16 Aralık 2012 Pazar

When discussing the solution to gun violence, good people may disagree on the importance of gun control laws vs improved access to mental health services. But I think we can ALL agree that keeping guns and the mentally ill separate is a no brainer.

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I just read this staggering by the Washington Post this morning:

Adam Lanza lived among guns. 

His mother, Nancy, collected them. She showed them off to her landscaper. 

“Guns were her hobby,” said Dan Holmes, the landscaper of Nancy Lanza’s sprawling yard here on the edge of town. “She told me she liked the single-mindedness of shooting.” 

Holmes said she even spoke of taking her son to the firing range to practice his aim.

The article goes on to detail the mother's fascination of, and perhaps even fetish for, guns.

She apparently collected a variety of weapons, and so far it appears she did so legally, in preparation for the need to protect herself.

She was so comfortable around the guns that she also took her son Adam to shoot them with her at the firing range. The same Adam who was, by all accounts, suffering with some rather severe mental health issues: 

"If that boy would've burned himself, he would not have known it or felt it physically," Novia told The Associated Press in a phone interview. "It was my job to pay close attention to that." 

"He would have an episode, and she'd have to return or come to the high school and deal with it," Novia said, describing how the young man would sometimes withdraw completely "from whatever he was supposed to be doing," whether it was sitting in class or reading a book. 

Adam Lanza "could take flight, which I think was the big issue, and it wasn't a rebellious or defiant thing," Novia said. "It was withdrawal."

And THIS is the child that his mother felt would benefit from learning how to accurately fire some of the numerous readily available guns in his home?

Now contrast THAT with the words of another mother struggling with a child that has mental health issues from an article now gone viral provocatively titled "I am Adam Lanza's Mother: 

"I live with a son who is mentally ill. I love my son. But he terrifies me. 

A few weeks ago, Michael pulled a knife and threatened to kill me and then himself after I asked him to return his overdue library books. His 7 and 9 year old siblings knew the safety plan—they ran to the car and locked the doors before I even asked them to. I managed to get the knife from Michael, then methodically collected all the sharp objects in the house into a single Tupperware container that now travels with me. Through it all, he continued to scream insults at me and threaten to kill or hurt me.

The author of that piece goes on to describe the difficult process of finding appropriate mental health services for her son, and it is a MUST READ in my opinion. 

However I must correct the title of this poor mother's article first.

She is most certainly NOT Adam Lanza's mother, which is evidenced by the fact that the recognized her son's potential for violence and took precautions to keep herself and her other children safe. And SHE was only dealing with knives!

Look I am certainly not going to speak ill of a woman who was murdered by her own son, however in the abstract the idea of living in a house full of guns with a person who is mentally unbalanced is, in my opinion, certifiably insane. (Now from some of the first person testimony we have read there IS the possibility that Nancy Lanza had some problems of her own, but I don't know enough right now to weigh how much that might have affected her judgement.)

I am sure that most of you agree with my statement above, but let me take you down the rabbit hole of mental health services for a moment. (Well at least the rabbit hole that exists in Alaska.)



I don't talk about my job very often on the blog, because usually it quite literally has NOTHING to do with what I write about. Friday that changed.

I do work with children suffering from mental health issues, and I have had to address many of the problems faced by the author of the above article and Nancy Lanza herself.

The problem associated with getting services for a child with depression, anger issues, or simply disruptive behaviors are incredibly complicated and almost ALWAYS requires that the child be hospitalized (Read "traumatized") at some point and quite often also requires the involvement of law enforcement.

Until a child is in what is defined as a "state of crisis" it is VERY hard to get much support, and the parent will receive virtually no financial help. However once a child is hospitalized and evaluated by the on staff psychiatrist, then the doors open up and the money flows.

However just because there is now money available does NOT mean that the correct services are also readily available. Unlike fixing a broken leg, or removing a kidney, the area of mental health is far less straight forward, and the same children can easily receive three different diagnoses from three different doctors. ( I have personally witnessed this almost a half dozen times.)

This means that while your child might receive plenty of attention and "services" they might do little to actually impact their underlying difficulty. This can result in years of frustration for both the parent and the child, and ultimately do little except manage certain behaviors chemically. but never actually provide the parents or the child with the tools or understanding necessary to help deal with the root problem.

And unlike a broken leg, these problems do NOT simply go away over time. Once properly diagnosed, the patient and their parents need to understand that this is now a life long situation, which they need to accept and then learn how to manage. The goal is to maintain the most normalized environment possible for the child, which sadly may not always be with the birth parent.

Now Nancy Lanza may not have understood the extent of her son's incapacity, nor wanted to risk losing him to the "system." Having said that she certainly SHOULD have been aware that having him living in a house surrounded by an arsenal of weapons was equivalent to dropping a lit match on a keg of gunpowder.

However lest we judge her too harshly let me introduce a conversation I once had with a licensed psychiatrist here in Anchorage, who by the way, like many Alaskan men, was also an avid hunter.

After a session with a mutual client, he asked me to stay after and discuss some of his concerns. During that conversation he suggested that the teenager in question might benefit from some time outdoors in the Alaska wilderness.

I concurred and suggested some carefully supervised camping trips and possibly a fishing trip or two.

"Well that would be a good start" he said, "But what do you think of the idea that I take him out hunting with me in few weeks. You know just to get him involved in some more masculine activities since he currently lives with two women?"

"Let me get this straight," I said. "You want to take a teenager with emotional problems, unpredictable mood swings, and a history of violence out into the woods FAR from law enforcement officials and hand him a rifle? The same boy who once beat a fellow student with a plastic baseball bat badly enough to require stitches?

"Well yeah but..."

"Let me tell you something Doctor, I know this kid, I know how hard it is for him to keep it together when he gets upset. You might both enter the woods for this hunting trip together, but only ONE of you is coming out. And buddy, it ain't you!"

And that was the last time we had a conversation like that.

Understanding the limitations of children with severe mental health issues, as well as their strengths, is vitally important to their futures.  The mother in the above article obviously understand that, Nancy Lanza, for whatever reason, clearly did not!

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