Mental health issues rise for adolescents, teens and young adults

A key article for all to see appeared in The Charlotte Observer yesterday called “Mental health crises on the rise among US teenagers. What parents can watch for” by Laura Brache. Here are the first couple of sections, with a link below.

“’A national emergency.’

That’s what the American Academy of Pediatrics calls a recent increase in mental health crises among children and teens in the United States. ‘It’s unlike anything I’ve experienced in doing this for 20 years,’ said Gary Maslow, a child and adolescent psychologist at Duke University. Maslow joined fellow Duke pediatric psychologist Nathan Copeland and professor Sharika Hill in a virtual discussion Wednesday to help parents and caregivers help children and teens facing anxiety, depression, self-harm and suicidal thoughts.

YOUTH SUICIDE IN 2019

More kids died by suicide in 2019 ‘than at any point in American history,’ said Copeland. In fact, suicide was the second leading cause of death among youth that year. ‘Among the 10 to 24 age group, suicide accounted for nearly 25% of all death among kids,’ he said. ‘And among … individuals 15 to 24, suicide accounted for more deaths than the next seven core medical causes combined.’ Those causes include accidents, congenital issues, homicide, and cancer, according to the Center for Disease Control and Prevention. ‘The worst outcome is children dying by suicide,’ Maslow said. “That is happening, but that is the tip of the iceberg.” Just as in many facets of health care, Black youth were among the most impacted by suicide in 2019. ‘Where we were seeing things like systemic racism and how it was impacting Black youth, we were seeing that [suicide] rate increase faster for Black youth than for any other demographic,’ Copeland said. In Durham, Maslow added, Hispanic youth are also ‘presenting at much higher rates that we’ve seen before.’

PEDIATRIC MENTAL ILLNESS IS COMMON

Nearly 1 in 5 youth will experience pediatric mental illness during their childhood, Copeland said. People in this group often go undiagnosed and untreated for years, he said. It can take five to 11 years for a child to get treatment for mental health and behavioral issues from the moment they start experiencing symptoms. ‘For a kid that’s a significant 11 years,’ he said. ‘That’s a long period of time that a kid has been experiencing mental illness.’ What’s more, only 20% of youth experiencing mental illness end up receiving the potentially life-saving care that they need. Academic pressure and school in general also fuel “peer victimization” and bullying, Copeland said. ‘In Durham, what we frequently see or what we have seen is that when school starts, compared to when kids are on break, there is a 60% increase in rates of pediatric mental health emergency department visits,’ he said. Copeland said, before the pandemic, ‘mental illness was the most common cause of drop out in school of any disability group.’”

I encourage you to read the full article via the link below. And, note this is before the pandemic made the situation even worse. This is a key reason why guns need to be better governed and locked away. Homes with guns have a higher rate of suicide than homes without one. One impulsive decision and it is over.

There should be less stigma to getting help. We all may need it at some point.

Read more at: https://www.charlotteobserver.com/health-wellness/article263427108.html#storylink=cpy

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Two questions on gun deaths – a letter to the editor

The following is a letter I wrote to the editor of my local newspaper. It is necessarily brief but poses two questions that I want to ask certain politicians. Please feel free to adapt and use, if you like it.

Members of a political party are saying our gun death issues are not a gun problem, but a mental health one. Two questions. 1) If that is the only reason, then why does the US have more gun deaths than the next twenty-two first world nations combined? I presume these 22 countries have people with mental health issues as well.

2) If this is only a mental health issue, then why are members of this party against expanding Medicaid which provides mental health benefits? The number one cause of gun deaths in the US is suicides. Access to a weapon plays a role and saying it does not is naive and political. All it takes is one impulsive act and it is over.

As a result, any solution has to be multi-faceted to work including better gun governance and access to mental health services as only two of the components.

The majority of people want better gun governance (a redundant plea)

Another week, another mass shooting in America. Ho-hum. Another day, more suicides by impetuous acts and more homicides by uncivil arguers. Boring. And, of course, we have the inevitable accidental shooting by a curious child and discovered weapon. This does not seem to bother anyone, either.

