>> WE HAVE HEARD QUITE
OFTEN SINCE AURORA, SINCE
NEWTOWN, THAT GUN VIOLENCE
IS INTIMATELY CONNECTED TO
MENTAL HEALTH.
INTUITIVELY, THAT MAKES SOME
SENSE, BUT WHAT DO WE KNOW
ABOUT THE PEOPLE WHO COMMIT
GUN VIOLENCE?
JOINING US ARE UNIVERSITY OF
NEW MEXICO PSYCHOLOGY
PROFESSOR EMERITUS LYNETTE
COFER.
SHE STUDIED THE MEDIA AND
HOW CHILDREN PROCESS WHAT
THEY SEE ON TELEVISION.
AND FROM THE UNM DEPARTMENT
OF PSYCHIATRY, STEVEN
ADELSHEIM, WHO RUNS THE
CENTER FOR RURAL AND
COMMUNITY BEHAVIORAL HEALTH.
AND DAVID GRAEBER, ALSO WITH
THE UNM DEPARTMENT OF
PSYCHIATRY.
LIKE STEVEN, HE ACTIVELY
SEES PATIENTS AND IS THE
DIVISION DIRECTOR OF CHILD
AND ADOLESCENT PSYCHIATRY AT
THE UNM HEALTH SCIENCES
CENTER.
NOW, DAVID, I'D LIKE TO
BEGIN WITH YOU.
WE'VE SEEN TRAGEDY AFTER
TRAGEDY, AND STUDY AFTER
STUDY ABOUT MENTAL HEALTH
AND GUNS.
STILL THE NATIONAL DIALOGUE
ISN'T A CONSENSUS.
SO, WHY IS THAT?
WHY CAN WE NEVER GET TO A
CONSENSUS ON THIS?
BECAUSE THIS HAS BEEN A
FIELD OF STUDY FOR TWO OR
THREE DECADES AT THIS POINT.
WHAT'S GOING ON HERE?
>> WELL, I THINK IN TERMS
OF GUN VIOLENCE AND THE
MENTALLY ILL, I WILL FIRST
SAY THAT ONE OF THE
DISTRESSING THINGS ABOUT THE
RECENT MEDIA COVERAGE IS
THIS IDEA THAT GUN VIOLENCE
IS PERPETRATED BY CRIMINALS
AND PATIENTS, INDIVIDUALS
WITH MENTAL ILLNESS, AND I
THINK THAT DOES NOTHING BUT
INCREASES THE STIGMA, WHICH
IS EXACTLY THE WRONG
DIRECTION THAT WE NEED TO BE
MOVING IN TERMS OF PEOPLE
GETTING ADEQUATE TREATMENT
AND HAVING ACCESS TO CARE.
>> LET ME ASK YOU THIS.
WHERE DOES THAT STIGMA --
WHAT IS THAT STIGMA ABOUT?
WHAT IS THAT BASE OF FEAR
THAT THAT STIGMA COMES FROM?
>> WELL, I BELIEVE IN THIS
CASE, IT'S A PORTRAYAL OF
MENTALLY ILL PATIENTS AS
BEING, IN PARTICULAR,
DANGEROUS AND MORE LIKELY TO
COMMIT VIOLENCE WITH GUNS
THAN CITIZENS WITHOUT MENTAL
ILLNESS.
25% OF THE ADULTS IN THE
UNITED STATES HAVE A MENTAL
ILLNESS OF SOME KIND, AND
THAT'S A LARGE NUMBER OF
PEOPLE.
22% OF ADOLESCENTS IN THE
UNITED STATES HAVE A
DIAGNOSABLE MENTAL ILLNESS
WITH SIGNIFICANT DISTRESS OR
IMPAIRMENT.
SO THIS IS A VERY LARGE
SEGMENT OF OUR POPULATION
THAT SUFFERS FROM MENTAL
HEALTH ISSUES THAT MANY
WOULD BENEFIT FROM
TREATMENT.
AND I THINK THAT PORTRAYING
THEM AS POTENTIAL
PERPETRATORS OF VIOLENCE
DOES A GREAT DISSERVICE.
AND, IN FACT, THERE ARE MANY
STUDIES THAT SUGGEST THAT
HAVING A MENTAL ILLNESS IS
MUCH MORE LIKELY TO PLACE
YOU IN A ROLE OF
VICTIMIZATION OF VIOLENCE.
>> WHY WOULD THAT BE?
