Addressing Violence With Social Programs

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Addressing Violence With Social Programs

The cost of social welfare programs for mental health is high, but so is the price we pay for not offering them.

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This is a very hard topic to have a reasonable discussion about. It's hard to bring up, which makes it very difficult to even see how to find a solution.

I actually know someone who was sent to an institution for a short period of time. Originally he was going to be released due to a problem with his insurance. That was settled, and they were going to keep him even longer. He went to the staff MD to see about a rather bad swelling on his leg, and the doctor immediately dismissed it. Two days later there was a state inspection, and he, along with two others who were medically mistreated were discharged the morning before. His first action was to go to the local ER and be treated for his brown recluse bite. He is now part of a lawsuit against the institution that ignored the problem.

It doesn't help that it's hard enough to discuss, but when you realize that proper treatment isn't given, it actually makes it even worse.

Thank you for writing this. I've had more than my fair share of friends end their lives because they were unable to find adequate mental health care, despite actively seeking it out over a long period of time. Eventually they just became hopeless...

In college my friend made the mistake of telling the University that he was severely depressed and considering suicide. They removed him from school and informed him that he would not be welcome back, worsening his depression and eventually resulting in the fulfillment of his death wish. Later I discovered that the school has a policy of removing "at risk" students. They see it as a liability. Better that he killed himself privately, that way they're not responsible.

Anyway... I just wanted to say... yes I agree that this is a huge issue and I'm grateful that more light is being shed on it here. Hopefully some awareness could eventually save a life or two.

I think this was an amazing quality column. Great read!

Glad to see Dr. Mark back on the site :)

Going to echo the welcome back to Doctor Mark. Enjoy the quality of writing and the insight he provides.

On the actual topic.. while the event is absolutely devastating, the real tragedy is that it is not unique. It has happened before, and may happen again. There are a number of factors that contribute to these events, all of them difficult to deal with and address. Mental health and dealing with it, gun control, outside influences, and whatever else came to bear on the outcome. Absolutely mind boggling, where does one begin?

I'm sorry man. It must be hard hearing that kind of thing from your mother. I get a bit of that from loved ones too. But I think it's important to plant seeds of truth rather than beat them with the full grown tree. It's hard to know how to do that though.

Mark J Kline:
Addressing Violence With Social Programs

Some will point to gun availability as the problem. Others will wonder if the perpetrator was bullied or humiliated. Some will think the problem was laxity in school security protocol. Some will look to problems at home. Some will reflect on the young man's chronic mental health issues.

But, of course, all of these perfectly reasonable contributors to the problem at hand (which could be accompanied by over-glorification of violence in media) are ignored, for the most part, by the public. The news media wouldn't dare try and look to PRIMARY sources of aggression! No! They have to fight competitors!

I hadn't considered the effect of America's healthcare system on those who could require being institutionalised. This does seem to be a clear case where it's extremely difficult to rely on private business to care for these people, given a lot of the mentally ill may not be financially stable.

Nasrin:
Thank you for writing this. I've had more than my fair share of friends end their lives because they were unable to find adequate mental health care, despite actively seeking it out over a long period of time. Eventually they just became hopeless...

In college my friend made the mistake of telling the University that he was severely depressed and considering suicide. They removed him from school and informed him that he would not be welcome back, worsening his depression and eventually resulting in the fulfillment of his death wish. Later I discovered that the school has a policy of removing "at risk" students. They see it as a liability. Better that he killed himself privately, that way they're not responsible.

Anyway... I just wanted to say... yes I agree that this is a huge issue and I'm grateful that more light is being shed on it here. Hopefully some awareness could eventually save a life or two.

I am truly sorry to hear about that situation. I wish we, as a society, would start to treat mental illness more like Pneumonia or a broken bone. No Doctor would just ignore the problem and immediately discharge someone.

