Friday, December 28, 2012

More Armed Guards At Pharmacies

In the aftermath of Newtown, Connecticut and the massacre of twenty first graders, the debate has shifted from the obvious (guns and gun control) to the nutty (blame video games), to the not so obvious (mental illness).

The desire to chalk up the actions of a "mad man" to mental illness is, of course, the default setting for most people. "How could a sane person do such a thing?" is an obvious but incorrect question. Having studied mass shootings for years now, I can assure you the last thing these people are is mentally ill.

Mass shootings, spree killings, and serial murders all possess a sense of mental acumen that indicates high intelligence and thoughtful planning. A "crazy" person would not possess the wherewithal to methodically carry out a mass shooting like Newtown, Virginia Tech, or Columbine.

Which is why this guy's call to start diagnosing mental illness in children earlier and earlier is a frightening premise. He asks "we diagnose serious medical conditions" with rapid accuracy and utilization of all available resources. Why not apply the same thing to children's "mental conditions" as well?

We must change our thinking and our approach to ensuring mental health for children. I propose beginning with the following steps: 

1. Accept that mental health is a children’s health issue. One in five children in the United States suffers a medical condition that affects their mental health. These encompass a wide range of diagnoses, including depression, anxiety, eating disorders and developmental disorders. Of the 15 million children affected by such conditions, only 20 percent ever receive treatment. This is especially sobering when we consider that by age 14, half of all lifetime diagnoses of mental illness will begin manifesting, and that 75 percent will show up by age 24.
Not to be terribly un-academic, but so? That's like saying "most sexually transmitted diseases will begin manifesting when sexual activity begins." Of course most adult mental illness presents in the 20's. But that has nothing to do with children.

As to his other assertion "one in five children" already being mentally ill, isn't it odd that 20 years ago, the percentage was less than 5%? Does not the growth of the biomedical view of madness (and the corresponding influence of Big Pharma) play into the equation?
2. Start screening early. As with obesity and diabetes, pediatricians know that, by detecting disease in childhood and intervening early, we can have a tremendous effect on the health of that person in adulthood. By contrast, there is an average delay of eight to 10 years between the onset of symptoms and treatment for children with mental health issues. This is driven in part by a lack of focus on early identification. For the one in five children who has a mental health condition, such early recognition could be lifesaving.  
Or it could permanently label them "mentally ill" and create a self-fulfilling prophecy of drug dependency, academic and social segregation, and ultimate aloneness. Unlike pediatric diabetes (which is measurable) there are no simple measures of childhood mental illness. One person's "Oppositional Defiance Disorder" could be another person's "go F yourself" syndrome.
4. Address genetics. As with several forms of cancer or metabolic diseases, many mental health conditions have a significant genetic predisposition. Technological breakthroughs the past few years — in molecular evaluation, genetic sequencing and variation, biomarkers and advanced imaging — have helped us understand, identify and intervene in many medical issues before they manifest symptoms.
Incorrect. While most of these "breakthroughs" are correlational, none have been proven to be causational. And even if they could be proven so, what then? Genetic engineering? Quarantining? Sterilization?
Now is the time for leadership. As we form task forces, forums and expert panels to respond to the shootings in Newtown, Conn., a discussion must take place about how we ensure the mental health and well-being of our children. If it does not, we will have failed both the children who perished Dec. 14 and those we are fortunate enough to still have in our care.
I'll agree that we certainly need to help the children and adults traumatized by those shootings with proper psychological counseling over the coming months and years. I do not, however, think that mass diagnoses of questionable childhood mental illness is going to prevent another Newtown from occurring.

In fact, it's probably the opposite: as mental illness diagnoses and the requisite prescription drugging of children has skyrocketed over the past 20 years, school shootings have increased proportionately.

Beyond the media's obsession with guns, Lanza's Asperger's diagnosis, his love of video games, and his social awkwardness, has anyone investigated the role of psychotropic meds in his history? Was Lanza on psychotropics, and if so, how long had he been on them? While this study suffers from the same correlation does not equal causation rap too, I think it's very important to recognize that 90% of school shooters in the last 20 years have been on high-powered psychotropic medications.

The point being: increasing the vast net of mental illness diagnoses among children, and putting them under the social control of Big Pharma, is not going to stop another Newtown from occurring. It may actually be increasing the chance that we have more and more of them. 

The NRA laughably said the answer to prevent another Newtown was more armed guards at school. I'm thinking we need more armed guards at pharmacies to keep the psychiatric-industrial complex at bay.

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