>> BECAUSE PEOPLE AT TIMES
WHO HAVE MENTAL ILLNESS, AND
ESPECIALLY SEVERE MENTAL
ILLNESS, MAY HAVE DIFFICULTY
IN ASCERTAINING THE CONTEXT
OF VARIOUS INTERPERSONAL
RELATIONS, MAY NOT READ
SOCIAL CUES AS WELL, MAY
ACTUALLY PUT THEMSELVES IN
MORE DANGEROUS POSITIONS
WITH OTHERS.
THEY'RE ALSO SEEN AT TIMES
AS RELATIVELY EASY TARGETS.
>> THAT MAKES SENSE.
STEVEN, I'D LIKE YOU TO ADD
TO THAT, BUT THEN ALSO, IN
YOUR RESEARCH, AS WELL, THIS
IS A HIGHLY NUANCED
SITUATION, CERTAINLY, BUT
FOR FOLKS WHO HAVE MENTAL
ILLNESS AND THE IDEA IN THE
PUBLIC THAT ONE CAN READ A
PROBLEM COMING, IF SOMEHOW
WE JUST MAGICALLY SIT DOWN
WITH THESE FOLKS, OR WITH
SOME KIND OF QUESTIONNAIRE
WE CAN PIN THIS PERSON AS A
POTENTIAL VIOLENT
PERPETRATOR, IS THAT PART OF
THE STIGMA HERE?
HOW DOES THE PUBLIC GET
STUCK ON SOMETHING LIKE
THIS?
>> WELL, IN TERMS OF
FOLLOWING UP ON DAVID'S
POINT, I DO THINK IT'S
IMPORTANT TO REALLY
ACKNOWLEDGE THE FACT THAT
PEOPLE WITH MENTAL ILLNESS
HAVE A MUCH HIGHER RISK OF
BEING VICTIMS OF VIOLENCE,
AS HE SAID.
I THINK IT'S A CRITICAL
POINT TO MAKE.
AND I THINK, ALSO, WHEN WE
LOOK AT THE ISSUE OF GUN
RELATED DEATHS, IN NEW
MEXICO, FOR EXAMPLE,
TWO-THIRDS OF THE GUN
RELATED DEATHS ARE SUICIDES,
AND IN MANY CASES THOSE ARE
PEOPLE WHO MAYBE HAVE A
MENTAL HEALTH CONDITION THAT
MAY BE TREATED OR UNTREATED
AND THAT ARE HAVING A MOMENT
OF CRISIS.
AND SO GUNS CAN REALLY BE AN
ISSUE, TO A GREAT DEGREE, IN
TERMS OF RISKS FOR PEOPLE
FOR VIOLENCE TO SELF, AND
IT'S SOMETHING THAT WE
REALLY NEED TO BE THINKING
ABOUT AS A STATEMENT OF THE
COUNTRY, AS WELL.
I THINK IN TERMS OF YOUR
QUESTION ABOUT SORT OF THE
LOOKING AT THE ONE POINT, AS
WE ALL KNOW, NOT ONLY ARE
MENTAL HEALTH CONDITIONS
MULTI-FACTORIAL, BUT SO IS
VIOLENCE.
AND I THINK WHEN WE LOOK AT
PEOPLE OFTEN WHO ARE
INVOLVED IN VIOLENCE, YOU
KNOW, A NUMBER OF STUDIES
TALK ABOUT THE EFFECTS OF
TRAUMA.
PEOPLE WHO ARE ABUSED MIGHT
HAVE MORE RISK OF BECOMING
ABUSERS THEMSELVES AT LATER
TIMES DURING LIFE AS A
RESPONSE TO THAT, ESPECIALLY
WITHOUT TREATMENT AND
SUPPORT.
I THINK THERE'S ALSO OFTEN
BIOLOGICAL ASPECTS.
HEAD INJURIES MAKE PEOPLE
POTENTIALLY MORE LIKELY TO
MAYBE HAVE A VIOLENT
EPISODE, AS WELL.
BUT I THINK ONE OF THE
THINGS THAT'S IMPORTANT FOR
US TO UNDERSTAND, FOR MENTAL
ILLNESS IN GENERAL, HALF OF
ALL MENTAL HEALTH ISSUES
START BY THE AGE OF 14.
THREE-QUARTERS BY THE AGE OF
24.
AND WHAT BECOMES VERY
IMPORTANT, I THINK, FOR ME
AND FOR MANY OF THE PEOPLE
I'M WORKING WITH IS HOW WE
IDENTIFY YOUNG PEOPLE EARLY
THAT MIGHT HAVE MENTAL
HEALTH CONDITIONS, AND TO BE
ABLE TO LINK THEM
EFFECTIVELY TO THE SUPPORTS
THAT THEY NEED.
AND RIGHT NOW, WE DON'T HAVE
SYSTEMS IN PLACE TO DO THAT,
BOTH WITHIN OUR STATE, BUT
FRANKLY, IN THE UNITED
STATES AS A WHOLE.
