After Newtown shootings, calls for more focus on mental healthExperts in North Dakota, Minnesota say stigma of mental health and shortage of psychiatrists hamper adequate response.
In the week since Newtown, Conn., became the latest scene of a mass shooting involving a disturbed young man, the national conversation has turned to the question of how the treatment of mental illness could prevent another such incident.
For Dr. Ellen Feldman, chairwoman of the psychiatry department at Altru Health System in Grand Forks, the response to Newtown should include reducing the stigma of mental illness, improving attention for its sufferers and identifying the chances of someone harming themselves or others.
“It was just such a horrible thing, such a tragic thing,” she said. “You have to take a multi-disciplinary approach.”
One way to remove the stigma is to emphasize that mental illnesses aren’t something their sufferers can help, according to Dan D’Allaird, a clinical psychologist who works with children at the Duluth Psychological Clinic. “Understanding the biological basis of a lot of mental health problems takes those problems out of the realm of character and into the realm of illness.”
“If there’s one thing people can do right now… it’s to not treat it any different than if people have an appendectomy,” Feldman said.
Mental health professionals also point out that mental illnesses do not often result in violence.
“What we know, hands down, is the vast majority of people who have mental illness are not violent and never will be violent,” said Dr. Jon Ulven, a psychologist at Sanford Health in Fargo.
Attempts to profile people to see if they’re prone to violence simply don’t work, Ulven said. “The problem is you can take characteristics of people you think will commit violent acts,” he said. “You can look for some of these, but you’ll find thousands of other people share these same common factors and they will never be violent.”
“I don’t know if it’s possible to identify every person that’s a potential threat out there,” said Dave Lee, director of public health and human services in Carlton County, Minn. “I think what we can do is develop our services to be more responsive to people so it’s easier to reach out.”
The problem, some mental health professionals say, is such services are not always immediately accessible.
When Fargo resident Christine Heinze took her 4-year-old son Connor to a pediatrician, she was told he likely had a mental or behavioral illness.
“I was a new mom, so I didn’t know other children his age. I thought he was normal,” she said.
Professionals diagnosed Connor with about 16 illnesses, including Asperger’s syndrome and attention deficiency hyperactivity disorder, and formed treatment plans for him, Heinze said.
Parents must get involved if a mental illness is suspected, but it can be tough to admit there’s a problem, she said. “There are a lot of parents who deny their kids have issues.”
Parents have never had more resources to turn to than they do now, said Andrew Larson, department chairman of integrated behavioral health services at Sanford Health in Fargo.
Sanford, for example, recently made accessing mental health care easier.
In the past, a parent could ask a pediatrician about a child’s mental or behavior issues. The pediatrician could refer the child to a specialist, but it would be up to the parent to make an appointment.
This could take weeks or months, and, more often than not, the follow-up appointment would not be made or kept, said Sanford spokesman Darren Huber.
Today, a primary doctor could immediately refer a patient to in-house mental health professionals.
“Doctors will literally send the patient across the hall and (patients) are seen then and there,” Huber said.
Access to care
Ed Eide, executive director of the Minnesota Mental Health Association calls the approach excellent, and a big step toward improving access.
“I think that because there is such a shortage of mental health practitioners, especially outside the metropolitan facilities, anything that works that gets more access to mental health professionals is a good thing,” he said.
Alex Schweitzer, who oversees the Human Service Centers in North Dakota, said he feels North Dakota’s system has been adequate so far, but as the state continues to grow, more people may need mental health services.
Eide doesn’t think today’s services are adequate, at least in Minnesota and on the national level.
“There is a shortage of psychiatric services for both children and adults,” Eide said. “There are even fewer beds for children than there are for adults.”
According to the American Psychiatric Association, there are about 50,000 practicing psychiatrists in the U.S. and about half of them are over the age of 55 and will soon retire.
In the Duluth region, the Amberwing Center for Youth and Family Well-being, a new intensive mental-health treatment center for those 25 and younger, is aiming to shorten the wait for young people needing help. But it, too, is challenged by a shortage of mental health professionals.
The center is a “partial hospital” program, meaning clients aren’t kept overnight, but they do get much more intensive therapy over daily seven-hour visits than they would in traditional outpatient treatment, said clinical supervisor Rick Gertsema.
Though Amberwing has room to treat up to 60 clients, it’s currently staffed for 32, he said, and it already has a waiting list of 20 for its program for teens.
“We just don’t have enough testing psychologists or psychiatrists in the region,” said Allaird at the Duluth Psychological Clinic.
After news broke linking Adam Lanza, the Newtown, Conn., shooter to mental illness, Heinze said she worried about what people would assume about her son.
Despite his illnesses, Connor has never been a violent person, she said.
In 2010, Heinze worked with North Dakota legislators to pass an anti-bullying law after Connor was bullied in middle school.
The boy is doing well, but Heinze said she worries about his future and whether he’ll be able to receive the adult mental health services he’ll need.
Forum Communications staff writers Christopher Bjorke in Grand Forks, Wendy Reuer in Fargo and John Lundy in Duluth contributed to this report.