I take hope that the US Military is getting better about mental combat stress related injuries (PTS and PTSD). Commanders could lose their command now for pulling what Gen. Patton did (long story short, he should have been striped of his rank and command). I am hopeful this translates to society as a whole in a few years, as Americas Soldiers join the workforce.

I have actually stayed in a mental hospital before, which I wrote about on this website here : http://www.escapistmagazine.com/forums/read/18.247024-Ask-a-guy-who-just-spent-a-week-in-a-psych-ward-anything?page=3#9066756

So, whenever mental health is discussed in any sense it always catches my eye and my interest. I found your piece to be very well written and sensible, I kind of wish I could sit down with you and talk about my own problems.

Thanks for this article, I agree that more could and should be done, it's no excuse to blame costs, especially in America with the funding the military receives.

It's very good to see you back Dr. Mark, and I greatly appreciate you taking the time to provide insight on the real issues at hand here. It feels sometimes like there's a stigma in the media to delve into mental illness as a topic of discussion, maybe due to a lack of sensationalism or out of fear that humans just might be capable of things like this on their own. It actually disturbs me that much of modern society hasn't advanced enough to quit blaming entertainment. There's real problems that require real solutions, and talking heads spouting off political agenda on TV does nothing but insult those we lose in tragedies like these.

Regarding the last question asked: yes, it appears we can afford to avoid them. How many people die a year in America from mass killings? How many millions of dollars are you willing to spend to avoid that many deaths? How do the above numbers stack up to other avoidable deaths caused by exposure or hunger? Are those kinds of death less or more expensive to prevent than providing universal mental health care? Lastly, of all the mas murderers in America, how many would have been confined to an institution before the murders?

"A viable social welfare safety net should include access to a continuum of mental health care, ranging from long-term inpatient hospitalization, to shorter term community inpatient care, to supported residences, to intensive day treatment programs, to outpatient services including psychotherapy and medication. This care should be available to both children and their families, as parents are often stressed and overwhelmed by the task they face."

Okay, obviously I'm no expert, but that sounds really, really, really, really... expensive. As in, way too expensive to happen any time soon kind of expensive.

Besides, aren't you folks already facing severe difficulties just getting any kind of government-funded health system into action?

Zhukov:
"A viable social welfare safety net should include access to a continuum of mental health care, ranging from long-term inpatient hospitalization, to shorter term community inpatient care, to supported residences, to intensive day treatment programs, to outpatient services including psychotherapy and medication. This care should be available to both children and their families, as parents are often stressed and overwhelmed by the task they face."

Okay, obviously I'm no expert, but that sounds really, really, really, really... expensive. As in, way too expensive to happen any time soon kind of expensive.

Besides, aren't you folks already facing severe difficulties just getting any kind of government-funded health system into action?

Yeah. It'll be extremely challenging to get any kind of "social welfare" spending package approved, especially in regards to health care, the way our government has been running.

Nasrin:

In college my friend made the mistake of telling the University that he was severely depressed and considering suicide. They removed him from school and informed him that he would not be welcome back, worsening his depression and eventually resulting in the fulfillment of his death wish. Later I discovered that the school has a policy of removing "at risk" students. They see it as a liability. Better that he killed himself privately, that way they're not responsible.

I'm severely disgusted and angered to read this. What an absolutely appalling policy. ugh!

Zhukov:
"A viable social welfare safety net should include access to a continuum of mental health care, ranging from long-term inpatient hospitalization, to shorter term community inpatient care, to supported residences, to intensive day treatment programs, to outpatient services including psychotherapy and medication. This care should be available to both children and their families, as parents are often stressed and overwhelmed by the task they face."

Okay, obviously I'm no expert, but that sounds really, really, really, really... expensive. As in, way too expensive to happen any time soon kind of expensive.

Besides, aren't you folks already facing severe difficulties just getting any kind of government-funded health system into action?

Such a system already exists in some countries. And yes it is indeed very expensive. Whether it works or not is difficult to determine, but it costs a LOT of money.

