School Shootings: The Sad Reality of Mental Health Care For Children

People everywhere are searching for answers.  Looking for a reason that this massacre occurred.  Guns.  No prayer in school.  Video games.  Violence in the media.  Mental illness.  You name it.  When something terrible happens, it is our natural societal response to search for a cause.  We can’t help ourselves.  It’s a defense mechanism of sorts, used as we try to come to terms with such an unthinkable tragedy.

But if I was the parent of any of these precious children, I can promise you that knowing the cause wouldn’t help.  My child would be gone forever and no answer would change that devastating fact.  No more kisses and hugs.  No tucking them in at night.  No growing up.  Nothing.  Gone.

The parent side of me knows that.  The child psychologist in me knows another story.  I speak from the trenches, not as the parent trying to access services, but as the child psychologist helping parents navigate the system day in and day out.  I firmly believe that our mental health system is not the reason this massacre occurred.  Adam Lanza is.  But he clearly suffered from serious mental health problems.  And this tragedy should serve as a wake up call to change our mental health care system now.  By doing so we could very likely prevent this devastation from occurring again in yet another classroom, movie theater, or shopping mall.

Currently in my community I can count on one hand the number of child psychologists and psychiatrists available to assist children.  That means that if you are concerned about your child and want to access outpatient services then you will have to wait.  For a long time.  I’m talking months.  There are waiting lists in my state that are a year long.  Can you imagine being told that you may have cancer but you won’t be able to be seen by a doctor to discuss your diagnosis and treatment options for six months?  That’s what it feels like to parents who have children with serious mental health issues waiting to be seen.  Unimaginable.  There simply aren’t enough child psychologists and psychiatrists to go around.

If you are fortunate enough to get an appointment after your agonizing wait, you then have to either be wealthy enough to pay for it out of your pocket or lucky enough to have health insurance that covers outpatient mental health services adequately.  Good luck with that.  In my experience, the inability to pay eliminates the opportunity for quality mental health care for the majority of children.  If they can’t pay, parents are told to ask their pediatrician for advice because then it might be covered under their health insurance policy.  They are advised to get help instead from their school counselor because that would be free.  Those options might seem like good ones, but behind the scenes the pediatricians are equally outnumbered by the volume of mental health care patients, and typically one school counselor is responsible for the mental health needs of an entire school.

And what happens when your child still isn’t well after rounds and rounds of different medication trials and years and years of outpatient therapy?  Sadly there aren’t many options.  Private inpatient beds are hard to come by and often the length of treatment approved by insurance carriers is not sufficient to meet the needs of the patient.  Other alternatives include having your child put in a juvenile detention facility or state mental health hospital.  Neither are appealing options and so the child who desperately needs help and the parent searching frantically for it are often left to their own devices.

It’s a sad but familiar commentary.  It feels hopeless.  But I don’t believe that it is.  I think there is a way to change our system for the better.  To do something now that will allow children with mental health concerns to get the help they so desperately need.  I wrote about it in August after the massacre in Colorado.  The post Does My Child Need Therapy? came from my honest belief that the parents of these perpetrators know something isn’t right with their child from a young age, but either don’t know what to do or over time have exhausted the resources available to them.

I wrote Does My Child Need Therapy? as a guide for parents to know where to start to get the help they need for their children.  But I also wrote about an ideal system.  One where all children starting at a young age get to visit with a therapist for regular check-ups.  Here’s an excerpt:

In a lot of ways, I think all children (and parents) could benefit from some therapy.  Sort of like going to the dentist every six months for a cleaning or the pediatrician annually for a well visit.  Just to check in and see how everything is going.  Any problems?  Anything you’d like help working on?  If so, let’s set some goals and get to work.  If not, we’ll see you again next year but feel free to call us sooner if you have any problems come up.

If all parents had regular contact with a therapist from the time of their child’s birth, they would be able to get help with typical and atypical childhood behaviors throughout their parenting journey.  Studies show that by adulthood, 1 in 4 Americans have a mental health condition.  We must change our system to focus on the prevention of mental health problems right from birth, not wait until the problems are so severe that they cannot be treated.

A shift of this magnitude would require A LOT of work.  Increased funding for mental health services. Insurance reform to cover preventative mental health care.  Training of more professionals to provide these services.  Better integration with the medical community to provide quality long term care to those suffering from serious mental illnesses.  A shift in our collective thinking about the value of mental health.  Overcoming the stigma of mental illness.  At some point, accessing mental health services should be as simple and routine as getting your flu shot each fall.  We’re not there yet, but together we can be.

In loving memory of the victims of the Sandy Hook Elementary shooting.

For more information on talking with your children about this tragedy, visit my first two articles in this series How To Talk With Kids About Unthinkable Tragedy and Your Follow Up Questions Answered.

 

Comments

  1. says

    Hi Dr. Dunn-
    I’m a child clinical psychologist too (I specialize in working with parents of young children who have had traumatic experiences) and I agree that parents get nowhere near the support they need and deserve, especially around parenting children who are exhibiting challenging emotions and behaviors. I thought you might be interested in an organization I think is great called Hand-in-Hand Parenting (www.handinhandparenting.org) that offers a lot of free/low-cost support and helps parents set up this kind of support for themselves. Ultimately their vision is to have “Parent Rescue Squads” available when parents get into particularly sticky situations. Currently, they run a great moderated list serve that people can post questions to, a library of teleseminars, a huge but easily searchable archive of articles, a series of podcasts for parents of infants, an online course that addresses hitting/aggression, and also more in-depth 6-week in-person or by-phone classes. One especially helpful resource is their pamphlet on setting up listening partnerships with other parents (a way for parents to support each other where they basically swap time listening to each other, without the advice/judgement/confidentiality/cost that is sometimes involved with other sources of support). They also maintain a database of people who are interested in setting up listening partnerships, which many people do by phone or Skype. One thing they have offered just today are some free support calls moderated by their certified instructors (basically facilitated listening time) where parents can talk about their own reactions to the shootings in CT, clear out their own emotions, and be better prepared to help their children with whatever their reactions may be. Anyway, I think the work they do is amazing and I’d love it if all parents had access to that kind of support. Thanks too for your great post!

  2. says

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  3. Joni says

    Our mental health care system is abominable. I called our county mental health dept. to make an appt. for my clinically depressed (adult) son. Nope. He had to make it himself and they couldn’t help unless he hurt someone or himself. Does putting a bullet in your head qualify? That’s what he did.

    My point here (and I wish I had known all of this at that time) is there is almost always a physiological reason someone is depressed – hypoglycemia, thyroid problems, allergies or sensitivities to man-made chemicals, heavy metal toxicity, excess histamines, nutritional deficiencies, and on and on. If doctors would do their job and look for these causes instead of handing out dangerous psychotropic drugs like candy, there would be many less depressed people.

    BTW, did you realize these mass shootings were almost unheard of before 1989? Do you know what came on the market then? Prozac, followed by other SSRI’s.

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