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November 9, 2018
The Critical Treatment Difference Between Mental and Physical Illness Can Be Fatal

This past Thursday*, a gunman opened fire in a bar in Thousand Oaks, California, killing 12 people with no apparent rhyme or reason known to investigators at this time. What we do know is that the shooter was experiencing a reportedly untreated mental health condition.

With mental illness steadily on the rise across the nation, there has been a lot of media attention surrounding the reduction of the stigma attached to the disease. But despite the upsurge in alleged diagnoses, reports and statistics, one critical factor is missing in educating the public about mental illness: The stark difference between a mental emergency and a medical one.

Imagine your loved one has just collapsed and can’t consent to a transport to the emergency department. But they’re rushed to the hospital for life-saving treatment. Doctors tell you they’ve had a heart attack. He/she is stabilized, maybe admitted for a few days and sent home with instructions on cardiac rehabilitation.

In this case, doctors have provided tangible medical intervention, restored function and encourage outpatient treatment. If you fail to follow-up with outpatient care, your condition could return and/or worsen, causing further decline and, over time, may even cause loss of life. However, your hospitalization has set you on a path to recovery and you are motivated to engage in follow-up, ultimately returning to your previous level of functioning.

Now imagine your brain, also a vital organ, has experienced a crisis. You are feeling unsafe, experiencing terrifying thoughts or emotions. Your family calls 911 and mobile crisis, the equivalent of the behavioral health paramedics, comes to your home.

Like the heart attack victim, by nature of your illness you find yourself unable to consent to treatment. In this instance, unless you’ve expressed intent to imminently hurt yourself or others, treatment experts will not rush in and implement life-saving treatment. Rather, in the absence of imminent, foreseeable harm to yourself or others, you are discharged with no stabilization. Experts recommend that you follow up outpatient; they ask you to consider a stabilization program, evaluation by an outpatient therapist, and possibly medication to stabilize you.  You don’t seek further treatment, and in the absence of follow-up your symptoms worsen, causing further decline and potentially even loss of life.

In the case of the shooting in Thousand Oaks, authorities report that the gunman’s mother called a mobile crisis team, like the team described above, roughly six months ago, and mental health experts found him unwilling to consent to care; he was ineligible for mandated treatment.

He reportedly had no further treatment after that date, and his mother is noted to have “lived in fear” of what he might do.

Stories like this are all too common. Surely all of us remember the Sandy Hook shooting in 2012, when a young man experiencing a mental health disorder entered an elementary school and killed 27 innocent victims, including 20 children. These are extreme examples of the effects of untreated mental illness, but they do highlight the seriousness of treating our mental health like our physical health.

If your throat was sore causing significant discomfort, you’d see a doctor. You’d get medication, and you’d treat the condition. If you have diabetes, you take needed insulin to manage your blood sugar, regulating your pancreas. Your brain is an organ—like your heart, your pancreas, and the rest of your body.

The solution to gun violence in our country is a complex issue, one requiring input and participation from politicians, mental health experts and others. However, we all have the ability to impact utilization and access when it comes to mental health—download this comprehensive fact sheet from NAMI here for how you can help those around you.

To contact Harrington’s Department of Behavioral Health, call (508)  765-9167.

*This article was written following the tragic shooting in Thousand Oaks, California. While the days and weeks have continued, the urgent need for mental health resources continues to extrapolate.