"Our system goes to great lengths to protect the individual from unwarranted incarceration in a psychiatric facility, but does it do enough to protect the rest of us from people who need to be in a safer place?"

I think the first condition takes precedent over the second, a position society and constitutional law seems to back up.

That being said I have always thought our availability of treatment for mentally ill individuals is woefully inadequate. Even with good insurance, through Kaiser Permanente, the best you could do with the mental health department was one appt. every three weeks. Pitiful. Many, many people in this country have ZERO access to mental health treatment and those people are usually the people who most desperately need it.

I can only hope the Affordable Care Act changes some of this. Mental health is just as important as physical health when it comes to living a healthy and happy life.

We do still have a place for people with mental illnesses to go here in the states, we call it prison because we are stupid. Allow me to explain, we are more than willing to put money into prisons to punish people who might have done things because of mental illness but we are unwilling to spend less to treat them before hand, partly because we have this weird idea that if we do that then we are enabling them and they are somehow getting something for free but we love to pay to punish people.

90sgamer:
Regarding the last question asked: yes, it appears we can afford to avoid them. How many people die a year in America from mass killings? How many millions of dollars are you willing to spend to avoid that many deaths? How do the above numbers stack up to other avoidable deaths caused by exposure or hunger? Are those kinds of death less or more expensive to prevent than providing universal mental health care? Lastly, of all the mas murderers in America, how many would have been confined to an institution before the murders?

You are making the mistake of assuming that preventing mass killings is the only benefit a society might get out of good mental health care. In reality that, if it is even true, would be only one of the smallest benefits to society.

vxicepickxv:

It doesn't help that it's hard enough to discuss, but when you realize that proper treatment isn't given, it actually makes it even worse.

Mental Health Care in America really does suck.

It reflects our general attitude towards it, though.

Mygaffer:

I can only hope the Affordable Care Act changes some of this. Mental health is just as important as physical health when it comes to living a healthy and happy life.

At the very least, it removes lifetime caps.

Nasrin:
In college my friend made the mistake of telling the University that he was severely depressed and considering suicide. They removed him from school and informed him that he would not be welcome back, worsening his depression and eventually resulting in the fulfillment of his death wish. Later I discovered that the school has a policy of removing "at risk" students. They see it as a liability. Better that he killed himself privately, that way they're not responsible.

I actually agree with the college's stance, although not for reason of liability. The key ingredient for treatment of potential suicides and many other mental illnesses is a strong support system. Most people at college are far away from home, family, friends and everything familiar. Sending them back to familiar surroundings and people who love and care about them makes sense, although they should also see a mental health professional.

OT: As much as believe in minimalist government and preventing government from acting outside of its intended purpose, establishing and maintaining a system of mental health care as outlined in the article is one of the areas I think that the public should bite the bullet and allow government pay for. It is too expensive for most average families to support a family member that needs long term care, whether that includes institutionalization or just regular outpatient visits and medication.

The truth though is that having the best mental health care in the world that treated all mental illness would only lower violent crime by about 5%. Mental illness is not a major determinant for violence

source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/

So basically, yay for the American health care system again?

Anyway this is rather silly. How many parents would actually ever accept the fact that their kid is a future mass murderer? You can have all the clues and parents won't see it, either because they don't want to or because in the current economy, they just don't have the time to notice. Nope, if your kid goes on a rampage, just blame GTA IV.

I agree it seems that there is no one thing that you can point fingers at for violent acts like this, its many things.

First you have a base which usually is a mentally unstable individual. You add things like a abusive house hold or severe bullying at school. You add things for them to fantasize about by giving them video games, movies, television shows, books, etc. After a while the fantasy isn't good enough and then they turn to opportunities. This can be a weapon from as simple as a knife to as complex as a bomb depending on the intelligence of the individual. Give them a situation to fill out their fantasies and you have the Connecticut shooting.

Its exactly out of the serial killer playbook too... funny connection there, never realized it.