The following is a repeat of post from three years ago. It is a variation of a post I have written countless times. Yet, we do not seem to care. I am glad the president is going after ghost guns, but that is only part of the problem. When the leading US gun death cause is suicide, by far, you would think legislators, especially Republican ones, will stop counting the NRA donations and do something about this obvious problem.

From an article called “Polls find Americans mostly are supportive of stricter laws on guns” by Dawn Baumgartner Vaughn of the Raleigh News and Observer, please note the following cited survey results. Note these results have been fact checked by the paper’s Fact Checking Project.

– Gallup’s poll from August, 2019 noted “61% would support a ban on semi-automatic guns known as assault rifles.”

– The Civitas Institute (a conservative policy group) poll from September, 2019 showed “58% of respondents saying gun laws were not strict enough.” Note of the Civitas poll respondents, “48% either owned a gun or had someone in their home who owned a gun.”

– A Quinnipac University poll from May, 2019 showed “61% of Americans support stricter gun laws. The same poll showed 94% of Americans support required background checks for gun buyers. And, 77% of those polled support ‘requiring individuals to obtain a license before being able to purchase a gun.’”

– In 2017, Politifact Wisconsin “found multiple previous polls citing support for background checks ranging from 84% to 94%.”

The numbers 58% and 61% are meaningful, but let’s focus on the 94% (or even 84% to 94%) of respondents who want required background checks and the 77% who want a license before hand.

These are consequential majorities. Earlier this week, the Houston Chief of Police challenged his two Texas Senators (Ted Cruz and John Cornyn) and Senate Leader Mitch McConnell to act after yet another police officer was killed.

The NRA has spoken. Now, we need to set their ardent, sales focused rhetoric aside and act sensibly. Just the two items highlighted above will help – background checks and pre-buy licensing. No loopholes. Cars require ownership and driving licenses to operate. Yet, they are not designed to kill.

I am long-ago tired of the standard “thoughts and prayers” line offered by legislators followed by “now is not the time to discuss changes.” Since people are dying everyday by suicide and other reasons, waiting for a time with no deaths will not happen. Further, the mass shootings of more than a few victims are happening with alarming frequency.

To be brutally frank, Democrats should push this issue to the nth degree. Maybe, the Senate and president will act. It matters not who pats themselves on the back – JUST DO SOMETHING! And, these legislators are in my “thoughts and prayers” to actually act like the parents and grandparents we hope they would be.

Truisms of not great importance, mixed in with few that are

A few miscellaneous truisms:

  • a character killed off a soap opera is really not dead; they do come back in new permutations.
  • suicides are more prevalent in homes that have a gun on the premises; all it takes is one impulsive act.
  • the soap actor who played said deceased character is not married to the dead person role, so they may come back in a new role
  • the most prominent reason for gun deaths in America is suicide, not terrorism, not violent crime related.
  • a horror movie bad guy never dies, even when he does; the code word is “sequel.”
  • accidental shootings are one thing we should be able to avoid, yet a sad search to do is to Google “Four-year old kills six-year old” and read the related stories.
  • per Black comedian Chris Rock, a Black crew member on “Star Trek” should not beam down with Captain Kirk, as he is not coming back. Rock is heard to say in his routine, “Brother, don’t go.”
  • allowing guns on college campuses is a horrible idea, as college campuses have a higher rate of depression than in general society – again all it takes is one impulsive act.
  • when the bad guy is shot in a crime show, the police don’t remove his weapon; so someone else tends to get shot.
  • the surveys I have read convey most gun owners want better gun governance laws; yet the gun making lobby is too overwhelming to allow things to get done.
  • if a hospital, police or federal agent team includes a male and female, there will be future episodes of mutual attraction.
  • my own survey tells me I have heard too many “thoughts and prayers” or “it is a slippery slope” comments from legislators who want to stall to let the temperature for change abate. To me, our country needs more political courage to do needed things to make us safer.
  • if you watch Hallmark movies, no lead character is ever divorced; he or she is widowed, often with a child. I guess there are no greeting cards for divorces.
  • one of the things that scares more than me about the increased civil unrest in our country is we have more guns than people.
  • movies on channels with commercials will start immediately following the end of the previous movie’s credits finish – and you wonder why we binge watch.
  • there are changes we can make that people from the two parties can agree, if we can just get them to forget who put the money in their pocket.
  • finally, Chris Rock has a good solution for gun deaths – make the bullets cost $5,000 a piece. Shooters will become more judicious in shooting someone.