ONE CAN LOOK AT MODELS IN
AUSTRALIA, NEW ZEALAND, ALL
OVER EUROPE WHERE THERE
REALLY HAS BEEN A MUCH MORE
CONCERTED EFFORT TO BUILD
EARLY INTERVENTION MODELS,
TO TARGET ON ADOLESCENTS AND
YOUNG ADULTS, TO BUILD
COMFORTABLE PLACES FOR THEM
TO ACCESS SERVICES, TO COME
TALK TO EACH OTHER, TO GET
PEER SUPPORT.
AND I THINK THE STIGMA ISSUE
BECOMES HUGE BECAUSE I
THINK, GENE, IF SOMEONE SAID
TO YOU, WELL, WHO IN YOUR
FAMILY HAS A MENTAL ILLNESS,
IT'S NOT A QUESTION I'M
ALLOWED TO ASK YOU, AND IT'S
NOT ONE THAT YOU MIGHT FEEL
COMFORTABLE ANSWERING.
AND I THINK FOR ALL OF US,
WE ALL HAVE FAMILIES WITH
SERIOUS MENTAL ILLNESS
ACROSS ALL OF OUR
GENERATIONS.
THE STIGMA BEGINS WITH US
NOT FEELING COMFORTABLE
TALKING ABOUT IT.
>> INTERESTING.
THAT'S WELL STATED.
I LIKE THE WAY YOU PUT THAT,
ACTUALLY.
LYNETTE, SINCE WE'RE TALKING
ABOUT KIDS NOW, ANY IDEA
THAT SOMEHOW -- AGAIN, IN
THE PUBLIC'S MIND, WE HAVE
BEEN ABLE TO TELL OURSELVES
THAT IT'S ALL THESE EXTERNAL
FACTORS, MEDIA, GAMING,
OTHER THINGS THAT ARE
INFORMING KIDS THAT MIGHT BE
SUFFERING WITH A PSYCHOSIS
OR MENTAL ILLNESS THAT
HASTENS OR WORSENS THE
PROBLEM.
IS THAT, IN FACT, WHAT YOUR
RESEARCH HAS SHOWN, OR ARE
THESE OTHER FACTORS JUST NOT
AS BIG AS WE THINK THEY
MIGHT BE?
>> WELL, MY RESEARCH WAS
FOCUSED ON NORMAL KIDS,
LITTLE KIDS AND PRESCHOOL
CHILDREN, YOUNG CHILDREN.
BUT THEN WE REVIEWED
HUNDREDS OF STUDIES.
WE WROTE REVIEWS ON HUNDREDS
OF STUDIES OF OLDER KIDS,
AND SO ON AND SO FORTH.
SPECIAL GROUPS, NOT SPECIAL
GROUPS.
BUT THE CONSISTENT FINDING
IS, IT'S NOT A SILVER
BULLET.
AND I SAID EARLIER, IT'S NOT
UNLIKE THE CONTROVERSY OVER
CIGARETTE SMOKING.
THE INDUSTRY ALWAYS SAID,
YOU HAVEN'T PROVED IT, YOU
HAVEN'T PROVED IT, IT'S ONE
WAY.
IT'S A ONE-WAY CAUSAL
CONNECTION.
DOES TELEVISION VIOLENCE OR
GAME VIOLENCE CAUSE KIDS TO
BECOME VIOLENT?
YOU CAN'T ANSWER ANYTHING
LIKE THAT.
PEOPLE ARE COMPLEX AND
FUZZY.
SO WHAT YOU CAN SAY IS,
OKAY, WHAT WE'VE FOUND, IF
YOU LOOK AT THE
PREPONDERANCE OF THE
EVIDENCE ACROSS THE BOARD,
LAB STUDIES, CORRELATIONAL
STUDIES, FIELD STUDIES AND
SO FORTH, THEY ALL KIND OF
GO IN THE SAME DIRECTION,
AND METANALYSIS SUPPORT
THAT.
IS THERE AN EFFECT?
YES, BUT WHO IT IS.
OKAY, IN OUR STUDIES, NORMAL
NURSERY SCHOOL KIDS,
WONDERFUL NURSERY SCHOOL
PROGRAM, JUST THREE PROGRAMS
A WEEK IN THE COURSE OF A
FINE NURSERY SCHOOL DAY FOR
A MONTH, THE BOYS WHO WERE
MORE AGGRESSIVE IN THE
BASELINE PERIOD RESPONDED
WITH SIGNIFICANT INCREASES
IN AGGRESSION.
JUST NORMAL NURSERY SCHOOL
STUFF.
