When a mentally deranged gunman opened fire on a theater full of unsuspecting movie goers in Aurora, Colo., on July 20, 2012, killing 12 and wounding 70, it shocked and saddened the entire nation. A vigorous debate about the merits of more restrictive gun control laws soon followed, as Americans tried to make sense of this tragedy and policy-makers searched for solutions that might decrease the likelihood of something like this happening again. But just 21 weeks later, it did happen again. On Dec. 14, another young man with mental health troubles and apparently unlimited access to high-powered weaponry walked into an elementary school in Newtown, Conn., and mercilessly executed 20 small children and six adults before turning a gun on himself. Once again the issue of gun control was pushed to the forefront, as outraged citizens wondered why it was apparently so easy for people with serious mental health problems to gain access to highly-lethal semi-automatic assault rifles. Guns are always an easy target in a situation like this, but those who have chosen to look a little deeper beneath the surface see these tragic shootings as a sign that our understanding of mental illness is lacking and that our treatment services and protocols for helping those struggling with mental illness is outdated, underfunded and altogether inadequate. It is perhaps too harsh to suggest that these incidents are proof that the system has failed, but they do suggest that much more—or at least something different—needs to be done to help mental health care professionals enhance their ability to accurately diagnose mental illness and intervene effectively in a broad range of circumstances. If funding for mental health services had been soaring, it might be tempting to write off the actions of Aurora killer James Holmes and Newtown shooter Adam Lanza as aberrations. After all, there is only so much that can be accomplished with treatment, no matter how hard we might try to help everyone. But over the last decade or so, public funding for mental health services has been dropping at the state and federal levels, often precipitously, and that is why—in the aftermath of Aurora and Newtown—many in the mental health field have been imploring politicians and government bureaucrats to finally get serious about addressing mental illness in a comprehensive and intelligent way. They point out that the economic and social costs of untreated or inadequately treated mental diseases are enormous, and they see these two recent mass shootings as profoundly sad examples of what can happen when mental health treatment is neglected in the name of short-term expediency. Fortunately the voices of these advocates have been heard, and since the carnage in Aurora, scores of bills are being debated or have already been signed into law in virtually every state that will fund new initiatives for the treatment of mental illness or restore old ones that had previously fallen victim to budget cuts. In Colorado, where the pain was most acutely felt following the movie theater massacre, a bill was passed and signed into law in May that will invest $20 million in a variety of innovative mental health services, including walk-in crisis counseling centers, a round-the-clock mental health hotline, and mobile units that can provide immediate mental health intervention wherever it might be required. During the first two months of 2013, when the wounds of the nation were still fresh following the mass killing of innocent children in Connecticut, approximately 60 bills were introduced in state legislatures across the country that dealt with mental health issues in some way. Meanwhile, at the federal level, President Obama’s 2013 budget included a request for $235 million in new spending for mental health care that, among other things, would support initiatives designed to increase the availability of emergency mental health treatment services in public schools. Promises and Reality With about 5 percent of the adult population now suffering from some sort of mental illness, and millions of younger people afflicted with such troubles as well, sacrificing mental health on the altar of fiscal responsibility is a choice that we simply cannot afford to make. Even if one were to make the case that what happened in Aurora and Newtown could not have been prevented by more accessible mental health care alone, these two horrific examples of what can conceivably happen if mental illness is left unchecked do help to illustrate how high the costs for society can be if we choose to ignore the needs of those who are suffering from diseases of the mind over which they have no real control. Unfortunately, there is no guarantee that this burst of interest in sponsoring expanded mental health treatment at the state and federal level will actually lead to much meaningful action. Introducing bills and launching initiatives designed to address the problem is a good first step, but these gestures could prove to be futile if rigid ideological thinking that rejects the utility of all government spending and investment if continues to carry the day. So far much has been proposed but only a scattering of new initiatives have been passed into law, and we have good reason to be skeptical going forward as to just how serious policy makers really are about providing necessary investment dollars to fund effective intervention programs that can make a difference in the lives of the mentally ill. Promises and bold talk are cheap. But the costs of failing to adequately deal with the problem of mental illness will be enormous, and that is a heavy burden that will have to be borne by all of us if we do not take action now to see that those who need help can get it before it is too late.
