Category Archives: Mental Health Field

The “Mental Health System” is NOT Responsible for Stopping Mass Shootings

Posted on by
Reply

by

JC Schildbach, LMHC

If your power was out, would you call up your dentist and cuss her/him out for not fixing your wiring? If your car wouldn’t start, would you say it was a problem for your plumber? If your spouse filed for divorce, would you seek the help of your dog-walker?

I’ll assume your answer is, “No.”

Yet, it has become a routine part of the American dialog that when mass shootings are committed, not only are we all immediately told by politicians not to ‘politicize’ such situations–politicians being those people in our society who are tasked with establishing law. But we are also told that such killings are a problem of the ‘mental health system’–which has no power to enforce law or even to make anybody get mental health care. All while law enforcement—which is, well, the means by which laws are enforced—is left out of the picture, except to say that if current laws were enforced, then we wouldn’t have such situations, and that no new laws are necessary.

In other words, pro-gun/pro-gun-lobby forces tell us that an issue properly dealt with by the legal system and law enforcement is actually a problem of the mental health system.

Think of all—or even a few–of the forms of human tragedy that involve human actions inflicting harm—or even death–on human victims.

How many of those types of violence are attributed to flaws in the ‘Mental Health System’?

We could eliminate terrorism if only we could fix the mental health system!

Drunk driving could be eradicated if only the mental health system would address the problem!

Embezzlement could be ended if only white-collar criminals had access to appropriate mental health services!

Child molestation is, at base, a mental health issue, not an issue of…what? Access to children?

Granted, it’s possible that terrorism, drunk driving, child molestation and white collar crime could potentially be reduced if those people who engage (or potentially engage) in such actions had mental health supports or other forms of guidance that led them away from those behaviors and toward more positive actions. But exactly when does anybody expect those supports to intervene, and in what form?

Gee, ma’am, we see you’ve been looking up ‘jihadist’ websites, would you maybe like some counseling to help you get those bad ideas out of your head?

Son, I notice you’ve had quite a few drinks, and your car is just outside. Perhaps if I could help you clarify your goals around driving right now, you might see that Lyft would be the better option.

Ma’am, it appears you might be toying with the idea of skimming funds from your clients. Would you mind talking with me for an hour or so, so we can map out some better life goals for you, that you then might be able to share with your friends and co-workers?

Sir, we’ve noticed you frequently hanging out just outside the Claire’s, and it seems you might be taking an unhealthy interest in young girls. Would you, perhaps, like some counseling to prevent you from ever molesting a tween?

Just so we’re all clear, mental healthcare is not predictive, except in the very narrow aspect of identifying factors that might make someone more pre-disposed to one behavior or another. But mental health interventions are rarely brought to bear, unless a person who is at risk for committing a particular act has had the foresight to seek out help her/himself, or the legal system has gotten involved because of harms already inflicted.

How many of the people who blame the shortcomings of the ‘mental health system’ for gun violence and mass shootings could give even a rudimentary explanation of what that ‘mental health system’ consists of, or offer any kind of reasonable, fact-based, evidence-based ideas that might offer even minimal improvements in the ‘mental health system’s’ ability to stop gun violence? How many of the ‘mental health system’ blamers can even explain how anybody would access mental health services…or be pushed into those services if they were a potential risk for mass shooting?

Lucy bullet

I’d guess that number is hovering somewhere between the number of arms on a rattlesnake, and the number of good sequels to ‘The Godfather’.

One major problem with the argument that the ‘mental health system’ can stop gun violence is that there is no way for the ‘mental health system’ to know who has guns and who does not, aside from the owners of guns (and perhaps their friends and family, where privacy laws don’t get in the way) telling providers in the ‘mental health system’ that they own guns—and that they intend to use them.

That is to say, unless the client of a mental health provider makes a fairly specific threat to use a gun or guns to kill somebody, or multiple somebodies, and the mental health provider knows that the client has access to those weapons, the mental health provider has very few options to stop such violence.

Hell, even in the presence of a specific threat, the mental health provider has few options other than to inform police, and hope the police can act to stop the person making the threats.

And, in case you’re wondering, the police have very limited powers to intervene where potential ‘mass shooters’ have a legal right to own guns, or when those potential shooters have not done or said anything that is actionable by police—like having made a specific threat to use firearms against specific people, and/or in specific places.

So the option to inform law enforcement is often little more than a mental health provider covering her/his own ass.   ‘I made the call to 911 at exactly 8:19 p.m. on September 29, 2017, and spoke to operator #224.’ It goes in the client record, just in case it becomes relevant in a court case.

