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Let's get specific about mental health fixes
Stuart News - 3/5/2018
It's been a week filled with impassioned discussions about gun restrictions ranging from banning bump stocks to restricting the sale of assault weapons to hardening schools and even arming teachers.
Yet there's been too little talk about mental health, one factor that certainly played a prominent role in Parkland shooter Nikolas Cruz's choices.
Two references to mental health struck me last week.
First, on Monday I attended a press briefing by St. Lucie County school and law enforcement officials. It was intended to reassure parents and the community that authorities are on the ball in keeping schools and students as safe as possible.
Afterwards, Port St. Lucie Police Chief John Bolduc talked with me about the difficulties law enforcement officials have in dealing with the Baker Act.
More properly known as the Florida Mental Health Act of 1971, the measure allows the temporary involuntary institutionalization and examination of an individual if he or she is suspected of having mental illness or is in danger of harming themselves or others.
Examinations may last up to 72 hours after the person is deemed medically stable. They may be released to the community, involuntarily committed as an inpatient, or be recommended for outpatient treatment.
To Bolduc, it doesn't make sense that officers can send a violent individual for evaluation, but cannot confiscate his weapons to prevent more problems in the future. Legally, if the individual has not committed a crime he is able to get the guns back, even if law enforcement suspects he may need to be Baker Acted again in the future.
A story published Tuesday under the headline "Teachers wanted Nikolas Cruz transferred to alternative school with mental health services" chronicled the combined efforts of a passel of mental health experts to head off a crisis, all to no avail. Since Cruz was older than 18, he had the right to refuse all help.
I decided to poll area mental health experts on how they'd change the system.
Jeff Shearer, CEO of Stuart-based Tykes and Teens, a family-oriented mental health clinic based in Stuart agreed with Bolduc about the shortcomings of the Baker Act.
Some children he sees have been "Baker Acted 10 to 15 times, and there's still no accountability," Shearer said. "It's a very unwieldy intervention. Nothing miraculous happens within 72 hours. I'd like to see more follow-up requirements. How can we prevent future episodes, how can we better support individuals?"
Deborah Dreher, chief clinical officer for New Horizons of the Treasure Coast and Okeechobee, would like to see widespread training of lay people to recognize the signs of mental illness or distress in individuals, before a crisis develops. Dreher spoke of Mental Health First Aid, a program created by the National Council for Behavioral Health.
"It's like teaching CPR for mental health," Dreher explained, and could be useful for teachers, law enforcement officers and other community members.
Dreher believes enhancing mental health awareness in the general population could also help reduce the stigma that is still attached to mental illness.
John Romano, longtime CEO of New Horizons of the Treasure Coast, said his top priority would be improving lines of communication between different mental health agencies. Romano believes HIPAA, (the Health Insurance Portability and Accountability Act of 1996) while intended to protect personal privacy, can actually be a stumbling block in coordinating help for clients.
Romano said he'd like to see some relaxation of the rules between separate mental health organizations that have treated an individual about sharing medical information.
"They can talk to each other now, with formal releases of (patient) information, but often they don't. Why not? We're all supposed to be looking out for the best interests of the kid, after all," Romano pointed out.
"You have to have common sense," Romano believes. "We'll tell law enforcement if there's an imminent threat of violence, even if it may violate HIPAA. In today's world, where kids can buy assault weapons, you have to do all you can."
That thought was echoed by Shearer, who also has issues with HIPAA.
"We should reexamine (the law's) function to better serve the community and the individual," Shearer said. "For instance, often we cannot speak about a person's mental state, even with their parents or partner. That inhibits our effectiveness."
Of course, money is always a factor, Romano and Shearer agreed. While we can provide services to those undergoing some sort of trauma, often we do not fund prevention efforts, even though we know that can have the biggest impact, Shearer said.
He pointed to the success of Project Northland (later called the Alcohol Literacy Challenge) which was designed to combat several lethal teenage binge-drinking incidents in Martin County a few years ago.
Tykes and Teens staff teach an anti-alcohol curriculum to every middle school student in the county – 4,000 of them to date – all for about $60,000. That's only $15 a head to perhaps save a life.
"And it's worked," Shearer said, "we maxed out (on alcohol-related incidents) within six years."
Shearer noted the recent frequency of mass shooting incidents in Florida correlates with our state's 49th rank in mental health spending.
Let's hope that along with all the talk about weapons and who should be allowed to carry or purchase them, the Parkland tragedy also brings about a deeper look at our mental health system. Listening to the experts, we sure do need one.
Anthony Westbury is a columnist for TCPalm.com. This column reflects his opinion. Contact him at 772-221-4220, firstname.lastname@example.org, or follow him @TCPalmWestbury on Twitter.
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