NOTE: As I said violent video games wont turn a normal kid into a killer. Only people who fantasize about killing their classmates will see a fps and imagine their classmates dying instead of the "aliens" or whatever.

I think there's a lot we could be doing as a society to help people with mental health issues, we don't do enough here in canada either. then there's also the problem of getting youth out of violent activities by providing social programs and sports programs (those actually work) in my city one Councillor (who is absolutely stupid) opposes allocating $300,000 for new programs at a community center in one of our "Ghettos" but is perfectly willing to spend more on arresting prostitutes for "Jaywalking" or having a truck driving around the city to neuter stray cats.

$300,000 isn't that much, and it might prevent some young girls from turning to prostitution, as well as curb gang violence.

the problem with a lot of people is that they can't get their priorities sorted out, or have the wrong ones to begin with. If we want to prevent more Sandy Hooks, columbines, or gang related violence, then we need to seriously reevaluate the way we look at social programs and mental health issues.

though it's easier to blame the things we don't like, and i fear another oppertunity to fix some of the ills in our world will be lost among useless rhetoric and political posturing.

I've had this issue affect me on a personal level back when I was having issues in high school. Now, it wasn't a big issue compared to the next guy, and it might go off in a tangent only congruent to this issue but in my state of being, I thought that my behavior, my mental health, would eventually lead to the harm of myself or others around me. There was a constant threat to bullying in my High school for me that was nearly unavoidable, suffice to say, it got the better of me. I sought out psychiatric help to cope with my problems; regularly the facility I had gone to dealt with substance abuse, but also provided a place to treat those with mental illness and mental health issues. After one visit, I received a tremendous bill for the small hour session I had been given. Nothing had changed, nothing had been told or given to me to help improve my status; it ended up being me telling a professional psychiatrist about all the troubles I had been having for an hour for several hundred dollars.

From then on, it became a bizarre question that I don't think anyone should have to have: "Can I afford to be sane?"
I never did go back to that place, but it taught me that the value of ones own mental health in this day in age might be something that not everyone can afford.

. . . Or maybe I'm just a little emo bitch talking out of my ass here. . .you be the judge, everyone else has.

taciturnCandid:
The truth though is that having the best mental health care in the world that treated all mental illness would only lower violent crime by about 5%. Mental illness is not a major determinant for violence

source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/

You know I had been wondering how much of an effect mental illness really has on violent crime with all of this talk about it going on lately.

I find myself in this weird position of being a patient, as it were, of the mental health care system of the US and seeing the other side of it. My mother and her husband both work in the mental health field, a social worker and a private practice therapist repetitively, so I see their struggles on that end as well. Whenever I feel frustrated at the system, at my last therapist no longer taking my insurance, I was told that those in private practice are paid roughly 50% less by insurance than what they normally would/should charge. They too also need to afford their own health insurance, ironically.

Then, on a daily basis, I see my mother work at a hospital, doing admissions and discharges for the psychiatric ward, working the best she can to see families, to see patients, to see doctors, to call health insurance companies and all for the patient's benefit. More than 75% of the time she can't accomplish all of these things for the 1-6 patients she deals with on a daily basis and the regret is clear as day. And that's just the floor she mainly works on, voluntary.

Is everyone getting adequate mental health care? No. Should they? Absolutely, 100% yes and there is a solution. Forget the cost. This article was informative enough but, for the public at large, most don't understand that mental health care is not something those in need can pass up, it's required to live. Give people care and, maybe, they'll be able to function. At times, that's the best some can hope for.

I'm lucky in that I at least have access to a psychiatrist (my insurance labels it as a doctor's visitor and therefore falls under "health" not "mental health"), but the cost of finding a therapist is still high. Not to mention any medications one might need. I only wish that my mother could care for her patients better, that my step-father could get more from insurance, and that everyone could see a therapist. I think we've all needed one, at some time or another.