Let’s fix the larger gun death problems

Mass shootings are very tragic and heart wrenching. Homicides are also tragic. Yet, the biggest gun problem and another tangible and avoidable problem make up between 60% and 70% of annual gun deaths in America. The lion’s share of gun deaths in America are suicides. Last year, over 23,000 of the 38,000 plus gun deaths were suicides. This ratio is not unusual and tracks pretty well year in and year out.

The other much smaller, but more avoidable gun death problem is accidental shootings. And, tragically the ones doing the shooting or getting killed are children who come across a weapon. To lose a child is the worst nightmare I could possibly imagine. But, to lose one because you did not put away your gun, is even more traumatic. The gun owner has to live with the guilt. While accidental shootings are about 2% of gun deaths, they seem to be ones we should be able to avoid irrespective of one’s fervor for the 2nd Amendment.

After each mass shooting, there is concern registered by kids and parents about not letting this happen again. The people for and against more gun control go into camps with some saying now is not the time, while the others asking when is the time. I must give a huge amount of credit to the Parkland kids and others around the country who are forcing action. But, outside of a little lip service in Washington, nothing tangible happens. They may regret inaction come November.

These past few months, the barest of minimum change was done, but there was the President of the United States speaking before the NRA convention last week. He was the one who taunted Congress representatives for not standing up to the NRA. These were obviously just words, which we should be used to by now. With this said, I do give kudos to Florida who acted a little more demonstrably than DC.

To prevent more suicides, background checks on all sales with elongated waiting periods are needed. Doctors must be permitted to ask patients if there is a gun in the house as the propensity for suicide is much higher than one without. All it takes is an impulse and it is over. We must add more psychologists and counselors to schools. The greater gun risk is a depressed student taking his or her life. And, we should expand Medicaid in the remaining 18 states along with its mental health benefits.

As for the accidental shootings, the majority of states require guns to be locked up at home, but why do not all states have such a requirement? I have shared this before, but I asked my father-in-law to lock up his weapon, as I did not want his grandkids around a loaded weapon. He did so. One idea that has merit is requiring a finger printed trigger, where only the owner can use the weapon.

Please note that none of the above speaks of taking weapons away. These steps would help reduce the number of suicides and accidental shootings. Even if the number is only 100, 500 or 1,000, those are lives saved. Isn’t this what it’s all about?

 

 

You see something, say something only works…

It is hard to get involved when it could be indicting of someone. But, we are encouraged to do so, if we see looming danger, a threat to many people. The term often used is “if you see something, say something.”

On several occasions the last year or so, people called in to local or federal officials to register concern over the mass murderer who killed seventeen students in Parkland, Florida. Some even explicitly noted they feared he would shoot up a school. Yet, only a modicum of steps were taken.

Law enforcement needs to recognized how hard it is to get involved. It is harder when the possible backlash of the person being accused exists. I realize we have the benefit of 20/20 hindsight. With that said, the specificity and rationale for the concerns had veracity.

As people dole out reasons and look for single answer solutions for these and other kinds of gun deaths, we must understand how the holes in the Swiss cheese aligned to let a killer pass through.

Finally, we should recognize that 2/3 of all 30,000 plus annual gun deaths in America are suicides. We must look at all reasons for gun deaths (not just the mass shooting of the month) to craft good solutions to make us safer, including better governing the requirements to get and own a weapon. So, if someone takes the time to call a law enforcement or social worker official with concern over a person who is a threat to themselves or others, please exhaust all means of investigation and make sure we have resources where most effective. Otherwise, people may die.

 

Terrorists are the least of our concerns for violence

Since we are in the middle of a Presidential race, those out of power tend to use the politics of fear to terrify people that they are best suited to handle things. In my long voting history, I also have seen fear used when your story is not as good to tell. This is especially true with our economy doing pretty well, the stock market more than doubled and unemployment down to 5%.

