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US mental health system 'broken'

8th January 2013

As Americans face the enormity of the school shootings last month in Newtown, Connecticut, experts are calling for greater investment in mental health care.

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They say that more funding and new legislation is needed to address the mental health needs of individuals before such tragedies occur again.

In a letter to President Barack Obama, the American Academy of Pediatrics published a letter to Obama a week after the Sandy Hook massacre, asking him to lead an effort to reform mental health care, as well as to ban assault rifles.

The letter coincided with similar appeals from dozens of mental health and substance abuse groups making the same requests.

The letters called for a doubling in capacity of community mental health services, better education in schools about mental health problems, and school and community based programmes for evaluation and treatment.

According Ron Manderscheid, who heads the National Association of County Behavioral Health and Developmental Disability Directors, the global economic recession has made a poor mental health care system into a broken one.

Since 2009, figures from the National Association of State Mental Health Program Directors show that US states have cut at least US$4.35 billion from the budgets of public mental health services, amounting to around 12% of the budget.

As state-level government's grapple with the need to cut funding, more than 3,200 psychiatric hospital beds, almost 6% of the total, have been lost, while a further 1,249 beds are in danger of being axed.

Even those with health insurance often have no way to pay for residential psychiatric care of the kind needed in extreme cases where a person is a potential threat to themselves, their family, or the general public.

According to Manderscheid, most families are forced to rely on publicly funded hospital care, and that it is virtually impossible to get mental health care that way.

According to figures released by the National Institutes of Health, one in three people with a mental illness classified as "severe" never receive any treatment whatsoever, while two-thirds of people with "moderate" conditions have to get by without treatment of any kind.

Nearly 60 million adults suffer from complaints ranging from attention-deficit hyperactivity disorder, to depression, anxiety, anorexia and schizophrenia.

While one in four adults will suffer from a mental health problem at some point in their lives, many in the US still regard mental illness as a character deficit.

Meanwhile, one in five children overall have a "diagnosable mental illness," according to the American Academy of Pediatrics.

While there has been scant information from police regarding the mental state of Adam Lanza, 20, who killed his mother at her home, and 26 others at Sandy Hook Elementary School in Newtown, before killing himself, some reports say Lanza had a diagnosis of Asperger's.

Asperger syndrome in itself is an autism spectrum disorder not normally associated with violence. But those who have it can also suffer from concurrent mental health problems.

There has been no information from police about whether Lanza had additional mental health problems or not.

However, mental illness has been a part of the picture for many people who have carried out similar public mass killings.

Those who carried out massacres at Virginia Tech in 2007, Tucson in 2011, and the Aurora, Colorado "Batman" cinema shooting last summer had all struggled with mental illness.

Public feeling is running high in the wake of the Sandy Hook shootings, where the victims were so young, and President Barack Obama called immediately for greater access to mental health care in the wake of the tragedy.

Access to mental health care should be as easy as access to a gun, he told a news conference.

For now, parents of young people with severe and disturbing symptoms face grappling with services that are fragmented and hard to find.

Many patients have to wait for months for in-patient mental health treatment, and their families can empty their bank accounts to pay for it.

Restrictive laws on psychiatric committal make it hard to send someone to hospital against their will.

Mothers like Lynne Peterson of Minnesota, whose sons both suffer from mental illness, say they are speaking out now in the hope of preventing further violence.

People do not always see her sons' conditions as a disease that is beyond their control, but which can be treated with therapy and medication, Peterson said.

According to the USA Today newspaper, a mass killing involving at least four victims takes place on average once every two weeks in the US.


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