Thursday, May 3, 2007

Friday My View: Mental health isn't simply a safety issue

By Maggie Labarta

Kudos to Gov. Charlie Crist for swiftly signing an executive order that establishes the Gubernatorial Task Force for University Campus Safety, which will review all security measures on Florida's college and university campuses.

One of the benefits of this important response to the tragic events at Virginia Tech will be the increased dialogue regarding the treatment of students with mental illness. As this occurs, we should consider a few important points.

The first is that the overwhelming majority of people with mental illness are not violent. In general, those with a mental illness are more likely to be the victims than the perpetrators of violent crime. The tragedy in Blacksburg should not make us afraid of those with mental illness, but it should make us realize that mental illness cannot be ignored without consequences.
Without early and consistent care, the condition of those who suffer from certain illnesses can deteriorate, making their symptoms more severe and increasingly difficulty to treat.

Second, for far too many Floridians, mental illness remains untreated because of a lack of sufficient investment in our state's mental-health system. Florida currently ranks 48th in the country in per-capita spending for mental-health services, 47th in Medicaid spending for child beneficiaries, and 43rd in Medicaid spending for adult beneficiaries.

Florida also ranks second in the number of homeless, first in the number of substantiated reports of child abuse and neglect, second in the number of children in juvenile detention facilities, and third in the number of prison inmates in comparison with other states.

A significant portion of these problems can be traced to the lack of mental-health care. It is an embarrassing and unfortunate testimony to our lack of commitment to care for those with mental illness; we are not adequately funding proven and cost-effective local mental-health programs.

The success of these programs in communities across our state proves time after time that treatment and community supports work and that access to local mental-health care is the key to providing those with mental illnesses with much-needed help at a reasonable cost to taxpayers.

Without adequate investment in the mental-health system through the funding of community-based services, we will by default be investing in hospital inpatient services, emergency-department care, shelters, foster care, juvenile detention facilities, jails and prisons.

Or worse.

Today's college campuses are more vulnerable than ever to problems associated with untreated mental illness simply because more young people than ever with mental illness are in school.

The Americans with Disabilities Act bans the exclusion of students because of mental illness, but is there enough support on campus for ill students suddenly faced with the additional financial, social and academic pressures of college life?

Florida's institutions of higher learning are assessing their capacities to deal with an increasing number of students with mental illness and are working toward needed changes. Undoubtedly, however, some of these students will require services that will be beyond our colleges' and universities' capacities to meet those needs, and they will rely on community-based programs to help.

Our communities with colleges and universities have an excellent history of collaboration on these issues, but often, students and others end up encountering mental-health services through the legal system instead. Just as we wrongly depend on emergency departments to be the front door for physical health care (instead of focusing more on routine and nonemergency care), jails often end up being the front door for mental-health care.

We must reach these people sooner - long before they are referred for treatment by the courts. That is accomplished through the recognition that mental illness can affect anyone and needs early identification.

We must remove the stigma of mental illness, continue efforts to educate the public on the facts about mental health, and encourage people to seek treatment early. Identification works only if there is an adequately funded array of community-based programs that can provide care after screening and early identification.

Establishing a task force focused on campus safety is a needed and important step. But identification and communication is just part of the battle to prevent another tragedy as happened at Virginia Tech.

Our failure to treat mental health is one of the significant health issues in this state. Until we are serious about addressing it, the number of people left untreated until they commit a crime will continue to increase. And that is an unnecessary risk that none of us should be willing to take.

Maggie Labarta is the chairman of the board for the Florida Council for Community Mental Health and the CEO of Meridian Behavioral Healthcare in Gainesville. Contact her at

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