WELL, DOES THAT MEAN THAT'S
NOT IMPORTANT?
WHEN YOU LOOK AT WHAT THE
FINDINGS ARE, GUESS WHAT,
THOSE KIDS ACROSS THE LIFE
SPAN SEEK OUT MORE
AGGRESSIVE TELEVISION AND
RESPOND MORE TO IT.
DOES THAT MAKE IT LESS OF A
SOCIAL PROBLEM?
I WOULD ARGUE, NO, NO, NO.
WE NEED VERY MUCH TO OFFER
KIDS GOOD ALTERNATIVES AND
ACTIVITIES, AND THE KINDS OF
THINGS THAT BRING THEM INTO
COMMUNICATION WITH PEOPLE.
I WILL SAY QUICKLY, THE
OTHER RESULT THAT ISN'T
DISCUSSED AS MUCH IS THAT
CHILDREN, NO MATTER WHAT
THEIR BASELINE AGGRESSION
SCORES WERE, WHO WERE IN
THIS VIOLENT TELEVISION OF
BATMAN AND SUPERMAN CARTOONS
OF THE '70S, WHICH ALL THE
PARENTS SAID, SURE, YOU CAN
SHOW THEM THAT, OKAY, THEY
SHOWED SIGNIFICANT DECREASES
IN MEASURES OF SELF-CONTROL.
LIKE, HOW TOLERANT ARE YOU
IF YOUR JUICE IS LATE AT THE
TABLE?
OR, WHAT HAPPENS IF SOMEBODY
STEPS ON YOUR FOOT?
OR, HOW LONG DO YOU CONTINUE
WITH AN ART PROJECT?
WHEREAS THE CHILDREN THAT
SAW MR.
ROGERS NEIGHBORHOOD
PROGRAM -- THIS WAS
EXCITING, BECAUSE NOBODY HAD
SHOWN THIS BEFORE -- SHOWED
INCREASES IN LOTS OF
SELF-CONTROLLING KINDS OF
BEHAVIORS AND INCREASES IN
COMMUNICATION.
SO THAT'S WHAT WE WENT ON TO
BUILD ON, NOT CONTINUING TO
LOOK AT THE AGGRESSION
STUFF.
>> SURE.
>> BUT YOU THINK, WHAT ARE
WE DOING AS A SOCIETY,
BECAUSE WE'RE GIVING KIDS A
CONSTANT DIET THAT'S MUCH
WORSE NOW THAN IT WAS THEN.
>> AND IN THAT CONTEXT OF
THE CONSTANT DIET AND WHAT
WE KNOW NOW ABOUT HOW LONG
ACTUALLY THE BRAIN IS
DEVELOPING -- IT USED TO BE
WE THOUGHT WE WERE ALL
ADULTS BY 17-AND-A-HALF, OR
SOMETHING, BUT WE KNOW
DIFFERENTLY NOW.
WELL INTO YOUR EARLY 20s
THERE'S STILL A LOT OF
DEVELOPMENT GOING ON.
SO WHAT HAPPENS IN THAT
NEXUS OF WHAT YOU'RE TALKING
ABOUT THERE?
WHEN A KID IS EXPOSED TO
THAT KIND OF THING, BUT NOT
QUITE FULLY WIRED, AS THEY
SAY, WHAT'S THE POTENTIAL
THERE?
WHAT HAPPENS?
>> GOSH, I DON'T HAVE ANY
MAGIC ANSWERS TO THAT.
I'LL SAY THAT I THINK WHAT
HAPPENS WITH A LOT OF KIDS
IS THAT THEIR SOCIAL CONTEXT
WITH FAMILY, WITH FRIENDS,
WITH COMMUNITY ARE
DIMINISHED, AND THEY BECOME
MORE RELIANT ON THE
EXCITEMENT THAT COMES FROM
WHETHER IT'S THE LATEST
PROGRAM, OR THE LATEST GAME,
AND THEY CAN BECOME MORE
ISOLATED.
NOW, YOU ALL KNOW MORE ABOUT
THIS THAN I DO, BUT THAT
WOULD BE --
>> DR.
GRAEBER, DO PICK UP
ON THAT, BECAUSE THERE'S
SOMETHING INTERESTING THERE.
>> I THINK LYNETTE MAKES A
GOOD POINT.
ONE THING WE KNOW, THESE
VIOLENT EVENTS ARE VERY HARD
TO PREDICT AND THEY'RE QUITE
COMPLEX, I THINK MOST PEOPLE
WOULD AGREE.
