Mental Health Day

Honolulu - Capitol Building, DebiPeople talk about taking a mental health day when what they really mean is, I’m fucking stressed out and I just need a day off. People with mental health issues, diagnosed or not, do not have this luxury. Every day is a mental health day spent trying to navigate this world the best they can with what they have, which is not much for most of them.

It’s easy for the general public to say, Oh, another school shooting…the shooter must be psychotic. And they’ll say this without a true understanding of what psychotic means or looks like. It’s easy to link school and other mass shootings to mental instability. Everyone is shouting for better gun control this week to keep guns out of the hands of psychotics. I understand why. There have been seventy-four school shootings since the Newtown, CT school shooting in 2012.

Poor gun control is to blame for “psychotics” shooting masses in public and in schools. Only in America. Because gun control here sucks.

So does mental health services and access to it. In America. AND NO ONE WANTS TO TALK ABOUT IT. Because maybe if we don’t talk about the pink elephant it will disappear. Forget that there is a revolving door with people going in and out of hospitals never quite getting the help they need because once they are stable (read: no longer an immediate threat to themselves or others) they are released with no follow-up, no access to follow-up services, or refuse to follow-up because they don’t think they need more services to keep them stable. Two months later, they’re back in the revolving door.

I saw this play out all too often with clients and/or their family members. I can’t tell you how many kids lost services they desperately needed because of insurance or inability to pay out-of-pocket. In the rural areas of Kentucky, services are limited because that’s what happens in rural areas. It also happens to be the poorer areas where people don’t have their own transportation and there is no public transportation to get them to their local community mental health center (CMHC).

Then there are cases like my cousin who lost insurance when he changed jobs. He loved his new job because it was less stressful, but it also didn’t provide him with the insurance he needed to keep his medication and mental health services. He went on a downward spiral because without the meds he lost a lot of rational thought. I tried to help him and point him in the direction he needed to go to access services without insurance, but he was too far gone. His was a slow decompensation that ended in him hanging himself.

While I’m on the subject of insurance. How about how private insurance will only allow a set amount of sessions per year? This is not enough for people with severe and chronic issues. Did you know that getting out-of-home-intensive services is nearly impossible with private insurance. Same with intensive-in-home services. Medicaid will only pay for services that are deemed medically necessary and only on a Wednesday if you jump through hoops set on fire with a clown and a toy dog with a pink tutu. I think they’re all pretty much medically necessary, but each level of service has a different set of parameters to determine medical necessity like the previously mentioned no longer being an immediate threat to self or others for a psychiatric hospital. Then there is the appalling lack of services for our veterans. Men and women who return from war zones with severe post-traumatic stress disorder (PTSD) and have no services to help them manage life with it.

So where are the services for everyone who needs them? Why are they denied access? What are we going to do about it? Because if you want to blame mass shootings on “psychotics” with guns, then we need to address the sorry state of mental health services and accessibility in America along with gun control.

For some perspective: out of the hundreds of former clients, youth and adult, I can count on one hand how many of them were involved in some kind of gun violence after I worked with them and still have fingers left.


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