Wow, I didn't know some of this. All emphasis mine. Let's hope the government and health care industries pay attention and don't obsess just over gun control!

Is it 'mental health' or 'behavioral health'? (opinion from Linda and Graham L. Champion)

For more than the past 12 years we have been involved both in Alabama and on the national level as mental health advocates. We have witnessed the good, the bad and the ugly of treatment of those individuals living with a mental illness as well as the treatment of the caregivers for these individuals. The events of last week in Newtown, Conn., bring into special relief events that we have witnessed firsthand.

There has been much discussion about the possibility that Adam Lanza had an undiagnosed mental illness. He also has been described as being autistic or having Asperger's Syndrome.

We may never know if Lanza had a mental illness even if his mother had been told that it was suspected that a mental illness existed. We have seen situations where a psychiatrist will tell parents that the doctor strongly suspects a mental illness diagnosis but refuses to apply that diagnosis to a child or adolescent for fear that the stigma might follow the child into later life.

What a shame. Would a doctor ever say that an asthmatic child was just short of breath? Would a child with a congenital heart problem be label as just frail? Are children that have been diagnosed ADHD referred to as just being active? The answer to all of these questions is of course not.

Why then should a child with a diagnosable mental illness not be receiving that diagnosis?

One of the biggest problems lies in the fact that our society is afraid to deal with mental illness and to deal with those with a mental illness diagnosis. Most people have no idea that statistics show that one in four American adults in any given year have a diagnosable mental illness. That is approximately 57 million people - but we do not talk about things like that.

In fact, the stigma surrounding mental illness is so powerful that our society has been moving at lightning speed toward referring to mental health as "behavioral health." There are several reasons for this, including an attempt to avoid the truth about the illness and an attempt by the insurance industry to avoid having to cover treatment.

Think about it, you can get health insurance but what about behavior insurance?

Mental illness is the result of a biological brain disorder. In some cases, the illness is manifested in behaviors that are not normal but the illness is not the result of behavior. Poor diet and lack of exercise can significantly contribute to heart disease or diabetes, but neither of these conditions is ever referred to a "behavioral health" state.

It has not been that many years ago that a person with AIDS was feared and when in the hospital might have been referred to as having a form of cancer. Look how far we have come in just 20 short years with the advent of AIDS outreach programs and very public fundraisers.

There is a general lack of knowledge in the community about mental illness and how to get mental health care. The pervasive stigma, or rather social stereotypes, that prevail towards mental illness serve as a deterrent for people to seek help when they need it. Families sometimes do not know to get help for loved ones manifesting symptoms of possible mental illness, or where to go.

When individuals or families do seek help and services, these services are frequently not available. This situation has grown worse in recent years with budget cuts, narrowing of eligibility criteria for services, limits on what services are available, etc.

We must intervene earlier and ensure that essential mental health services and treatment are available at the earliest stages. We must demand ease of access to mental health professionals, earlier and more assessable treatment and access to effective treatments and strategies.

Again, we may never know if Lanza had ever been evaluated as having a mental illness regardless of what his diagnosis should have been. Until we, as a society, start to treat mental illness for what it is - an illness and not a behavior - and quit trying to hide the truth, we will not get those who need it most the health care services they deserve and we will continue to leave or citizens unprotected.

Think about the numbers we mentioned above. If properly diagnosed and treated individuals living with a mental illness live a very normal and successful life. If the illness goes undiagnosed and untreated, the patient and society both lose. Look around the room where you work or play or worship. Remember that statistically one in four adults is likely to have a diagnosable mental illness at any time.

Can you tell who that person is?

http://blog.al.com/birmingham-news-comm ... er_default

Interesting read and I honestly have no answers to this problem except to say it's sad for everyone involved.

That's because there are no easy answers. I worked at Atlanticare Behavioral Health by the way. There is also a difference between a mental illness (caused by the brain) and a personality disorder (caused by circumstances). The article does not address this and is fairly incomplete.

There is a very real stigma against mental illness. Do you really think a gun-obsessed violent person is going to go for treatment when he knows a diagnosis will prohibit him from gun ownership?

This is not easily solvable by making the services available. They would have been available to Lanza; a man of means in CT.

Behavioral health usually includes substance abuse, and there is very high coincindence of substance abuse and mental illness.

On Anderson Cooper 360 on CNN last night, they had an expert on who has examined the brains of people who have died who had committed mass murders. He pointed out that the frontal region of their brains is different from normal people. The front area of the brain is responsible for feelings of empathy and sympathy. So in other words, they lack or have a reduced capacity to have the ability to feel empathy or sympathy for others.

I'm with Kathy on "... there are no easy answers" ~ there is also not a one-size-fits-all answer ~ the problem is immense ~ and extremely complex ~ it goes waaaaay beyond guns and waaaaay beyond mental/behavioral health ~ I see the entertainment industry as playing a major role here ~ we are constantly bombarded with violent behavior in movies, TV, video games, books ~ some of the story lines are based on true life ~ some suggest new "kicks" for the mentally/emotionally unstable ~ even the rhetoric we hear on a daily basis suggests violence ~ the constancy of this bombardment serves to, at least sub-consciously, desensitize us to the violence ~

Sooz

The problem being we aren't going to stop TV shows and movies that involve violent behavior. CSI Parts 1,2 and 3; NCIS, Criminal Minds, Person of Interest, Law and Orders Parts 1 to x. Just about every episodic TV series revolve around violent behavior. Video games you are usually shooting something from bubbles to aliens to people.

