On the issue of mental health, from a psychologist's blog, on the topic of the recent shootings:
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"One of the scripts, which scarcely needs dusting off as it is brought out so regularly, is the need for increased funding for mental health services. Given what I’m about to say, let me be clear: I do think that mental health services are poorly funded in most countries, and what funds are available are even more poorly managed. Let’s take that as a given.
The assumption, however, is that increased mental health funding will result in lower rates of school shootings and other mass killings. With better funding would come better screening of the population. Individuals at risk of perpetrating events such as these would be identified. Treatment would ensue, and tragic outcomes would be averted. The rate of mass killings would decline.
All of this is possible. But I am not aware of any evidence that any of these assumptions is true. If you survey mental health clinicians, many believe these ideas, and they may well be right. Certainly there is little reluctance for anyone to express these beliefs in the media.
What we seldom hear is the converse opinion, which is also held by many people.
Imagine a world in which the funding for mental health programs is doubled or trebled. My own belief is that this would not have any significant impact on the incidence of mass killings.
That may not be a popular idea, and so I suppose I should have strong evidence to back it up. I don’t. In the absence of clear evidence, it is merely an opinion – just as the belief that an army of clinicians could reduce mass killing is an opinion.
I’m not alone in holding this idea, and others have doubtless thought it through better than I have. But here’s my reasoning, such as it is:
With better funding would come better screening of the population. Cadres of new clinicians would have to go looking for clients, and we would institute mass screening of students, disaffected employees, and other citizens. This seems both unlikely and undesirable. I strongly doubt that improved mental health funding would result in more community screening, and if it did there would be an outcry.
Individuals at risk of perpetrating events such as these would be identifie. The common refrain after events like these is “he was such a nice, quiet boy; I would never have imagined him doing something like this.” This from friends, family, and neighbours. Later it often emerges that there were signs from facebook postings or other online activity. Mental health workers have no magical ability to divine dangerousness, and have access to considerably less information about the people they see than the person’s own family. We might be able to identify people at somewhat higher risk of perpetrating mass murder by looking at specific variables – like the fact that someone happens to be male – but the resulting number of false positives would make this pointless.
Treatment would ensue. Mental health treatment is almost always voluntary. Most perpetrators do not seem to have seen themselves as mentally ill and so would probably not seek out or cooperate with treatment. The very hostility of their acts suggests a belief that the problem lies outside themselves and that they are justified in their rage. As well, the perpetrators usually seem to be middle-class individuals who would already have access to the mental health system if they chose to seek it out (there may be data on this point, and perhaps data that contradict this observation, but mass shooting does not usually seem to be a crime of the impoverished).
Tragic outcomes would be averted. If treatment was provided, the risk of offending would be eliminated, or at least much lowered. This might be true, though there is scant evidence in support. One argument against is the number of instances in which perpetrators (such as the accused in the Aurora theater shooting) were already in some form of treatment. There is a problem with this, obviously: deeply troubled young men are more likely to be in treatment anyway, and perhaps treatment reduces their likelihood of offending without, unfortunately, eliminating it. But we would still need evidence to claim decisively that mental health services reduce risk at all.
So if we can’t troll through the population, if we can’t really identify risk very well, and we can’t control risk should it be found, it’s hard to see how increased mental health funding will eliminate school shootings.
A colleague of mine once observed that mental health clinicians are the ones who chase after the horse after the barn door has been left open. By this reasoning, we would be no more likely to reduce the incidence of shootings than by increasing the number of emergency trauma surgeons.
Why bother making this point? In times of tragedy, it’s always tempting to go for the easy answers. Let’s just increase mental health funding. And mental health clinicians, all too aware of the gaps in service, are reluctant to contradict anything that might result in a more comprehensive and well-funded system.
But this particular problem may not be caused by the lack of mental health care – not much, at any rate. The real culprits almost certainly lie elsewhere: the availability of guns, the aggrandizement of violence in media and its actual practice in the artificial world of video games, a cultural sense of entitlement and rage. And an obsession with celebrity causing some to seek it in the only way a young, talentless male can manage: by destroying the lives of others. A method that is based not on distortion but on an accurate perception of the consequences of amassing a high body count.
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http://www.psychologysalon.com/2012/12/tragedy-and-mental-health.html
(emphases mine)