I THINK WE DO KNOW THAT
AGGRESSION IN KIDS IS A
MARKER FOR POTENTIAL
AGGRESSION AS KIDS GROW, AND
SO THAT CAN BE HELPFUL IN
TERMS OF SCREENING AND EARLY
INTERVENTION.
AGGRESSION IN YOUNG, EVEN
PRESCHOOLERS AND SCHOOL-AGED
CHILDREN, IS AN IMPORTANT
BEHAVIOR TO RECOGNIZE.
AND THINGS THAT DO IMPROVE
PRO-SOCIAL BEHAVIOR AND
SUPPORT TEND TO BE SHOWN AS
FAIRLY EFFECTIVE IN THIS
GROUP.
>> RIGHT.
>> SO THAT'S ONE PIECE.
I THINK THE ISSUE OF
DEVELOPMENT IS QUITE
INTERESTING.
I THINK, AGAIN, HOW DO
PEOPLE HAVE THE SUPPORT OF
FAMILIES AND SIGNIFICANT
OTHERS.
AND THE OTHER PIECE, REALLY,
I WANT TO GO BACK TO IS THIS
IDEA, GETTING BACK TO
VIOLENCE, YOU KNOW, AND THE
GUN ISSUE, IS THAT OF THE
31,000 GUN DEATHS IN 2010,
ABOUT 19,000 WERE HOMICIDES,
BUT 11,000 WERE -- I'M
SORRY; 19,000 WERE SUICIDES,
AND 11,000 WERE HOMICIDES.
>> AND THAT'S NATIONALLY.
>> THAT'S NATIONALLY.
AND EVEN THOUGH THESE MASS
SHOOTINGS ARE TRAGIC,
THEY'RE RELATIVELY RARE
EVENTS.
>> INTERESTING ON THAT IDEA
OF SUICIDE.
LET ME GO BACK TO THAT FOR A
QUICK SECOND, STEVEN,
BECAUSE ONE OF THE THINGS
THAT I DID NOT REALIZE IS
THAT THE LENGTH OF TIME
BETWEEN THE INITIAL THOUGHT
THAT A SUICIDE MOMENT IS
THERE, AND AN ACTUAL EVENT
HAPPENING, IS LESS THAN AN
HOUR.
>> RIGHT.
>> THIS IS NOT SOMETHING
YOU PLAN FOR A WEEK AND
THEN, YOU KNOW, AFTER YOU
GET A REPORT DONE, YOU GO DO
THIS.
BUT HOW DOES ONE, AS A
CLINICIAN AND OTHERS IN YOUR
FIELD, HOW DOES ONE PREDICT
SOMETHING IN SUCH A SHORT
PERIOD OF TIME, THAT WE'VE
GOT A POTENTIAL DISASTER
WITHIN AN HOUR?
THAT SEEMS VERY DIFFICULT TO
ME.
>> YOU KNOW, THE DATA SAYS
THAT SOMEONE LIKE ME IS NO
BETTER AT PREDICTING
SOMEONE'S SUICIDE THAN
ANYBODY ELSE, THAN YOU OR
ANYBODY BEHIND ONE OF THE
CAMERAS HERE.
I THINK THE ISSUE IS WHAT WE
CAN DO TO BUILD SUPPORTS
WITHIN THE COMMUNITY, TO
BUILD PROGRAMS, DECREASE
THAT ONGOING RISK.
>> WHAT WOULD THAT LOOK
LIKE TO YOU?
IF YOU HAD YOUR PERFECT
ALBUQUERQUE TEMPLATE, WHAT
WOULD THAT LOOK LIKE?
HOW WOULD WE ATTACK MENTAL
HEALTH ISSUES TO PROVIDE
THAT SUPPORT BEFORE THAT
HAPPENS?
WHAT'S MISSING IN OUR CITY
RIGHT NOW?
>> WELL, I THINK, YOU KNOW,
THIS IS A NATIONAL ISSUE,
AND I DON'T WANT TO SAY JUST
ALBUQUERQUE IS REALLY SO
MUCH THE PROBLEM, BUT I
THINK RIGHT NOW WITHIN OUR
COUNTRY, WE HAVE NOT REALLY
BUILT A FOCUS ON MENTAL
HEALTH TO THE SAME DEGREE
THAT WE HAVE AROUND PHYSICAL
HEALTH CONDITIONS.
SO AS A RESULT, WE DON'T
HAVE -- WE HAVE THE SAME
ISSUES, AS WE'VE TALKED
ABOUT BEFORE.
WE DON'T HAVE, I THINK, THE
EARLY INTERVENTION AND EARLY
DETECTION SYSTEMS THAT I
THINK WE NEED.
