Our Broken Mental-Health System

There are countless unanswered questions about why Jared Loughner allegedly went on a shooting rampage, but of this we can be sure: across America there are thousands of parents of older adolescents and young adults who are terrified that their child’s strange behavior, paranoid rants, drinking, drug abuse, conspiracy fantasies, and other red flags of mental illness will lead to violence—possibly against a public figure like Rep. Gabrielle Giffords, possibly against a family member. That most of these parents have no idea what to do is frightening enough. It’s a national scandal that, even if they succeed in getting their child mental-health care before tragedy strikes, the system is set up to thwart them at every turn.

Thousands of anguished parents face a system that thwarts them at every turn.

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Mamta Popat / AP-pool

Pallbearers place the casket carrying 9-year-old Christina Green in a hearse. She was the youngest victim in a shooting in Tucson.

“The mental-health-care ‘system’ in America is a broken system,” says Michael Fitzpatrick, executive director of the National Alliance on Mental Illness (NAMI). “The system was already in crisis, and has become even less accessible over the last three years as state budgets for mental health—psychiatric beds [in hospitals], counseling, and other services—have been cut by $2 billion. States have eliminated 4,000 in-patient psychiatric beds.” NAMI’s Katrina Gay adds, “In many cases you can’t even get an evaluation for two to three months—and that’s assuming you know how to get one in the first place.”

The nightmare scenario begins when an adult child refuses to acknowledge that he or she may be suffering from a mental illness. (Parents can force a child under 18 to go to a physician, though persuasion is always more effective than coercion.) Yet often the signs are clear. There are changes in behavior: the child no longer has friends or engages in any activities, becomes socially isolated, stops bathing, dresses inappropriately, stops working or going to school. In Loughner’s case, fellow students and faculty at Pima Community College were terrified of his rants and incoherence, with one woman making sure she always sat by the door in the classroom they shared so she could make a quick escape. A second sign of mental illness is that moods change: the child becomes more irritable, angry, or depressed, or simply loses his or her spark. Finally, thoughts change, turning to the delusional and paranoid, such as Loughner’s belief that former friends were stalking him at 2 a.m., as The New York Times reported. Don’t make the mistake of thinking that a child is too young to suffer from mental illness: half of all cases first appear by age 14, and three quarters by age 24, found a 2009 report by the Institute of Medicine of the National Academies. Continue ►