IN THE WAKE OF SANDY HOOK - SIX MONTHS LATER

In the Wake of Sandy Hook - Six Months Later

by Andrew Malekoff

On June 3, 2013, at a White House conference on mental health, President Obama urged Americans to “help bring mental illness out of the shadows” and pledged that his administration will provide new resources to support the effort. He called for an open dialogue on mental illness. He said a lack of public understanding about mental illness leads to a lack of treatment. These are timely and encouraging words.

On April 3, 2013, I participated as a panelist in a National Public Health Week event, organized by Hofstra University School Health Sciences and Human Services, on mental health issues in the wake of Sandy Hook. My emphasis was on eradicating stigma and improving access to quality mental health care and child care.

The American reality today is one out of five children has a serious emotional disturbance and more children suffer from psychiatric illness than from autism, leukemia, diabetes and AIDS combined. Yet, we continue to treat illnesses above the neck differently than those below the neck. 

People with mental health problems, and their families, often feel a sense of shame and suffer in silence; while people with physical health problems evoke the sympathy, support and comfort of others. It is shameful that the editors of major metropolitan newspapers exploit and discredit people suffering with mental illnesses with malicious name-calling that reinforces fear, mistrust and stigma, causing labeled persons to lose status and experience discrimination.

We know that the most violent acts are not committed by people with mental illness. In fact, people with mental illness are disproportionately the victims of violence. New gun laws require that the names of designated individuals with severe mental illness be recorded in a national data-base. Whether this will improve public safety or generate a witch hunt that further stigmatizes the mentally ill remains to be seen. In any case, what it does not do is address the problem of better access to quality mental health care.

Here are the facts: seventy-five percent of all serious mental illness occurs before the age of 24; and 50% before the age of 14. Yet, only one out of five children who have emotional disturbances receive treatment from a mental health specialist. We must do more to identify mental health problems early and then, when indicated, provide ready access to quality community-based mental health care.

Early screening by schools and pediatricians is a promising development. Yet, New York State has implemented a "clinic reform" plan that assures continued access to care only to children and families with Medicaid insurance coverage. This leaves a significant number of children and adults in the lurch. 

What’s more, New York State does not support universal access to quality child care, which is critical to a child’s healthy emotional development. By lowering income-eligibility levels for child-care subsidies, thousands of Long Island children are now being denied quality child care, leaving parents to either curtail work or leave their children in unlicensed child-care settings.

When elected representatives and appointed officials champion early mental health screening in schools and pediatrician’s offices, while denying universal access to child care and community-based mental health care, there is only the illusion of caring, political sleight of hand and insult to the children and adults who died at Sandy Hook.