Mental health: Just one piece of the solution

by Bob Bick and Catherine Simonson In the two weeks since the tragic shooting at Marjory Stoneman Douglas High School in Parkland, Florida, we’ve again come together as a community to say “never again.” As an organization whose mission is to actively promote well-being and a safe and healthy community, we know that we cannot fully understand the depth of the grief and trauma felt by those impacted. Here in Chittenden County, our school based clinicians, teachers, professional staff, and First Call for Chittenden County crisis responders are providing support to children and families who are experiencing heightened anxiety for their personal safety.

Following these now too common events, the national conversation often turns to the need for better mental health care as a preventive measure. We in the mental health care field have an important role to play in these conversations as a source of accurate input in support of informed dialogue.

The vast majority of violent crimes are committed by individuals without a mental health diagnosis. Current research indicates only about 3-5% of all violent crimes can be attributed to individuals with severe mental illness, and an even smaller percentage of those crimes involve firearms. According to James L. Knoll IV, M.D. and George D. Annas, M.D., M.P.H., authors of Gun Violence and Mental Illness, (American Psychiatric Association, 2016) mass shootings by people with serious mental illness represent 1% of all gun homicides each year. (For comparison, deaths by suicide using firearms account for the majority of yearly gun-related deaths.) In addition, while other research indicates that the majority of people with mental illness are not violent, they are 2.5 times—and according to some research 12 times—more likely to be victims of violence than members of the general population.

The research into violence paints a complex picture that includes many factors. Among the risk factors found to be connected to violence are unemployment; poverty; drug and alcohol abuse; past violent victimization; isolation; living in disadvantaged communities; personal stressors like divorce, job loss, and bereavement; and past acts of violence such as domestic abuse. Risk remains low for people experiencing any one of these factors, but appears to increase rapidly for those experiencing two or more. Professor Jeffrey Swanson of Duke University has studied violence and mental health since the 1980s and found past violence to be the biggest predictor of future violence. Speaking to The New Yorker Magazine recently he said, “Any history of violent behavior is a much stronger predictor of future violence than a mental health diagnosis.”

For Howard Center and other mental health organizations, the reaction to this tragedy underscores the need for increased outreach and public education aimed at reducing stigma. Although mental health prevention and access to treatment have become part of the national conversation, they are not the only aspects to consider as we seek solutions. While we encourage an honest, national discussion that includes multiple perspectives, we recognize the fallacy of focusing on a single perspective, especially when that erroneously stigmatizes mental health and the individuals and families who are impacted by mental illness.

Common sense solutions aimed at preventing future tragedies will need to address a number of factors, including accessibility to guns, firearm safety and storage training, education about when to seek help and/or report problems, and policy changes and sufficient resources to have a meaningful impact on systemic social issues.

We support respectful solution-oriented community engagement and will continue to provide timely and accessible mental health care. And, we remain committed to continue to work to improve the health, well-being, and public safety in our community and to ensure that “Help is here.”

Our First Call for Chittenden County staff and mobile crisis service are available 24/7/365 for phone and in-person support at 802-488-7777 and provide an array of additional services including suicide prevention training, education about gun safety and free distribution of gun locks, and post tragedy and disaster response. Our website offers additional resources for the public at www.howardcenter.org.

Bob Bick, Howard Center’s CEO, and Catherine Simonson, LICSW, Howard Center’s Chief Client Services Officer.Last year Howard Center helped 16,000 people in over 60 locations and six counties with mental health, substance use, and developmental services. www.howardcenter.org. Help is here.