Thursday, May 19, 2022

America's Mental Health Crisis

Happily, those who have been following this blog have stayed ahead of the curve, as the old saying goes. As might be imagined, I have pointed out, yet again, that in the case of a crazed Buffalo shooter, the mental health profession has seriously failed. After all, young Payton Gendron was reported to the psychiatric authorities. He was evaluated by credentialed professionals. He was let loose to wreak havoc.

And his is not the first case of a mass murderer been cleared by the mental health profession, or better, having been ignored. For quite some time now I have been saying that involuntary commitment is a good way to deal with such people, but apparently such is not feasible.

And, dare I mention, public debate does not make relevant distinctions between psychopaths and psychotics, between narcissists and manic-depressives, between neurotics and addicts and so on. Some of these conditions are more obviously brain illnesses. Some are metabolic disturbances. Some are psychological disorders. Lumping them all together serves no useful purpose. It certainly does not facilitate treatment.

Anyway, the failure of the therapy profession, along with the failures of the psychiatric profession, should be clear enough by now. Thanks to the Covid lockdown policies instituted by one Anthony Fauci and a gaggle of public health officials, America’s children and young adults have been suffering a serious decline in mental health. About that, we keep hearing for more calls for treatment and better access to treatment. 

This is nice enough. And yet, more important is the fact that the quality of treatment available is seriously deficient, and that the profession, by its public presentation seems to push people away, not to invite them in.

In any event, Daniel Henninger exposes some other aspects of America’s mental health crisis this morning in the Wall Street Journal. (via Maggie's Farm)

It is becoming impossible to ignore it:

They are everywhere—on the streets, in our homes, our schools and prisons. Emerging from the Covid-19 pandemic, America is overflowing with people suffering from a broad range of mental disturbance. Mental illness is the U.S.’s next pandemic.

At one extreme, Buffalo mass-murder suspect Payton Gendron is another case study in how the U.S. looks past this problem. As with Nikolas Cruz, the Parkland, Fla., mass murderer, it is being widely reported that Gendron was admitted to a hospital last year for mental evaluation, that “signals were missed,” etc. At Virginia Tech 15 years ago, “signals were missed” for a disturbed 23-year-old shooter who killed 32 people.

And then, Henninger lights on a crucial point. Mental health professionals, nearly all of them, from Jordan Peterson to the least social worker, are obsessed with the question of motive. They want to know why this is happening. They assume that if they understand motive they will be able to provide illuminating insight that will resolve the mental problem and send the newly cured off to lead a productive life.

Dare we say that this feels more like a delusional belief than a constructive suggestion. The problem, Henninger correctly notes, is knowing what to do. And knowing what to do is quite different when dealing with a psychopath and a psychotic:

Signals aren’t missed. They are ignored, because there is no pragmatic understanding of what to do with the signals of mental illness. Instead, we divert into a largely irrelevant search for “motive.”

So, we have produced a pandemic of mental illness. And crisis centers and counselors are overwhelmed. You have to wonder whether they are offering effective treatment, or whether they are overwhelmed because they are the only game in town.

This column’s subject is not the psychotic young males whose outlet is killing. It is the emerging post-Covid reality that a slowly building crisis of poorly treated mental illness, anxiety, depression and suicide is cresting just as the pandemic ends. Suicide, already the second leading cause of death among people 15 to 34 before the pandemic, has increased.

In October, the American Academy of Pediatrics and others warned of “soaring rates of mental health challenges” among the young, and a similar warning followed from the U.S. surgeon general. Ask whoever is sitting next to you for anecdotal evidence. It’s omnipresent. Virtually any mental-health practitioner, especially at universities, admits to being overwhelmed with patients.

As the mentally ill homeless occupy major metropolitan areas, we should know that some are psychotic, some are addicts, some are sociopaths. 

Henninger remarks that it’s a policy failure, one that dates to decades ago, when optimism about the effectiveness of new treatments for psychosis produced a movement to empty the psychiatric hospitals:

The mentally ill homeless are piling up on the streets of San Francisco, Los Angeles, New York, Austin and on and on. New York City Mayor Eric Adams has been dismantling homeless tent camps, but he’s shoveling sand into the ocean. They have nowhere to go.

Absent medical treatment, some of the most severely ill self-medicate on the street with alcohol or drugs, turn violent and typically end up in holding pens like New York’s Rikers Island jail complex or Chicago’s Cook County jail.

With the societywide surge of mental disorder during the pandemic, the U.S. has arrived at a moment of reckoning for a policy failure that has run like an open hydrant since the deinstitutionalization movement of the 1970s emptied the mental hospitals. The solution was supposed to be outpatient “community care.” It never happened.

And then there is one other point, reported here last month, from the pen of the highly estimable Heather Mac Donald. She seems to be alone in having pointed out that the mental health profession has become something of a pink ghetto. Most practitioners are now female and their approach, naturally enough, is to mother people. Get in touch with your feelings, feel your feelings, develop your capacity for empathy-- these bywords of the mental health profession are alien to most young men, certainly, to most of those who are most likely to commit murder and mayhem. 

Young males are extremely unlikely to work with a professional who seems to want to make them into females. They are more likely to become more defiantly toxic. Thus, the party line in the therapy world is discouraging men from seeking any kind of treatment. 

Mac Donald was among the first to tally up the gender disparity. I have quoted it before. Here are some salient quotes again:

Nationally, about two-thirds of the students who sought treatment for mental-health disorders in the 2018–19 academic year were female, according to the Center for Collegiate Mental Health. At Yale, therapy use is heavily female and LGBTQ, according to students. “There are few straight men using therapy,” one self-identified “queer” girl in the GLC said. “It’s stigmatized for straight CIS men. Almost all my friends who go to therapy identify as gay or trans.”

The counselors and therapists from whom these anxious students seek treatment are themselves overwhelmingly female. 

Harvard’s Counseling and Mental Health Services department is nearly three-to-one female to male in its staffing. Fifteen percent of the 33 members of Williams College’s Student Health and Wellness are male. The psychology profession is dominated by females. In the 2016–17 academic year, females received 78 percent of all bachelor’s degrees in psychology; Ph.D.s were similarly lopsided. At Yale, psychology does not even show up among the top-ten most popular majors for male undergraduates; for females, it is the fourth most popular degree.

Clearly, the face of the psycho profession has changed. You might consider it a change for the better. You might consider it a change for the worse. At the least, it has become more flagrantly feminine, and this has put off males, both from practicing therapy and also from consulting with therapists.

Way to go, USA!

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