But the cops, like mental health providers, are not some pre-cog, future-crimes superstars, able to cull out dangers just by looking at people. And even those police and mental health providers who might be extraordinarily perceptive are often hobbled by the actual law. It’s rare that somebody can be arrested or put into mental health treatment for something they might do. You see, law enforcement works on principles of catching people who have already broken laws, not on the idea that people could or might break laws. I’m not sure changing those principles would be good for any of us—getting locked up or thrown into mandatory treatment based on what our personal profiles suggest we might do.

The ‘mental health system’ and the people working in that system, are there to help people overcome problems across the broad spectrum of all human problems that people can address with some psychoeducation and guidance aimed at improving self-awareness and promoting behavioral changes. The providers in that system rely solely on the communication of the people they are treating (verbal and otherwise) to convey information that might help to understand those problems and find solutions.

It’s rare for 1) a person intending to commit a mass shooting to relay that information to a mental health provider, or 2) for such a person to even be in treatment at the time s/he (okay, it’s essentially always a he) entertaining such thoughts.

On top of all that, it’s ludicrous that the gun-loving citizens of the U.S.A. somehow see the ‘mental health system’ as the solution to this problem, given their penchant for stereotyping mental health providers as a bunch of uptight women and effeminate men, and mental healthcare itself as being for the weak and obviously insane.

But then, the idea is that the people who would commit mass shootings are the type of people who would obviously be identified and locked up by professionals—because, well, that’s just how things work—right?

It’s as if the pro-gun/anti-gun-control forces simultaneously see mental health providers as the prime movers in the ‘wussification of America’, and, at the same time, super-badass profilers, who can somehow identify, and then take out, the trash that preys on innocent Americans who only want to enjoy a movie, or a day at school, or a concert, or a church service, or any other kind of public gathering, without having to fear being shot.

So what is it, all you opponents of gun control? Is ‘the mental health system’ the only thing standing between you and a bunch of violent psychopaths, hell-bent on shooting up all that is American? Or is the mental health system run by a bunch of anti-American, ivory-tower, namby-pamby know-it-alls who want to take your guns away?

You can’t have it both ways.

The real failure isn’t in the mental health system—or in law enforcement–it’s in the foolish idea that arming everyone leads to greater safety by ensuring the ability of everyone to stop everyone else who shouldn’t be allowed access to arms, and a legal system propped up by people that allow such foolishness to continue.

 

 

Thanksgiving Greetings from an Ingrate, 2016: Where’s the Mashed Potatoes?

Posted on by
2

by

J.C. Schildbach, LMHC

Okay…this post has nothing to do with a lack of mashed potatoes.  I just love that line.  It’s become a staple of M and my faux-complaining about, well, really any meal–not just Thanksgiving.  Not that we want mashed potatoes at every meal, but anyway…

A friend recently called me out for not being an ingrate. This via a Facebook post, wherein I was responding to her efforts at working through the 24-days-of-gratitude challenge, or whatever it’s called when you note something you’re thankful for every day throughout November until Thanksgiving. I commented that I had been planning to do the same, although “planning” is perhaps too strong a word…it had occurred to me that I could engage in that challenge, and that I had done it in the past…although, maybe not in November. I might have just chosen 24 or 25 random days, having missed the point entirely…or maybe having expanded the point out in the most glorious of ways by refusing to confine my thankfulness to some specific stretch on a calendar. At any rate, not being an ingrate perhaps takes away from these annual posts, but at least somebody gets the point…that I’m not really an ingrate.

To those who don’t know me, it might be easy to imagine I am such. I enjoy complaining–embrace complaining–as an art form. It’s performance. It’s fun. It’s pure joy, garnering accolades and laughs when in the right company—and disturbed, ‘are-you-okay?’-furrowed-brow looks when in the ‘wrong’ company.

You see, when a big portion of your work is devoted to listening, absorbing, and redirecting the misery of the world, complaining is life-saving, life-affirming, the stuff of thanks.

Or not.

It’s all a matter of perspective. Much of the ‘wrong’ company involves people in my same field, but with a vastly different view of how we need to approach life in order to receive the blessings of thanks, or the thanks of blessings, or whatever life-denying positivity they think will cancel out the darkness of the season…that same darkness our ancestors feared was the impending end of time.

ingrate-thanksgiving

Blurry and off-color…just like misplaced anger!

When I set out to write this annual exercise in ingratitude/gratitude, I tried to think of a good Thanksgiving story from my past.