WE'RE TRYING TO BUILD MODELS
OF PREVENTION IN SCHOOLS,
AND I THINK A LOT OF WORK
NEEDS TO CONTINUE IN
SCHOOLS, BECAUSE THAT IS
WHERE THE KIDS ARE, AND
THAT'S WHERE THE FAMILIES
BRING THEM, AND I THINK
THEY'RE INCREDIBLY IMPORTANT
ACCESS POINTS.
WE HAVE HAD A COMMITMENT IN
THE STATE TO SCHOOL MENTAL
HEALTH, TO WHATEVER DEGREE
WE'VE BEEN ABLE TO, BUT
CERTAINLY WE DON'T HAVE
ENOUGH.
WE DON'T HAVE ENOUGH
SCHOOLS --
>> HOW FAR OFF ARE WE?
HOW MUCH MORE WOULD YOU LIKE
TO SEE IN OUR STATE?
>> WELL, I WOULD LIKE TO
SEE EVERY SCHOOL HAVE THE
ABILITY TO HAVE, YOU KNOW,
NOT ONLY A SCHOOL COUNSELOR,
WHOSE ROLES VARY QUITE A BIT
FROM SCHOOL TO SCHOOL.
IN ELEMENTARY SCHOOL, THEY
MIGHT BE MORE EDUCATIONAL
AND DO SOME SMALL GROUPS AND
THINGS LIKE THAT.
I THINK AS YOU GET TO MIDDLE
SCHOOL, IT OFTEN BECOMES,
UNFORTUNATELY, MORE OF A
DISCIPLINARY ROLE AT TIMES,
OR THEY GET INVOLVED IN
SCHEDULING AND SOME OF THOSE
ISSUES.
AND IN HIGH SCHOOL, IT'S THE
SAME, AND THERE'S A
VOCATIONAL COMPONENT, AS
WELL.
BUT I THINK THE MENTAL
HEALTH SUPPORT ISSUES ARE
LACKING IN OUR SCHOOL
SYSTEMS THROUGHOUT THE
COUNTRY, AND I THINK WE HAVE
A STRONGER NEED TO BUILD
THOSE PARTNERSHIPS.
FEDERAL LEGISLATION THAT WAS
JUST PUT INTO THE MIX THIS
LAST WEEK OR TWO, A MENTAL
HEALTH IN SCHOOLS BILL ON
THE FEDERAL LEVEL, THAT
WOULD BUILD COMMUNITY MENTAL
HEALTH SUPPORTS WITH SCHOOLS
TO LINK FUNDS FOR ADDITIONAL
SERVICES ACROSS A CONTINUUM.
WE NEED TO BE LOOKING AT
MORE OF THOSE KINDS OF
PROGRAMS, AND THEN WITHIN
THAT FRAMEWORK, THIS WHOLE
ISSUE OF IDENTIFYING YOUNG
PEOPLE EARLY WITH THE
POTENTIAL OF SERIOUS MENTAL
HEALTH CONDITIONS.
AND IF WE CAN BUILD IN THE
SCREENING PROGRAMS, THE
FAMILIES CAN TOLERATE US
BEING ABLE TO DO THE
SCREENING, BECAUSE OF THE
SIGMA ISSUES OR THE CONCERNS
ABOUT BEING BLAMED IF
SOMEONE SAYS, WE'RE WORRIED
ABOUT YOUR CHILD MAYBE
FACING SOME ISSUE.
WE NEED TO DO A BETTER JOB
OF SUPPORTING FAMILIES WHEN
THOSE SITUATIONS HAPPEN, AND
THEN I THINK WE CAN, YOU
KNOW, REALLY HAVE MUCH
BETTER OUTCOMES.
DAVID AND I WORKED ON A
STUDY HERE IN ALBUQUERQUE
FOCUSED ON IDENTIFYING YOUNG
PEOPLE EARLY, WE DID
TRAINING ALL OVER THE
ALBUQUERQUE PUBLIC SCHOOLS
THAT I THINK WAS MUCH
APPRECIATED AROUND THOSE
EARLY WARNING SIGNS, AND WE
WERE ABLE TO SEE YOUNG
PEOPLE EARLY.
WE HAVE A PROGRAM NOW --
>> LET ME ASK YOU, IS THIS
DOABLE FOR THE LAYPERSON?
CAN THE LAYPERSON PERSON,
WITH A LITTLE BIT OF
TRAINING -- LET ME GO OVER
HERE TO DAVE FOR A QUICK
SECOND AND PICK UP ON THIS.
CAN A LAYPERSON ACTUALLY
HAVE THE SKILL SET TO
IDENTIFY POTENTIAL PROBLEMS
IN A CHILD?
