Opinion: Watching out for signs of mental illness
Publisher’s note: The following column is the first of a two-part series that looks at the availability and impact of mental health services in Northern Nevada and across the nation.
By Kristin Hestdalen
As Nevada and the Lake Tahoe Basin greet 2013 with a mix of optimism and concern, we have great issues facing our nation, including looming debates on the state of mental health services, gun control, and protecting Second Amendment rights.
We continue to collectively mourn the devastating loss of life in Connecticut, as 27 people were killed (mostly first-graders). As unbelievable as this tragedy was (and many recently like it), we still face multiple questions: What are we as a nation prepared to change? How can we prevent this from happening again? And what exactly are the possible causes of these horrific acts?
Many commentators and politicians, say it is our “broken mental health system” that needs to be fixed. I am certain that something needs to be fixed, particularly our access to mental health services. But to declare there is a system, broken or otherwise, is naïve. In Nevada, the legislative body has cut 38.1 percent from the total general fund mental health budget over the past three years, making it the state with the fifth highest cut to mental health funding in the U.S. (Statistic from the National Alliance on Mental Health.)
And while legislators and mental health professionals continue to debate next steps, the question remains, “What leads a person to commit such a horrendous act?” I’m not sure there is an easy answer to this question.
Given that hurdle, we do have some ideas about what might predispose someone to consider mass homicide. In a detailed case study done on five mass murderers it was found they all shared some common characteristics and background history. First, the individuals in the study were all bullied as children and often experienced painful loneliness, leading to despair and feelings of social alienation. These were loners who eventually developed extreme anger at their perceived injustice by others, externalized blame, became suspicious and paranoid of others’ intentions and lacked the capacity to look inward in order to create real change. Instead they tended to be rigid, inflexible and narcissistic, unable to see the world except through their narrow lens. Addition of a mental illness (i.e. schizophrenia) exacerbates all of this and further distorts already flawed perceptions of others and their world.
Here are some possible signs that someone needs urgent mental health treatment:
1. An increase in isolative behaviors, such as staying in one’s room, not wanting to interact with family or friends.
2. Changes in mood or personality, especially development of hostility and anger.
3. Changes in interests, particularly an unusual and obsessive interest in guns and violence.
4. Onset of paranoia or suspiciousness.
5. Development of unusual thoughts or ideas and other distortions of reality.
6. Development of frank delusions or hallucinations.
These behavior changes often occur in adolescence or early adulthood and are sometimes the warning signs of very serious mental illness, such as bipolar disorder or schizophrenia. Families or the educational system (high schools, colleges and universities) are often left with the responsibility of finding help for someone who doesn’t want it.
In the next article we will discuss where this help may come from, and look at some examples of how residential treatment, counseling or medications can make a positive impact. So, as debate continues on many fronts and we see continuing acts of seemingly random and unexplained violence, perhaps real change, advocacy, and prevention can come from each of us as we bring the issue of adequate mental health services to the forefront.
Kristin Hestdalen is a board certified child and adolescent psychiatrist for Tahoe Family Solutions in Incline Village where she is a staff psychiatrist as well as chief psychiatrist for Sierra Mental Health Associates.
Having a “professional” list an interest in guns as a sign of mental illness is an insult to serious discussion, especially considering that the article is supposedly about “the availability and impact of mental health services…”. That would put about 50 million Americans into the mental illness category. Mental health cannot be reduced to bumper sticker slogans and unsubstantiated political opinions. The attempt to disguise the statement with the word “obsessive” is thinly-veiled as it is a subjective description of behavior. Mental illness is a serious problem and will not be helped by grandiose statements by politically motivated “professionals” and pseudo-intellectuals, in my opinion.