As I’ve noted in previous ‘ingrate’ posts, I have very few specific childhood memories of Thanksgiving. It was just some day off from school—two days actually–where things were, perhaps, much worse than school…having to put on church clothes only to have a meal that wasn’t particularly interesting.

Perhaps my emotional deficit around Thanksgiving is that it comes between my own balls-out/dress-up/mess-up-the-house-with-monster-decorations/get-candy enthusiasm of Halloween, and the hyper-sentimentality/religious significance/songs/smells/twinkling-lights/PRESENTS!! of Christmas.

How can Thanksgiving compete with that? New Year’s doesn’t fare all that well in comparison, either. Perhaps as a child, I was too close to family, too frequently in contact with them, to realize the value in being able to meet up yet again.  Getting together with family is something that’s become far too infrequent, with siblings spread out across six states, and cousins across at least four more that I know of.

In the absence of the frequent family gathering, I have grown to love, if not the sham history of the holiday, then what the idea of the holiday represents…coming together, helping each other out, recognizing what we have, and why all those elements are potentially so great.

Again this year, my immediate family and I are going out to eat for Thanksgiving–at a favorite restaurant where we’ve enjoyed Thanksgiving dinner before. Again this year, it is a function of our work schedules. That is to say, we could request time off, but, as with every year of the last decade, I work in a 24/7 operation, and M works at a school that caters to doctors (who work in a 24/7 operation). So, we pick and choose which holidays to celebrate more or less enthusiastically.

M was insisting she wanted to make a Thanksgiving meal this year. When the idea was first proposed, I went along with it. Then, at some later time, the kid and I ganged up on her, and pointed out that she had to work the day before, and the day after, Thanksgiving, as do I.  Well, actually, I’m working the day before, the day of, and the day after Thanksgiving, which means a portion of the argument rested on what a pain it would be for me to help do the shopping and cooking and all that, while still attempting to get any sleep–have I mentioned that I work nights?  Coordinating the menu, the purchase of the food, and the preparation of the food, was far more work than we were all ultimately prepared to do, all for just the three of us.

We managed to nail down Christmas plans that would allow more time before and after that holiday to indulge in such excessive amounts of preparation and work, and still get in a fair amount of relaxation, all in the company of family. I’ll hold to my feeling that thanks shouldn’t be a chore, and that holidays should be centered around a desire to celebrate, rather than an obligation to go through the motions of celebration.

I am incredibly thankful, once again, that I have the great fortune to pay to indulge in the hospitality provided by others. And once again, I intend to tip with guilt-laden generosity.

Wherever you are today, I hope you have reason to recognize your situation as one of great fortune as well.

Happy Thanksgiving.

 

What? Me Network?

Posted on by
Reply

by

JC Schildbach, LMHC

A few weeks back, as a favor to a friend, I was invited (compelled?) to speak with a small group of victim advocates—county employees who serve as a kind of official support system for those people directly impacted by a crime. The topic: sex offenders and sex offender treatment.

I agreed to the meeting several months prior, when I was still working directly in the field of sex offender treatment. Having moved away from that field, I hadn’t exactly been immersed in relevant information. As ‘luck’ would have it, though, the Josh Duggar situation provided plenty of focus on issues of law and treatment regarding sex offenses, and an easy access point to discuss much of the involved information.

I had not prepared an actual presentation–the kind with Powerpoint slides, and handouts. Rather, the victim advocates sent me a number of questions via email, and I spent the allotted hour attempting to provide straightforward answers. As with any specialized field, though, nuanced and complex answers are far more the norm.

A quick sampling of some of the (paraphrased) questions and the (overly simplified/incomplete) answers:

Q: What are recidivism rates for adult offenders versus juvenile offenders?

A: Much lower than most people think, in both cases.

Q: Is treatment for offenders a “one size fits all” program, or is it tailored to the specifics of the offender and the offense?

A: There are standardized “assignments” and program requirements, but, as with any form of therapy, it works best when the particulars of the people involved are taken into consideration.

Q: Do you see a lot of commonalities among offenders?

A: As with any ‘diagnosis’ or behavioral category, there are going to be a great many similarities—or those points where behaviors, and justifications for those behaviors, share many similarities—for example…

The lunch hour actually went by pretty quickly. And, despite feeling a bit nervous about providing accurate information without delving into boring details, nobody fell asleep. (Which reminds me, I promised to email some information about various psych tests, which I never did—and I also meant to ask about doing a quick once-over of my friend’s notes to make sure I hadn’t misspoke or inadvertently conveyed any muddled or inaccurate information).

