Click here to buy my e-book A Conspiracy of Wizards for just $2.99!!!
The Denver Post published an article today on Denver truancy court, and on the importance of diagnosing the problem with a child who is chronically truant rather than just punishing the violation of the law (http://www.denverpost.com/news/ci_16425102?source=pop). As DPS truancy attorney Amber Elias put it, “School attendance is only a symptom. The purpose of truancy court is to identify what the disease is and how to address that.”
A good example of how important that is can be found in the case of 15 year old Louis Pollack-Trujillo, whose truancy was a direct result of an undiagnosed depression anxiety disorder. “I wanted to go to school; I just didn’t want to go in the building,” he said. “The rooms felt too full, and there was too much going on.”
There is a movement underway in child and family services, called “Systems of Care” (SOC), which integrates and coordinates child-oriented services and agencies across the spectrum, including schools, juvenile justice, and county health, mental health, family, and social services. Both federal and state legislation (including in Colorado) is making it easier to “blend and braid” different funding streams (traditionally difficult to do, due to the precise discrete reporting requirements of each program), so that services can be designed as an integrated package for each child and family. By doing so, we can prevent the problems that fester and grow in the absence of such proactive attention.
This is just one dimension of the choice we face as a nation: Whether we want to be the kind of people who justify failing to do the best we can to address the problems that kids face, and by doing so prevent the problems that ensue from failing to provide kids with an education, to address debilitating mental illnesses, to provide health and mental health care services, to address abuse and neglect issues, to address substance abuse issues by the children or their parents, to address truancy and other juvenile justice issues, and to address all of these as parts of a single whole.
Those who chant the mantra of “less government,” without taking into account the legitimate demands that government alone can adequately meet, are not only contributing to higher rates of adult non-productivity and public dependency, associated higher rates of crime, and the intergenerational reproduction of these same problems in a cycle of perpetual costly dysfunctionality, but are also costing tax-payers far more in the long-run by declining to invest in far less expensive early interventions rather than incurring the far more expensive costs of reactive but ineffective “solutions” like incarceration and welfare. By refusing to use government as a precisely targeted proactive tool addressing specific issues, we are trapped into using it as a blunt and costly reactive necessity.
It’s like failing to maintain upkeep on a house or car, allowing it to deteriorate instead, at far greater expense to the home or car owner. It’s just plain dumb. And in this case, the deterioration of the “house” we’re talking about not only costs us, but involves enormous human suffering, suffering which has detrimental rippling effects throughout society.
The choice exists on many levels: Whether to try to resolve conflicts or pay the costs of their eruption; whether to try to identify and treat mental and emotional disorders, or to wait until those who suffer them impose costs and suffering on others; whether to find and address the causes of problems, or turn a blind eye and only deal with the results of not having confronted those problems affirmatively and proactively.
The rest of the developed world has very definitely and clearly selected the former strategy of confronting problems proactively, and have far better success at diminishing violent crime and infant mortality, improving social mobility, reducing incarceration rates, and, in general, spending more of their public resources on improving the quality of life rather than paying for the failure to do so. Isn’t it time we joined the modern world as well?
Click here to buy my e-book A Conspiracy of Wizards for just $2.99!!!
Buy my e-book A Conspiracy of Wizards
Sometimes, the threads of your own narrative conspire to take you down unexpected avenues. Mental Health issues, both personally and as a matter of public policy, were never at the forefront of my concerns, though they should have been, on both fronts. And chance sprinkled bread crumbs along the path that led me to that realization.
First, as a (surprisingly recent) law school student more interested in public policy than litigation or transactional law, I sought out appropriate venues to do internships. During my 2L year (after having momentarily forgotten why I went to law school, and, while interviewing with big firms during the early fall “on-campus interview” process, remembering again), I heard about a small policy LLC called “Center for Systems Integration,” looking for one or two summer interns. I told the career counselor who mentioned it, “if they’re anything like their name, they’re perfect for me!” I interned with CSI that summer, researching legal and fiscal issues surrounding trying to implement mental health screening and services in and through the public schools. Almost instantly, I realized how logical that was, and how needed. After all, adolescence is a time when emotional and mental stability issues are heightened, and many, if not most, need far more assistance navigating those roiling currents than they currently receive. Like the shoulder strap on seat belts, back in the day when cars were equipped only with lap belts, the instant you hear the suggestion or independently think of the idea, you slap your forehead and say, “doh! Of course!” I’ve since done far more research on the subject.
This morning, a renewed reminder of the importance of mental health care appeared on the Today Show, as I was getting ready to leave for a legislative breakfast with Mental Health America of Colorado. The father of the girl with cerebral palsy who boarded her school bus to threaten the kids who had been bullying her was on, with his daughter, clearly a descent guy who loved his daughter and was just driven into a rage at what she was suffering. This story is laden with implications: The bullies, the father, and the daughter all needed their own mental health hygiene (what is sometimes called “behavioral health”) better attended to. And the failure to attend to it has a negative rippling effect throughout our social landscape, reinforcing the bad behaviors of the bullies, leaving the girl to suffer without learning how to cope, and letting the understandable frustration of the father percolate into rage. Unattended mental health issues are seeds of destruction and despair, germinating in the soil of our individual and shared existence, and forming the root of many of our individual and social systemic woes.