>> WELL, I MEAN, PROBABLY A
GENERAL ANSWER IS, YES,
ALTHOUGH I THINK THAT
REQUIRES A FAIR AMOUNT OF
EDUCATION.
>> OKAY.
>> YOU KNOW, IN MOST CASES
PEOPLE THAT KNOW A YOUNG
PERSON BEST IS THEIR FAMILY,
AND SO EDUCATING FAMILIES IS
REALLY IMPORTANT.
AND THEN AS STEVE POINTED
OUT, WHEN FAMILIES IDENTIFY
POTENTIAL CONCERNS, THEY
HAVE TO HAVE ACCESS TO CARE,
AND FOR MOST THAT REALLY
COMES IN TERMS OF PRIMARY
CARE, WHICH RAISES A WHOLE
ISSUE OF HOW WE ACTUALLY --
HOW BEHAVIORAL HEALTH IS
INTERFACED WITH PRIMARY
CARE, AND THERE ARE
INITIATIVES FEDERALLY THAT
LOOK PROMISING.
BUT, FOR EXAMPLE, IF YOU
LOOK AT PSYCHOTROPIC
MEDICATION IN YOUNG PEOPLE
IN THE UNITED STATES, IF YOU
LOOK AT ALL OUTPATIENT
PHYSICIAN VISITS, ABOUT 14%
OF VISITS WILL INVOLVE A
PSYCHIATRIC PRESCRIPTION,
AND THIS IS IN GENERAL
PHYSICIAN'S OFFICES.
OF THOSE, TWO-THIRDS OF
THOSE ARE WRITTEN BY
NONPSYCHIATRIC PROVIDERS.
SO THE BULK OF PSYCHIATRIC
PRESCRIBING IN THIS COUNTRY
IS FROM PRIMARY CARE
PHYSICIANS, WHO TYPICALLY
HAVE A LIMITED, I WILL SAY,
FORMAL EDUCATION.
THEY MAY HAVE A FAIR AMOUNT
OF EXPERIENCE.
>> SURE.
>> THAT DOESN'T SAY THAT
THEY'RE NOT COMPETENT.
BUT I THINK, HOW DO WE
ACTUALLY LEVERAGE BEHAVIORAL
HEALTH SERVICES AND
EXPERTISE TO PRIMARY CARE TO
SCHOOLS IS A REALLY
WONDERFUL OPPORTUNITY THAT
REALLY IS NOT BEING
CAPITALIZED ON.
>> I WOULD HAVE TO -- I
HEAR THIS FEEDBACK A LOT,
GUYS, ALL THE TIME, THAT THE
SCHOOL SYSTEM IS THE POINT
OF ENTRY FOR ALL OF THIS.
IN FACT, EXPANDING THE IDEA
OF THE SCHOOL PSYCHIATRIST
OR PSYCHOLOGIST INTO A MUCH
BIGGER THING, ALMOST A TEAM
SYSTEM WHERE YOU WORK WITH
THE FAMILY, AND ALMOST WORK
WITH THE CHILD ALL THE WAY
FROM ELEMENTARY ALL THE WAY
THROUGH HIGH SCHOOL TO KEEP
A TRACK ON THE FAMILY,
LYNETTE, SO YOU CAN TALK
ABOUT THE THINGS LIKE GAMING
GOING ON IN THE HOUSE.
YOU CAN HAVE A CONVERSATION
WHERE PEOPLE ANECDOTALLY
SAY, YOU KNOW, MY KID SEEMS
TO ZONE OUT ON A GAME, I
DON'T KNOW WHAT TO DO ABOUT
IT, THESE VIOLENT GAMES.
WOULD THAT BE A SYSTEM THAT
YOU COULD SUPPORT, AS WELL,
IF THE SCHOOL BECOMES A
CENTER CLEARINGHOUSE FOR
THESE KIND OF THINGS FOR THE
ENTIRE FAMILY?
>> I WOULD GO A LONG WAY
WITH THAT, BECAUSE I THINK
WE CAN DO NO BETTER THAN
JANE ADDAMS AT THE TURN OF
THE CENTURY AND HULL-HOUSE.
HULL-HOUSE WAS SET UP AS A
PLACE WHERE FAMILIES COULD
COME TOGETHER, THEY COULD DO
DRAMA, POETRY, ALL KINDS OF
DIFFERENT THINGS.
CRAFTS, GAMES, MARVELOUS
KINDS OF ACTIVITIES.
BUT ALSO, IT WAS HER WAY OF
SAYING, THIS IS WHERE CIVIC
EDUCATION BEGINS.
THIS IS HOW WE LEARN TO WORK
TOGETHER, TALK TOGETHER, AND
SO FORTH.