I’m “dumbfounded” by how your focus is on one single facet, which by the way is found in numerous studies and seen by families and teachers when kids are as young as 5. I know, I’ve seen that very behavior over the years as a classroom teacher. This one piece of information is not the article’s intent as a whole and it boggles my mind how narrow your vision is. It’s merely a “laundry list” of many indicators. Mental illness is all too prevalent in our own community and in our own nation. It’s a disease and it needs to be understood as one. The author is trying to resurrect a conversation that has to be brought to the table. And frankly, it needs to always remain there. California’s mental health “system” (I too use that word loosely) is not effectively serving the people and families that it should. Penny wise, pound foolish is again the statement that comes to mind. The absolute slashing of financial support for mental health over the years has left many in need here in Lake Tahoe in such a poor state that they no longer are receiving assistance. We used to have several counselors in our school and county mental health workers that partnered in identifying children at a young age who needed help. Children and their families received assistance and support through programs. Now there are only a couple of counselors in both agencies. They are incredible professionals who are spread so thin that I’m sure they are incredibly frustrated in not being able to do more. We used to have a physician that would see clients here in town in person. Now it’s over a TV monitor as the appointment is held via “skype-type” delivery from the other side of the hill. Can you imagine an individual who already feels paranoid and overwhelmed by everything being at all comfortable with dealing in a two-dimensional session, someone talking about them throgh a TV? Sadly this discussion has years of important topics. My hats off to everyone who continues to strive for the good mental health of our community members. Thank you to all of those connected with our local NAMI Chapter, thank you to Diana Hankins of NAMI, and thank you to the very few counselors who are responsible for so many individuals here in Lake Tahoe. Penny wise-pound foolish? Cutting costs for prevention ALWAYS costs more in lives and money down the road; ALWAYS. Everyone has a stake in this and everyone should be concerned and a part of doing things better.
Dumbfounded, “unusual and obsessive interest in guns and violence.” And violence. This person is not trying to take your gun away. There is a MAJOR problem with the mental health system. Money. Adults with mental health problems generally have none. Families of these individuals have no way to make them do anything. The police can do a 51-50 on them if they wind up in serious trouble but otherwise they are free to do what they ( or the little voices in their heads) want to do. Learning some of the signs of mental illness and it’s escalations might just save your life. Better than always falling back on a gun for protection.
Defunding of mental health is unconscionable. Nothing I said can be construed as trying to interfere with a discussion of mental health availability or impact.
I know of a lot of people that fit, but luckily don’t have a fascination with guns (yet). I think we have a lot of mental illness in this country, why? Have we always had this much? or has something changed? Has the world we live in become to overwhelming for some? Is there a way to improve life, and decrease stress for people, or is that their job to figure it out?
Not funding mental health is crazy. An ounce of cure is worth a pound of prevention.
Being mentally ill can be a little like a Jewish person complaining to Hitler’s gestapo and SS they got picked on. We have to admit we don’t get along with each other and the government is complicit with allowing the bullying.
WARNING WARNING WARNING ATTENTION EVERY ADULT NEEDS TO READ THIS. A few years back I learned how dangerous the mental health occupations are. Did you know that any person can be diagnosed (without justification) with a personality disorder? To unjustly diagnose a Paranoid Personality Disorder a psychiatrist simply avoids understanding reasonable fears. I most commonly fear lies and other forms of deceit. This characteristic that I possess is simply caused by me being victimized repeatedly by people who lie about me. I have now developed a keen reasoning ability that detects peoples lies. This is not paranoia. Those people that invested their life savings with Bernard Maddolf would have been better served by such justified fear of deceit. A symptom of Obsessive Compulsive Disorder is miserly spending. This is a symptom that many more people in the U.S. should have. PSYCHOLOGY CAN BE TWISTED, AND USED AGAINST NORMALLY FUNCTIONING PEOPLE. This is what often happens when a normal person visits a psychologist. The reasons the psychology occupation cannot be trusted is known to the psychiatrists. Psychiatry is the study of a person’s mind. Since we cannot prove what is happening within a person’s mind, we cannot prove that a psychiatrist is wrong. Thus, these psychiatrists whom may abuse their profession are safe from detection. More obvious is their motivation for money. They need business to make money. So, every normal person may be diagnosed with a problem, and this will cause additional patient visits and generate more money for the psychiatrists. If you do not believe this perspective, you should consult the American Psychiatric Association’s – – Personality Disorder Not Otherwise Specified. This is a disorder that is diagnosed when the psychiatrist cannot find anything wrong with a person. # s 4 and 5 above list two reasons we all need to be very skeptical of psychiatry. If an intelligent person detects corruption, that person is pooh poohed by this profession. A great example again is Bernard Maddoff who was running the biggest con in history. Harry Markopolis notified the SEC, and the SEC did nothing. A psychiatrist would have likely diagnosed Harry Markopolis as a paranoid. This diagnosis will result because the psychiatrist does not understand intelligence beyond or above the level of the psychiatrist. These people are dangerous and they seek government support.