, the U.S. and the world. Family, friends, co-workers, neighbors, first responders, psychologists, specialized agencies and people with their own experience with severe trauma are affected. Regrettably, the large wave of people in need of help is yet to come. These tragic events act like rocks in a pond–rippling for miles and for a long time.

The circumstances surrounding the event are still under investigation, but as a clearer picture develops, some have begun framing the tragedy in terms of the debate over gun control. Others are simply calling for the person responsible for this terrible crime to be quickly brought to justice. Social services and mental health organizations are putting together relief efforts and resources for the victims of the shooting and providing crisis counseling to survivors. Among the valuable suggestions is ensuring people that their responses of fear, depression, anxiety, sadness that result in sleeplessness, weeping, anger, impatience, or sitting and staring are perfectly normal and expected.

Besides these critically important responses, the bigger debate to follow is about what needs to be done about mental health issues in terms of preventing these incidents before it is too late. The debate isn’t a new one. After the 2007 Virginia Tech shootings, many discussions circulated about mental health interventions that could have prevented shooter Seung-Hui Cho from killing and injuring dozens of people. We need to reduce and prevent these tragic events by increasing awareness of the “whys” through a public service approach to mental health. But, bringing greater clarity to the mental health issues that may play a part should not be equated with lessening consequences for those who engage in violence.

At this moment, it is unclear whether or not the Aurora shooter received mental health treatment or received a diagnosis of a mental health problem, which is similar to other shooting rampages – the attack on Rep. Gabrielle Giffords in 2011; the shooting at Fort Hood in 2009, the massacre at Virginia Tech in 2007. But we do know that all of these shootings occurred at a time of decreasing resources and funding for the mentally ill in state budgets throughout the U.S. We also know that demand for mental health services is high in this time of severe economic distress and the crisis in mental health care continues. The impacts are felt throughout society as people go without the treatment they need. Increasingly, emergency rooms, homeless shelters and jails are struggling with the effects of people falling through the cracks due to lack of needed mental health services and supports.

The American Psychological Associations (APA) estimates that one of every five children and adolescents in the United States has a mental disorder. Left untreated, these disorders are often debilitating. Yet, despite the fact that these conditions exact heavy tolls on the young–including substance abuse, academic failure, criminal involvement and suicide–less than half receive treatment. Worse yet, even though evidence-based treatments exist for many mental disorders, including attention deficit hyperactivity disorder (ADHD), conduct disorder, mood disorders, and anxiety disorders, only 20 percent of children receiving services get the right kind of treatment.

For children and youth, mental wellness depends on risk and protective factors that exist at multiple levels of their environment. Preventing risky behaviors requires addressing risk and protective factors within the context of the child’s environment, such as the family, peers, community, school, as well as individual characteristics such as intelligence, temperament, and self-esteem. We know that the best place to address risky youth behavior is where it primarily exists – within the community.

Some strategies to promote thriving children and families and to prevent violence:

Focus on prevention: Due to the large numbers of children and youth affected and the existence of effective prevention programs at the individual, family and community levels, emphasis is placed on prevention strategies that target both high-risk groups and the population at large;

Promote evidence-informed approach: Strategies and services are informed by reviews of the scientific evidence of their effectiveness, emphasizing the monitoring and evaluation of implementation efforts;

Promote especially relevant programs for parenting support: promote access to evidence-informed parenting support strategies and resources for high-risk parents;

Frame services from a developmental perspective: The causes, consequences and prevention of violence are viewed from a life-course perspective which recognizes the need for prevention and intervention at all stages of development;

Enhance services for children and their families: It is critical to facilitate access to services and resources that will mitigate the consequences of violence and reduce its re-occurrence for victims and perpetrators.

Examples of prevention mental health services include the following:

•             Providing screening, assessment and early intervention for children who show high rates of aggression and other behavioral problems.

•             Providing early care school-based services to children in need of mental health interventions, counseling, and support

•             Referring children and families to community therapeutic mental health providers and comprehensive family services

•             Working with community partners to provide wraparound mental health services to students in need.

Regardless of Holmes’ mental health status, we need to insist that these issues are confronted early. We need to think about how awareness and collaboration in the area of mental health can possibly prevent tragic events like these in the future.


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