Mental health is implicated in virtually all aspects of our lives, in how well we do in school, in how well we address the normal challenges and tragedies of life, in how well we choose our course and pursue our ambitions, in how well we contribute to the production of material and immaterial wealth upon which we all depend, in how well we avoid being sucked into predatory and destructive behaviors. Mental health is the foundation of social health, of prosperity and domestic tranquility, of human happiness.
Public investment in the provision of extensive, universal mental health services is a cost-effective one, paying proactively to nip problems in the bud, problems that, unaddressed, fester into bigger problems, requiring less effective reactive “solutions”, imposing costs that are far, far greater, both materially and immaterially, than the relatively modest costs of addressing these issues early and affirmatively. Our failure to make mental health care more of a priority, a more normal aspect of our routine maintenance of our own well-being, results in poorer academic performance by more children, more juvenile delinquency and subsequent adult criminality, more people incarcerated (we have the largest absolute and per capita rate of incarceration of any nation on Earth, bar none, costing society while producing nothing in return, and screaming of a social failure that we insist on denying), more drug abuse and homelessness and domestic violence and child abuse and neglect, all creating ever-more fertile soil for ever-more profound and widespread mental health problems, escalating in a feedback loop of spiritually and materially costly dysfunctionality. Investing in mental health services, from birth to death, is just about the biggest bang for the buck we can get.
Personally, and not at all uniquely, I’ve always struggled with my own inner-demons, my own internal emotional turmoil (for which I unfortunately never sought help), manifested, as it often is, as character flaws. For a person who takes pride in his accomplishments, in his sincere commitment to our shared enterprise, these failings have always been a source of deep shame. But they shouldn’t be. They are not extraordinary failings, nor extraordinary character flaws, but they are gravel in the gears of both my own personal efforts in life, and the social interactions necessary to our collective efforts. And it is their very normalcy, their very commonness, which is so poignant, because they are not inevitable, they are not mere functions of the cards we are dealt over which we have no control. Nor do they have to be purely individual burdens, borne well or poorly but with only that informal assistance that those same cards we were dealt happen to bestow.
Not only do I as an individual have a responsibility, and the ability, to confront those challenges and address them, but so do we as a people. Because the successes and failures of each of us are the successes and failures of us all. The relative inability of numerous individuals to most effectively and cooperatively participate in our shared enterprise as a society is an integral aspect of the shared challenge we face, of how we collectively play the cards we are dealt, when we face the challenge of improving the quality of our lives by being responsible, rational, and compassionate members of a society. Just as the gods help those who help themselves, society should as well. We should be in a partnership, the individual doing his or her part, and the rest of us offering our support.
Instead of the anger and rejection we indulge in when we confront someone who has problems that manifest in unattractive ways, we should strive to offer a helping hand. What we perceive as character flaws in others are often, if not always, unaddressed mental health issues. That may sound like an exaggeration, or an excuse, but it is neither. What are character flaws but internal problems, imbalances, sometimes even biochemical in nature, that have not been diagnosed and addressed? To those who insist that some people are just “bad” and some are just “good”, why is it that the numbers vary from culture to culture, that some cultures have far less or far more violent crime, or far less or far more “friendliness,” or far less or far more “humility,” or far less or far more “arrogance”? And, even if conceptualizing character flaws as mental health problems is unpalatable to some, the realization that we can help one another to be better people should not be so hard to swallow.
Of course, we are still all each responsible for our own actions and choices, but that does not mean that our actions and choices have no causes, and can’t be collectively improved upon through better understanding and better intervention. And, of course, it is impossible for us to “cure” all such problems merely through improved mental health care services, but, like many such problems, we can do better at addressing and mitigating them, and can benefit enormously by doing so.
Mental Health America of Colorado, along with many other organizations and agencies, has made enormous strides in improving our ability to provide mental health services to those who need them. Throughout the human services community, a movement called “systems of care” is increasing both efficiency and quality of services provided, by creating more integration among different agencies and organizations providing complementary, supplementary, and overlapping services, so that individuals receiving these various services, receive them in a coordinated way, that reduces costly redundancy, reduces the fracturing of interrelated services into mutually isolated compartments, and increases the synthesis of services into more effective packages designed to best meet the needs of those being served.
Research is improving our knowledge, such as the importance of using peers in mental health care regimens, and that those who have been sufferers of specific mental health problems are often the most useful counselors to others who are suffering them as well. Our knowledge of the unity of physical and mental health issues, each affecting the other, both being aspects of a single whole, improves our ability to address the systemic needs of individuals and society as a whole.
