I have known and loved many people who have sought mental health treatment. Without exception, each and every one of them has had to wait years before finally getting proper treatment. Our mental health care system is a god damn travesty.
We keep stigmatizing people who seek mental health care, and then we're shocked -- shocked! -- when the people who need mental health care the most refuse to seek it out.
My husband has a client right now who did the right thing when he experienced symptoms of a mental health condition. Client never, ever behaved violently or had violent thoughts. He did, however, have a serious condition -- schizophrenia. My husband's client went to his school's counseling center, got on medication, and everything was hunky-dory. In return for his trouble, he got kicked out of school and out of his dorm. All because of a diagnosis. I doubt he'll ever seek therapy again, and if we keep penalizing people for seeking help, involuntarily committing people who are not a danger to others, and stigmatizing the shit out of mental illness, then the people most in need of treatment will continue to be the least likely to seek it.
We keep telling people to go to therapy if they feel violent or angry, and we keep providing those people with shitty therapy.
Therapy is effective. It's so effective when done correctly that part of me worries that writing this will convince people not to go to therapy. So I'll say it again: therapy is effective. But a lot of therapists are providing something that does not line up with even the loosest definition of therapy.
Everyone I know who has ever had a mental health condition has had to go to multiple therapists before finding someone who was even marginally competent. There was the therapist who encouraged his client to "get right with God to heal your depression." The one who repeatedly insulted her client's appearance. The one who claimed that being gay was a sign of repressed childhood sexual abuse. The one who did "Shaman therapy teaching sessions."* The one who vociferously promoted a religious cult. The list of pure, unbridled, insane incompetence goes on and on.
These stories aren't just anecdote. Therapy is a science, and can be a highly effective one, but the data makes it clear that a whole lot of therapists don't take therapy seriously, and certainly don't treat it like a science. About 12 percent of therapy clients actually get worse. Most therapists who treat people with PTSD don't offer the right treatment.Seven percent of male therapists have had sex with a patient. **
In such an environment, finding a good therapist takes luck, time, effort, and the ability to assert oneself. The people who need help the most are unlikely to have the energy necessary to wade through a pile of shitty therapists and find a good one, to assert their needs, and to ensure their therapists use valid treatment methods. This means that, should someone who is at risk of harming another person go to therapy, it's fairly likely he won't get the help he needs, and that this result will dissuade him from going to therapy in the future.
We make it completely fucking impossible for most normal humans to be able to afford the kind of therapy that can stop a killing spree.
As an experiment, I just searched for therapists in my zip code, then clicked on the first three names that popped up. Their rates per 50-minute session were $150, $110, and $200. People with serious mental health problems probably need therapy at least once per week, and some may need therapy a couple times per week. Very few people have $1,000 to spend on therapy each month, and very few insurance plans cover therapy. Among people who go on killing sprees, who seem to mostly be young and therefore probably pretty poor, I suspect it's even less likely that affording therapy is possible.
We treat our fellow human being like absolute shit, laughing in the face of an unbelievably large pile of evidence suggesting that being mean to people breeds more meanness.
Let's be real: while few of us are at risk of ever going on a killing spree, we all have a breaking point at which we become pretty nonfunctional. Our society seems designed to increase the odds of people reaching their breaking points, and among those who don't have much of a conscience, who are filled with hate, or who have serious mental health concerns, reaching your breaking point can be deadly.
We treat each other like absolute shit. We bully and ostracize one another. We pick fights in traffic. We're rude to everyone. We judge people and generally make life miserable for one another. And among young people, who seem to be the majority of shooters, it's even worse. Many shooters were horribly isolated and mercilessly bullied. Some couldn't manage to get help from the adults whose job it was to help them.
Until every one of us commits to treating our fellow human being a little bit better, there are always going to be a few people who are fragile and inhumane enough to be pushed to the brink by unkind treatment at the wrong time.
We pawn suicidal people off on suicide hotlines rather than actually trying to help them.
I once dated someone who was suicidal, and I called a suicide hotline when I no longer knew how to help him.Within two minutes of the conversation, I was literally screaming into the phone about how incompetent, rude, and unhelpful the person on the other end of the line was being -- and I am not a person prone to screaming fits or rudeness. I've heard similar stories from other people who have called suicide hotlines.
What people don't seem to realize is that the staff on suicide hotlines are volunteers, most of whom have no mental health training and many of whom are so young they've never experienced any of the major life crises that tend to push people toward suicide. This means that a suicide hotline is not anything close to treatment. It's certainly not a substitute for a little human compassion. But because we've all heard about the importance of suicide hotlines, we've come to believe that they are the end-all, be-all solution to crises. They're not.
A few weeks ago, a Facebook friend of mine was suicidal. He posted on his wall that he felt unloved and like life was not worth living. Several people posted nothing but a suicide hotline phone number. One posted, "Hey, if you need anything, reach out." Of course, my friend was reaching out. And what he got in return was a bunch of people trying to pawn him off on a hotline rather than pick up the phone, pick up my friend, and try to pull him out of his suffering. It takes a community of love coupled with excellent treatment to pull people back from the brink of suicide, and when we look for easy solutions that begin and end with a phone number, we offer nothing to the people who need the most.
In a society that is so miserable, sick, and disturbed that it has yielded a 25% mental illness rate, we can no longer afford to treat people with mental health conditions as pariahs, can no longer tolerate therapists who don't offer quality treatment, and should probably begin evaluating what it is about our society that drives apparently normal people to decide that the best thing they can do is go on a killing rampage, then kill themselves.
While we're at it, we should probably consider the fact that people with mental illness are much more likely to be crime victims than crime perpetrators, and that most mass shooters have not been diagnosed with any mental health condition -- unless, of course, diagnosis by a journalist counts.
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*No, he was not an actual Shaman, which makes him a racist who steals concepts he does not understand from cultures and religions about which he knows nothing, in addition to being a bullshit artist.
**The astute reader will note that these studies are really old. I couldn't find anything more recent. Because I'm biased, I'm concluding that this means people are no longer interested in studying the effectiveness of therapy.
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