We are told that our country is not doing enough to fight terrorists. And, we need to be hyper vigilant that terrorists will attack again in America like they did in California five months ago or in Paris, Belgium or Africa. The fear is based on some merit, which is why this election model works. Dial the fear up as much as possible. Forget the words of FDR who said “The only thing to fear is fear itself.”

Yet, what the continuing, day after day news stories show us, the much greater fear in America is gun deaths from Americans. We now have more guns than people in America. Think about that for a second. Just this past week, horrible gun deaths occurred in Ohio and Georgia. More law enforcement people were killed and people were shot at a prom in Wisconsin.

But, those are the event stories. Something bad happened en masse, so it is reported as it should be. The greater gun death problem is what happens everyday. Pick up any paper, any day of the week and count the gun death stories. Or, make yourself very sad and Google “toddler kills parent” or “six-year-old shoots four-year-old” and count the stories.

Or, think for a minute about what does not get reported, the greater tragedy in America with gun deaths – suicide. Over 2/3 of our gun deaths in America are suicide. A home that has access to weapon is far greater likely to house a suicide than one without. We have some states who are enabling students at college to have weapons on campus, where the rate of depression is higher than in general society, as a hoped for nirvana is not found on campus or kids feel they have disappointed their parents by failing. All it takes is one impulsive act and it is over.

The President has said failing to gain any common sense action from Congress on guns is his greatest frustration. I share that frustration, but I blame Congress who is too influenced by the NRA’s money to do what Americans have told them to do in surveys – background checks on all sales and elongated waiting periods. The “fog a mirror” gun sales at shows has got to stop. When a fourteen year old boy cannot buy cigarettes, porn or beer, but can walk out with weapon, that is a shame (this was a done as a demonstration project).

Guns do not kill people. People with access to guns kill people. But it is not just guns, so that argument is sound. It is the lack of civil discourse. Having access to a gun in bar is an unhealthy mix with alcohol and testosterone. It is the we/ they culture we have in news, politics, religion, entertainment and sports – we must divide us into factions. We cannot argue civilly, we have to do it angrily and a loved one, friend or acquaintance is dead because someone had access to a weapon.

It is the increased poverty which leads to crime filling the void. It is the increased amount of drug usage which begets crime. It is entertainment violence which desensitizes us to gun death. In the case of suicide and some mass shootings, it is not getting treatment for depression or other mental illness, although I want to avoid the perception that if you have a mental illness you must be a danger to others. And, it is due to the increased number of domestic terrorists groups who are hate groups.

We need the parents in legislatures to push the others to act. Those who don’t say “doing something won’t solve the problem.” But, it is obvious doing nothing at all won’t either. And, that is what our Congress is known for. Doing nothing at all.

 

 

Mental Health is one reason, but that means…

After the most recent mass shooting tragedy at Umpqua Community College, the new defense that it is not a gun problem, but is a mental health problem, have arisen. This is not an either/ or debate, as both are problems, but it is even more than that. But, let’s keep it simple and focus on mental health side for now, as there are some very telling things that need to be addressed.

Of course, someone killing people like this is indicative that there is likely a mental health issue. Even if the killer was aligned with a domestic terrorist group, wanted to commit a hate crime, or tried to start a race war as was the motivation in Charleston, SC, there is a sociopathic problem where the killer believes he is justified to do this.

Yet, as tragic as these types of mass shootings are in the US, the most prevalent reason for gun death is clearly a mental health concern and that is suicide. Suicides account for two-thirds of all gun deaths and are the leading cause of death in nine of the top ten states for gun deaths. Also, homes with a gun have a much greater propensity toward suicide than homes without a gun. All it takes is one impulsive act and it is over.

So, yes improving access to mental health is important. Denying access or restricting access to guns for those who have mental health issues is also a concern. Yet, that means you should not advocate actions to the contrary. What do I mean by this?