A tough issue to tackle pervasively.

Agreed, Kath ~ a very tough issue to tackle ~ coincidentally, I just stumbled across this article ~ it's difficult to not reach the conclusion that the "culture of violence" is insidious ~ personally, I have stopped watching Criminal Minds, because the gore and grisly episodes blot out "good guys get bad guys" for me ~ Sooz

Wednesday, Dec 19, 2012 06:15 PM CST
Politicians question link between entertainment and violence
President Obama has put together a task force to examine "a culture that too often glorifies guns and violence"
By Prachi Gupta

Since Friday, Hollywood has been scrambling to change its lineups, mindful of how the tragedy in Newtown has affected Americans. But so far, the changes — rescheduling TV shows with sensitive content, canceling or delaying movie premieres — appear more like a moment of silence from the entertainment industry than signs of serious introspection. Paramount removed a violent scene from the “Jack Reacher” trailer, but it will remain in the movie, which is still scheduled to release this week. The Weinstein Company canceled the premiere for “Django Unchained,” but the grisly Western is still due out on Christmas Day.

Many have remained skeptical that the shootings at Sandy Hook would affect the entertainment industry in any meaningful way — possibly because those in the industry don’t believe it should and possibly because we’ve heard this kind of talk after previous massacres. Martin Kaplan, director of the Norman Lear Center for the study of entertainment and society at the University of Southern California, told the New York Times, “What you hear from the industry is this: violence has always been a part of entertainment, back to Sophocles and Shakespeare and Edgar Allan Poe.” The industry’s logic, he explained, is this: “Why should modern entertainment deprive itself of a universal and timeless element of storytelling?”

But this morning, five days after the shooting, President Obama hinted at possible long-term changes when he announced that vice president Joe Biden will head a new task force in charge of curbing gun violence in America and examine ”a culture that too often glorifies guns and violence.”

The comment has reignited an age-old debate among politicians about the entertainment industry’s role in promoting violence — though so far, it’s being aimed almost entirely at video games, as some claim that Newtown shooter Adam Lanza played Call of Duty and Starcraft before the shootings.

“The violence in the entertainment culture — particularly, with the extraordinary realism to video games, movies now, et cetera — does cause vulnerable young men to be more violent,” said Sen. Joe Lieberman, I-Conn.

NRA-friendly Sen. Joe Manchin D.-W.V., who is so far “not supporting a ban on anything,” said ”Look at Grand Theft Auto, put out by Rockstar Games in New York City and see what it promotes.” He later added, “Shouldn’t that be looked into and maybe be banned?”

Colorado Governor John Hickenlooper noted, ”There might well be some direct connection between people who have some mental instability and when they go over the edge — they transport themselves, they become part of one of those video games.”

The link between video game and actual violence, however, remains unclear. As the AP notes, “It’s unlikely that lawmakers will pursue legislation to regulate the sales of video games; such efforts were rejected again and again in a series of court cases over the last decade.” Senate Commerce Committee Chairman Jay Rockefeller, however, intends to change that. Rockefeller has introduced a bill that would require the National Academy of Sciences to investigate whether a measurable link between “violent programming” in video games and violent behavior exists, arguing that “we need to do more and explore ways Congress can lay additional groundwork on this issue.”

For now, however, immediate change in the entertainment industry might come from consumers themselves. CNN notes that some of its readers are opting not to buy violent video games for their children. One reader acknowledged that for most people, video games don’t have a profound effect. But “for the mentally unstable, these fantasy scenarios are fueling the violence, and being re-enacted in real life.”

http://www.salon.com/2012/12/20/politicians_question_link_between_entertainment_and_violence/

How accurate are the diagnoses?
What motivates the diagnoses? profit or loss of profit? increased/decreased funding? genuine interest?

The problem being if you make Grand Theft Auto illegal, there will be an underground market for Grand Theft Auto. The sensitive to violence guys will be first in line. It's not unlike the drug culture. While we are at it, I think drugs and alcohol exacerbate violent behavior, too.

Like we said, it's not easy.

Not very. Go to three different professionals; get three different diagnoses. Some clients lie, too, which muddies the water.

Someone walks in the door to AtlantiCare Behavioral Health odds are they will get a diagnosis. It may just be Adjustment Disorder (e.g. your dog died and you are sad) but you need a diagnosis for insurance to pay.

Back later.

I truly hope the new DSM has some better names. Calling things "disorders" sometimes minimizes their severity, like conduct disorder where the diagnostic criteria is actually a list of felonies, or inflates their severity, like the forementioned adjustment disorder. I also wish that duration were part of the title or diagnosis. There si so much confusion around what is permanent, what is chronic, and what is eposidic or one time experiences of emotional dysfunction.

I remember one course on differential diagnosis, which was supposed to make us all better at choosing the same name for the same list of symptoms. It was the class joke that no one would pass because we couldn't come to consensus on anything.