As for violence in video games and mental health...it's strange seeing catharsis coming up in these debates when it was previously doubted as reliable means of letting go of aggression and anger. I certainly use it that way, Quake 3 used to be perfect, but I know the difference. Teach kids at an early age -- for the most part they understand what is right and wrong -- and maybe our world will be a better place. Or, maybe, it won't. Doesn't mean we shouldn't try.

However, on another glance at this, I realize one thing that hasn't been brought up regarding video games: self-isolation. Just a point for discussion.

i found this article to be delightfully informative.

it's difficult for me to comment intelligibly on social issue: any of them. pick one. the simple fact is that i just don't understand enough about them to have a reliable opinion. but i do know this: i know what i want. i usually stop there because what i want does not necessarily coincide with what i need or with what we need as a civilized society.

but if you were to press the issue a bit, i think my answer might be along the lines of, "we are asking the wrong questions and we can't agree on a goal."

Mygaffer:

90sgamer:
Regarding the last question asked: yes, it appears we can afford to avoid them. How many people die a year in America from mass killings? How many millions of dollars are you willing to spend to avoid that many deaths? How do the above numbers stack up to other avoidable deaths caused by exposure or hunger? Are those kinds of death less or more expensive to prevent than providing universal mental health care? Lastly, of all the mas murderers in America, how many would have been confined to an institution before the murders?

You are making the mistake of assuming that preventing mass killings is the only benefit a society might get out of good mental health care. In reality that, if it is even true, would be only one of the smallest benefits to society.

Well said. I did not acknowledge that there are other benefits. What are they? Mind you, I am not interested in the health and wellbeing of individuals. What I am interested in is the benefit to society as a whole. I feel welfare and similar social programs are justified because the expense of not providing those programs is even greater. I can't think of how a mental care program will save us money, therefore, on to you, Mister, to provide some input.

90sgamer:

Mygaffer:

90sgamer:
Regarding the last question asked: yes, it appears we can afford to avoid them. How many people die a year in America from mass killings? How many millions of dollars are you willing to spend to avoid that many deaths? How do the above numbers stack up to other avoidable deaths caused by exposure or hunger? Are those kinds of death less or more expensive to prevent than providing universal mental health care? Lastly, of all the mas murderers in America, how many would have been confined to an institution before the murders?

You are making the mistake of assuming that preventing mass killings is the only benefit a society might get out of good mental health care. In reality that, if it is even true, would be only one of the smallest benefits to society.

Well said. I did not acknowledge that there are other benefits. What are they? Mind you, I am not interested in the health and wellbeing of individuals. What I am interested in is the benefit to society as a whole. I feel welfare and similar social programs are justified because the expense of not providing those programs is even greater. I can't think of how a mental care program will save us money, therefore, on to you, Mister, to provide some input.

You may not care about the well being of individuals but I do. If someone you know or you yourself are affected by mental health that attitude may change. But neither of can know that today.

In any case I do not want to live in a society where I walk by homeless and mentally ill people every day, it brings me down. I live and work in a nice area, Contra Costa county but right by where I work there are several homeless people, several of them mentally ill. It brings down my standard of living seeing that human suffering every day.

Due to my experience with mental health I know that a lot of smart, driven and talented people can be brought low by mental health issues. Many of those people could directly contribute to society with proper treatment. Look at Howard Hughes, a driven man who accomplished a lot that ended up peeing in jars locked in a hotel room. Bottom line I put a lot of weight behind this statement, "A nation's greatness is measured by how it treats its weakest members."

EDIT: In any case it does not matter at this point, the mandate is health care for everyone, the only thing left to see is the extent to which mental health services will be made accessible.

Mygaffer:

90sgamer:

Mygaffer:

You are making the mistake of assuming that preventing mass killings is the only benefit a society might get out of good mental health care. In reality that, if it is even true, would be only one of the smallest benefits to society.