The folks who are shouting the loudest that this is not a gun issue, but is a mental health issue, have taken steps to block the path to addressing the mental health aspects, sometimes overtly advocating a policy change to make it easier to kill with a gun. The easiest example is the NRA, through the conservative group ALEC, has been supportive of state legislation that will make it a crime if a doctor asks a patient if he or she owns a gun. These laws are being considered in several conservative led states and have passed in a few.

So, think about this. The NRA, who says gun deaths are a mental health issue, advocates that a doctor cannot ask a presumably depressed patient if he or she has a gun at home. Maybe this doctor is already prescribing Lexapro, Risperdal or Seroquel, but the NRA and ALEC want to say it is a criminal act that the doctor inquires whether the patient has access to a weapon. Again, two-thirds of gun deaths in the US are suicide. I think it is well within the domain of the doctor to ask these questions.

But, it goes further. The retiring US Speaker of the House struck language earlier this year to some funding of looking at health care data in the US. He felt it was not appropriate to track gun death data as that was not germane to health issues. Please reread this statement as it takes a second to sink in. A conservative leader, whose party is heavily influenced by the NRA who says gun deaths are a mental health issue, does not want to spend our money to track reasons for gun deaths.

Finally, access to mental health care is key to this process. How are you going to do it? A behavioral psychologist, I used to work with, who helps employers design mental health wellness programs cites the following two statistics. 1 out of 5 people will have some level of depression during their lifetime. She also says that you can pick up any large employer’s health claim data and 1 out of 10 plan participants would be on depression medication. So, the need for access to mental health care is critical. The beauty is the Affordable Care Act provides more people with access.

Yet, the people who say gun deaths are more of a mental health issue also want to repeal the Affordable Care Act. If this is done, what would they propose to make sure access to mental health care exists? The ACA is successful in getting uninsured people access to health care, including mental health care. My recommendation is if this is what they believe, then they should do what most Americans want and continue the ACA and improve it.

We obviously need better gun governance. Two keys are detailed background checks on all sales and elongated waiting periods. Per various surveys, there is a clear majority of Americans who want these, even conservative voters. The waiting period may help save a life, as if someone is depressive, the wait may allow the impulse to wane. Yet, both of these steps along with some others, could help make a difference in gun deaths.

Yet, mental health is a concern. But, that means we should not restrict doctors from having conversations with their patients about guns, especially if they are treating a patient for depression. That means we should track gun death data and use it to make informed decisions. And, that means we should promote the access to mental health care through the Affordable Care Act. To do otherwise on any of these three issues, is highly hypocritical. Saying mental health is a concern and then doing the opposite is antagonistic to solving the problem. It has to be more than words.

 

Just a typical day in the news – shootings abound

A few weeks ago, I wrote a post regarding recent headlines on various shooting deaths that had appeared in recent press. The post can be accessed with the link below to “And the band played on as more people are shot.” In that post, I referenced that you could test my theory and pick up any paper on any day and count the number of gun deaths. So, with that in mind, here are domestic gun related headlines from the March 31, 2015 edition of The Charlotte Observer.

– 2 arrested after firing shots at Waffle House

– Man charged in Anson killing

– Mistaken identity murder case goes to jury

– Man charged after boy 8, shoots friend

– Officers named in Gaston County shooting

– Robbery suspect demands his charges be dropped (this relates to a slain couple)

– Youth group invites peers to discuss suicide

The above includes six stories about gun deaths in a metro area that counts about 2 million people. The last story is not specifically about a gun death, but I included it as it is trying to prevent gun deaths. With the significant abundance of gun deaths in America related to suicide, prevention has to be a part of the equation. It noted that “More than 1 out of seven Charlotte-Mecklenburg high school students said they had seriously considered a suicide attempt in the past 12 months…according to a recent Youth Risk Behavior Study.” With homes owning a gun having 3x the rate of suicide as homes without a gun, this is should be alarming to parents.

Test my theory with your own paper. Pick a day and count the gun stories. Better still, track them over a week or month. The end result is we have to do a better job of gun stewardship and governance. For politicians who say certain changes will not solve our gun death problem, the answer is neither will doing nothing.

https://musingsofanoldfart.wordpress.com/2015/02/27/and-the-band-played-on-as-more-people-are-shot/