The chief executive of AltaPointe Health Systems, the behavioral health care provider serving Mobile, Baldwin and Washington counties, is calling for sweeping reform of the nation’s mental health system in the wake of a series of mass shootings that have again put a spotlight on the intersection of gun violence and mental illness.
AltaPointe CEO Tuerk Schlesinger said in comments this week that after each mass shooting — from Columbine to Aurora, Newtown, Charleston and most recently the shooting at Umpqua Community College in Oregon — the public reflexively asks whether the shooter was mentally ill, often assuming the answer before the facts are known. Schlesinger said that instinct, while understandable, obscures a more urgent and solvable problem: a mental health treatment system that is chronically underfunded and difficult for families to navigate.
AltaPointe serves more than 23,000 people a year across the three-county area, according to Schlesinger, and the organization has had to find creative ways to stretch limited resources to meet that demand. Schlesinger said the complexity of severe mental illness, combined with the stigma surrounding both the diagnosis and the treatment, makes it difficult to build public support for the funding and policy changes needed to fix the system.
Schlesinger pushed back on the assumption that mental illness is a leading driver of gun violence. Citing a study by two Vanderbilt University researchers published in the American Journal of Public Health, Schlesinger noted that people diagnosed with a mental illness were responsible for fewer than 5 percent of the roughly 120,000 gun-related killings in the United States between 2001 and 2010. The same research found that people with mental illness are 60 to 120 percent more likely than the general population to be victims of violent crime rather than perpetrators.
Even so, Schlesinger argued that the stigma attached to mental illness keeps many people from seeking treatment in the first place, and that better public education about mental illness could reduce that stigma. With an accurate diagnosis, consistent treatment and adherence to prescribed medication, Schlesinger said, most people living with mental illness can achieve meaningful recovery — but only if they are able to access care.
That access, Schlesinger said, depends on money. A greater investment of federal, state and local funding is needed to support mental health services and psychiatric medical education, along with more equitable and reasonable civil commitment laws that could help thousands of people get treatment rather than cycling through courts and jails.
Schlesinger pointed to three pieces of federal legislation pending in Congress in the fall of 2015 that AltaPointe and other behavioral health providers were watching closely. The Helping Families in Mental Health Crisis Act (H.R. 2646) was designed to overhaul the federal government’s approach to mental illness, making it easier for family members to help a loved one without relying on involuntary commitment, forcing more coordination among federal agencies, funding evidence-based programs such as the jail diversion program AltaPointe operates locally, requiring additional psychiatric beds, expanding telehealth psychiatry, and training pediatricians to know when to consult child psychiatrists.
A companion measure, the Mental Health Reform Act of 2015 (S. 1945), sought to address gaps in resources and coordination by encouraging integration of physical and mental health care, creating a new Assistant Secretary for Mental Health and Substance Use, establishing an Interagency Serious Mental Illness Coordinating Committee and a National Mental Health Policy Laboratory, reauthorizing mental health research, strengthening enforcement of mental health parity laws, and improving mental health services within Medicare and Medicaid.
Schlesinger also highlighted the Improving Access to Emergency Psychiatric Care Act (S. 599), which had passed the Senate and was awaiting action in the House at the time. The bill would extend a Medicaid emergency psychiatric care demonstration project that had been limited to three years. AltaPointe’s EastPointe Hospital in Daphne took part in the original demonstration project for roughly two and a half years before it ended unexpectedly earlier in the year; passage of the bill could allow the hospital and others like it to resume participation through fiscal year 2016.
Schlesinger urged residents of south Alabama to contact their members of Congress in support of the legislation, saying the debate over gun violence too often fades once the immediate news cycle passes, and that sustained pressure on lawmakers is needed to keep mental health funding and reform on the agenda. Beyond the federal proposals, Schlesinger said local investment in behavioral health education, treatment capacity and diversion programs remains critical to helping people in Mobile, Baldwin and Washington counties get care before a crisis occurs.