AND THERE HAVE BEEN SOME
WONDERFUL STUDIES FINANCED
BY THE HOGG FOUNDATION IN
TEXAS WHERE THEY REALLY
PICKED UP -- BY WAYNE
HOLTZMAN'S GROUP, WHERE THEY
PICKED UP ON THOSE IDEAS,
AND THEY OPENED UP THE
PUBLIC SCHOOLS, REALLY
OPENED THEM UP SO PARENTS,
AS WELL AS KIDS, COULD COME
FOR SECOND LANGUAGE
LEARNING, THEY COULD COME
FOR SWIMMING, THEY COULD
COME FOR LOTS OF DIFFERENT
THINGS.
AND IT'S THAT KIND OF
BROADER COMMUNICATION THAT'S
OF SUCH INTEREST TO ME IN
PREVENTION.
AND I THINK IN THAT, WHEN
YOU BEGIN TO BUILD THOSE
KINDS OF TRUSTING
RELATIONSHIPS, THEN YOUR
KIDS ARE GOING TO BE MORE
LIKELY TO BE OPENED, AND
THEIR FAMILIES, TO MEETING
WITH MENTAL HEALTH
SPECIALISTS, OR BEING
IDENTIFIED, BECAUSE THEY'RE
GOING TO BE AROUND PEOPLE A
LOT MORE.
>> INTERESTING.
>> YOU KNOW, WE DO HAVE --
WE HAVE HAD A HISTORY OF
FAMILY RESOURCE CENTERS IN
NEW MEXICO, AND IN
ALBUQUERQUE, AND I THINK,
ACTUALLY, ONE OF THE THINGS
AROUND DEALING WITH THE
MENTAL HEALTH STIGMA IS WHEN
YOU CAN LINK OTHER SERVICES
TO THE SCHOOL SETTING AND
PEOPLE COME IN FOR MULTIPLE
REASONS, THEN YOU HAVE THE
CHANCE TO ASK THOSE
QUESTIONS AND DEAL WITH
THOSE ISSUES, AND WHETHER
IT'S ACCESS TO OTHER KINDS
OF FAMILY SUPPORTS, THEY
BECOME VERY IMPORTANT.
AND, YOU KNOW, I KNOW IN
ALBUQUERQUE AND OTHER PARTS
OF THE STATE, THOSE PROGRAMS
HAVE BEEN IN PLACE TO SOME
DEGREE.
I DON'T HAVE A NUMBER FOR
YOU ABOUT HOW MUCH MONEY WE
NEED TO DO IT, BUT I THINK
HAVING THAT COMMITMENT AND
THAT EXPANDED SUPPORT WOULD
TRULY BE VALUABLE, I THINK,
FOR MANY OF OUR FAMILIES,
BECAUSE THE ACCESS ISSUES DO
REMAIN SO DIFFICULT, AND
THERE ARE SO FEW DOLLARS
THAT HAVE REALLY FOCUSED ON
THE EARLY DETECTION.
AS WE DO SCREENINGS, ONE OF
THE ISSUES BECOMES, WELL,
YOU CAN'T SCREEN PEOPLE IF
YOU DON'T HAVE A PLACE FOR
THEM TO GET CARE WHEN YOU
IDENTIFY AN ISSUE.
SO HOW DO WE BUILD THAT
CAPACITY TO THEN BE ABLE TO
EVEN IDENTIFY THE ISSUE?
AND IF YOU LOOK AT ASTHMA,
IF YOU LOOK AT DIABETES, YOU
WOULDN'T SAY, WELL, WE DON'T
WANT TO SCREEN FOR THOSE
ISSUES BECAUSE WE'RE NOT
GOING TO KNOW WHAT TO DO,
BECAUSE WE'RE COMMITTED TO
THOSE PHYSICAL HEALTH ISSUES
IN A WAY WE HAVEN'T MADE THE
SAME COMMITMENT TO MENTAL
HEALTH ISSUES.
AND I THINK BY CHANGING
THAT, THINGS COULD IMPROVE
QUITE A BIT.
>> SURE.
THANK YOU ALL FOR COMING IN.
IT'S A HUGE ISSUE, AND I
APOLOGIZE THAT WE CAN ONLY
KIND OF SCRATCH AT IT WITH
OUR FINGERNAILS A LITTLE
BIT.
LOVE TO HAVE YOU COME BACK
AND TALK ABOUT THIS SOME
MORE, AND HAVE IT NONTRAGEDY
BASED.
>> THAT WOULD BE LOVELY.
>> EXACTLY RIGHT.
AHEAD, ERIC AND REGINA
GRIEGO ON THEIR FAMILY'S
EXPERIENCE WITH THE MENTAL
HEALTH COMMUNITY.