But the political challenge of working on how, rather than whether, to best address these very real needs, is just one more incarnation of the deeper political challenge in which we are embroiled: The dogmatic commitment to extreme individualism on the one hand, leaving each to fend for himself (which costs us all, because we are in fact interdependent whether we want to realize it or not); and, on the other, a commitment to working together as reasonable people of goodwill to do the best we can to address the challenges and opportunities of a complex and subtle world. It’s a no-brainer. But, unfortunately, sometimes even no-brainers are not no-brainers enough for reason to prevail. Not surprisingly, Colorado, the land of rugged individualism, has the 18th highest rate of depression in the country, the sixth highest rate of suicide, and the second highest rate of juvenile suicide. On the flip side, Denmark, one of the countries most committed to the collective welfare of its people, has the highest rating of self-reported happiness of any nation on Earth.
Some argue that such talk is an assault on individual liberty. But individual liberty is a function of being members of a society, based on the material, cultural, and spiritual wealth we create together. We are each free to think and say what we want, using a language and concepts that we have collectively produced over generations. We are each free to pursue our fortunes, within an economy in which we collectively participate, and relying on a material and immaterial infrastructure publicly provided. We are free to explore the wonders of the world, traveling on vehicles, reading books, engaging in entertainments, all produced through a collective enterprise, an enterprise which both requires and benefits from intelligently designed public policies. The question we face is not how much government we should have, but rather how best to use our government to provide the most opportunity to the most people to exercise and enjoy our individual liberty, to celebrate our freedom by living healthy and productive lives. We all benefit by addressing that challenge as wisely as possible. It’s time to stop shirking that challenge. Investing in the mental health care of our citizens is one important component of “getting it right.”
Buy my e-book A Conspiracy of Wizards
Many of the most pressing social problems we face are embedded in the loss of community, in dysfunctional families, in unaddressed behavioral and situational problems of children. Some consider these spheres of life to be beyond the purview of public policy, and too expensive to address even if government could or should be used to address them. I think this is mistaken on all counts, and more profoundly than immediately apparent.
First, the unaddressed (or under addressed) behavioral and mental health problems of children, and the unstable or unsafe family environments in which many find themselves, end up being extremely costly to society in the long run, both monetarily and socially. These under addressed problems are implicated in poor educational performance, delinquent and future criminal behavior, and a myriad of related problems that reduce individual productivity, increase economic and social burdens on society, and reproduce themselves generationally.
Second, our current programs tend to be piecemeal, reactive, and both fiscally inefficient and of more limited effectiveness than necessary. This is not a set of defects that we cannot substantially improve upon, and, in fact, there are many advances taking place right now which are doing just that. By placing ever-increasing emphasis on coordination among services and agencies that perform interrelated services for children and families in need, we reduce the costs of fractured and redundant services performed by seperate agencies with unconsolidated administrative costs. Those costs are far greater than providing oversight boards which help to coordinate and consolidate these overlapping services. By doing so, not only is the fiscal efficiency of providing services greatly increased, but also the outcome efficacy of these services, for when schools and juvenile justice agencies and mental health providers and child welfare counselors and others involved in addressing individual children’s needs are engaged in those efforts in better coordinated ways, all do their jobs more effectively, and contribute to a more effective regime of service provision.
Providing such proactive services more effectively, addressing the behavioral health challenges that so many of our youth face, helping to ensure that each child has a safe and nurturing permanent family environment in which to grow up in, and coordinating these efforts with both juvenile justice agencies and public schools, not only increases the present and future welfare of those children, but also reduces both the costs of reactive solutions to the problems thus avoided, and the costs to society of the problems themselves.
The costs of the relative failure of our educational system, for instance, are enormous, on many levels, costs that can be dramatically reduced through improvements in the effectiveness of our schools. And the enormnous costs of having the dubious distinction of being the nation, of all nations on Earth, with both the highest absolute number, and highest percentage of our population incarcerated, are perhaps directly tracable to our failure to address the childhood problems that lay the foundation for that unfortunate statistic.
Improving our proactive services to children and families is an up-front investment in our future, cultivating productive and well-adjusted members of society who contribute more to our collective welfare and less to our collective suffering. And even marginal gains on that dimension promise enormous future fiscal savings. It’s an investment we can’t afford not to make.
But the potential to improve the quality of our lives, and the prospects for our children, do not stop there. Increased community involvement provides one more pillar to the structure of improved support to children and families, increasing the vigilance with which problems are identified, the informal neighborly assistance and interventions with which they are avoided or mitigated, and the positive human capital with which child development is cultivated. Implementing robust community volunteer tutoring and mentoring programs is one easy step we can take to increase the strength of our communities, improve the quality of education our children receive, and provide our youth with a greater number of positive role models to emulate. In addition to such benefits are the benefits of increased informal mutual support in times of need, and just as an ordinary part of life, each of us helping one another out just a little bit more, because we have spent more time working together as members of a cohesive community.
There are no panaceas, and I do not mean to imply that the policy agenda I am outlining would solve all of our problems, would magically make all children well-behaved and studious, and all neighbors helpful. I am suggesting that, as always, we can do better or worse, we can improve on our current social institutional framework or not, and we can strive to increase the opportunities available to our children for their future success, and our improved shared quality of life.
No Comments »