At any rate, the lunchtime meeting was a good refresher about how necessary, and how difficult, it can be to properly ‘network’ within one’s chosen field. It’s quite easy to sit back and complain that people know so little about the specialization you’ve devoted a great deal of your working life to, without doing anything to address that lack of knowledge.

Happy face mad

Of course, it can be extremely difficult breaking through all the noise and confusion to relay one’s own specialized understanding of specific issues, or to have the patience to let the specialized knowledge of others in.

After all, we can all get bogged down in our day-to-day life. And going to trainings or other networking opportunities can feel like just another professional obligation—more about checking a box on a form, than about gaining knowledge and understanding that can truly help in one’s ability to help others—not to mention, the opportunity to meet and connect with other people who are potentially valuable allies and resources.

Still, I suppose we all have our fair share of networking disaster stories.

Take, for example, the time that I went to a breakfast fundraising event for the King County Sexual Assault Resource Center as a special guest of the Seattle Archdiocese (damn, that sounds important, doesn’t it? But, truth be told, I was actually the ‘plus one’ to my boss’ invitation as a special guest of the Seattle Archdiocese). Anyway, after the program of speakers, ranging from local media luminaries, to elected officials, to experts in the field of sexual assault treatment, to the families of sexual assault victims, as the time arrived for everyone to mingle and/or make a quick getaway to avoid mingling, I managed to upend a glass of water, which drained directly into the chair where I was sitting. Mingling in wet pants—not really a comfortable experience, or a good way to convey anything you want other professionals to remember about you.

Beyond various faux pas, I think many professionals go to trainings and seminars with those colleagues we already know—potentially insulating and isolating ourselves from other attendees. Whatever your impressions of people in the mental health field, plenty of us are actually introverts who find crowds and forced socialization to be extremely draining. For some, the same skills that make us effective in a one-on-one or group session, or even a phone-based intervention—such as being able to focus not only on a person’s words, but the whole of what people are communicating non-verbally—can make it very difficult to just mingle in a large crowd.

There is also the potential for fumbling when you’re on the ‘turf’ of some other specialization. I mean, imagine how potentially uncomfortable it can be when you work in the field of sex offender treatment, and are attending a conference for providers who treat the victims of such offenders. Ultimately, the goals are the same—to reduce the impact of such trauma, and combat the underlying causes of such offenses—but you’re definitely working different sides of the same street.

There are also several forms of specialization that can reach into most other areas of treatment—substance abuse, personality disorders, suicidality, and on and on. No practitioner has the ability to become truly well-versed in every possible situation they encounter. Ideally, though, they will learn enough to recognize when they need to refer out, and how to recognize the signs of those areas with which they aren’t particularly familiar.

I suppose this is all weighing on me a bit heavily, as I have my licensure renewal coming up, and need to make sure I have all of my trainings in order. I’ve done plenty of trainings, and perhaps a whole lot more personal study, over the past few years, but not all of that counts for official training credits.

On top of just staying abreast of one’s own field, and finding trainings of interest that fit one’s schedule and budget, the state instituted a requirement that all counselors have to have training in how to deal with suicidal clients at regular intervals. I’m trying to approach this positively. I get the reason for its necessity (although the real reason for the change in requirements had to do with previous problems in the state’s credentialing process that allowed people with little-to-no education in mental health to call themselves “counselors”—which led to multiple tragedies and other less-than-ideal outcomes).

Still, having worked in suicide prevention for years makes the requirement a bit redundant for me. I know and respect many of the people conducting the trainings, and certainly learn from them each time I have occasion to encounter them. But as a general topic area, I could be brushing up on or exploring other areas where I haven’t already spent years of professional focus, particularly given that the trainings are aimed at practitioners who aren’t particularly sturdy in their suicide prevention/intervention skills.

Mental Health practitioners are also required to take regular ethics trainings—I suppose for those therapists who can’t remember not to force their own views on people, not to run around blabbing about their clients, and not to sleep with their clients.

That said, I will look to make the most of my remaining trainings, try to be pleasant and sociable, and pay attention so that I might actually gain some new insight. And I vow not to be one of those terrible bores who offers up one’s own experiences during question-and-answer periods, just to show how knowledgeable one is, rather than actually seeking information from the experts providing it.

And perhaps I should just schedule one of those suicide prevention trainings ASAP—or maybe after I cast about a bit to see if any of my friends in the field have been blowing off that training too, and want to go along.