Advancing mental health: Gun violence in America, Part 2

originally published in The Herald

Gun violence generates a latticework of fix-something brainstorms, from arming teachers to repealing the Second Amendment. Arguments, both ad hominem and rational, cross-hatch the public square, but unite on mental health.

Here, consensus runneth over: Mental-health services must be enhanced, with an emphasis on intervention and access to care.

As an action-forcing horror, the Newtown shooting teased up a stereotype, of those living with mental illness gravitating to violence. In fact, the mentally ill are much more likely to cause harm to themselves than to others. Violence manifests when severely ill patients go untreated. While disease stigmas fester, they aren’t changeless. Cancer was stigmatized. So was AIDS. Education is the antidote, setting mental health on par with the broader spectrum of community health needs. (Parity means just that.)

Approaches come with a price tag. Strengthening the community mental health system, establishing community-based care for individuals with unique needs, and boosting hospital capacity (all part of Gov. Gregoire’s proposed 2013 budget) will tap millions.

Gun violence awakens and mobilizes the public. After a mentally ill Skagit County man murdered six people in 2008, the health care community sponsored a summit that drew more than 200 participants. Skagit Valley Hospital subsequently launched a capital improvement campaign to underwrite its behavioral-health facility. Rep. Rick Larsen secured $800,000 in federal support to leverage $750,000 in state capital funding.

For Washingtonians, priority one centers on families powerless to treat loved ones living with mental illness. In Olympia, one idea is to accelerate implementation of SHB 3076, concerning involuntary treatment, part of which was to take effect this year but got punted to 2015 because of a less-than-complete cost/benefit analysis. Mental health advocates want to resurrect the delayed portions for immediate implementation, providing for family-input consideration in involuntary-treatment decisions.

Better intervention tools are also demanded, and the best vehicle is tweaking the Involuntary Treatment Act (ITA.) The ITA provides for emergency involuntary hospitalization if a person, “presents an imminent likelihood of serious harm.” Advocates recommend the “imminence” requirement be nixed from the emergency-detention statute to allow more of those who need help to receive it before a life-threatening danger actually becomes “imminent.” There is also a call to establish universally available assisted outpatient treatment as an alternative to pricey hospitalization.

We don’t need more action-forcing horrors. Washington lawmakers know what to do.

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