Well said. I did not acknowledge that there are other benefits. What are they? Mind you, I am not interested in the health and wellbeing of individuals. What I am interested in is the benefit to society as a whole. I feel welfare and similar social programs are justified because the expense of not providing those programs is even greater. I can't think of how a mental care program will save us money, therefore, on to you, Mister, to provide some input.

You may not care about the well being of individuals but I do. If someone you know or you yourself are affected by mental health that attitude may change. But neither of can know that today.

In any case I do not want to live in a society where I walk by homeless and mentally ill people every day, it brings me down. I live and work in a nice area, Contra Costa county but right by where I work there are several homeless people, several of them mentally ill. It brings down my standard of living seeing that human suffering every day.

Due to my experience with mental health I know that a lot of smart, driven and talented people can be brought low by mental health issues. Many of those people could directly contribute to society with proper treatment. Look at Howard Hughes, a driven man who accomplished a lot that ended up peeing in jars locked in a hotel room. Bottom line I put a lot of weight behind this statement, "A nation's greatness is measured by how it treats its weakest members."

EDIT: In any case it does not matter at this point, the mandate is health care for everyone, the only thing left to see is the extent to which mental health services will be made accessible.

Thank you for the reply. It would seem that your position is based on an emotional response to the visual presence of homeless and mentally ill (how do homeless fit into this topic? They seem unrelated). You touch on a more practical concern regarding lost productivity as well. I must disagree with the emotional component and the claim of lost productivity.

Emotions have no place in legislation, especially legislation as broad an expensive as a national mental health care plan. Emotional responses are meant to guide your immediate survival, but are not a sound basis for long term planning.

Lost productivity is regarded as a slippery argument to make because it applies to so many things. Abortion: you can't abort fetuses because you might be killing off what could be a contributing adult. Death Penalty: many criminals are highly intelligent. We should focus on rehabilitation, pardons, then allow them to be contributing members of society. Immigration: We should let whoever comes into the country be a citizen, find work and pay taxes. Who knows how many immigrants will be intelligent and productive? Public education: Every citizen should receive free or subsidized higher education. Many people who are too poor to afford enrolling in a university have a very high potential. Welfare: People could be contributing adults if we just eased the burden of their existence to such a degree that instead of working two jobs they can work just one, while going to school part time. We'll pay for school too, as noted above. Health Insurance: So many people die a year or are unable to be productive because of illness. Of those that die, some were or could have been productive. Therefore, we should foot the bill for all or most medical expenses.

Obviously we have to draw the line at where "lost potential" is no longer a valid reason to do things, otherwise you'll be footing the bill for every else's education, kids, healthcare, mental care, and supplemental income. I propose we never accept that argument. It's largely hypothetical, which makes a cost-benefit analysis (ratio of dollars spent to productivity gained from treated individuals) impossible.

In response to your edit: just because there is currently a law that mandates health care does not make subsequent discussion of the subject "not matter." Laws change frequently.

While there are always many factors at play when it comes into mass-shootings; from ease of access to weapons, mental state and previous mental factors (bullying, learning disability, abuse) and the final emotional trigger and motivation; I still believe the number one culprit is the "News Media".

On some level, the people whom commit these acts, and by making such a gut wrenching act violent act of defiance against the system that they feel is against them, are still trying to reach out for help by making this public statement/display of violence. It's a morbid cry for help. They see the only course of future actions to stop what ever happened to them doesn't happen to anybody else; is to make themselves known, as loudly and largely known as possible.

The News Media makes this possible.

The News Media will display the shooters face all over the public internet and news channels for days. They will say his name a hundred times a day. They will rank his "achievement" in number of kills verses other mass shooters kill numbers. They will describe the manner in which every person they shot was killed; how long it took from the moment they knew they were in trouble, to dying, and perhaps, how long it took that person to die (instantly, hours..). They will plaster hours of "survivor stories" on to the air, asking those people to recounting how they felt, knowing that they too were so close to dying, but somehow, didn't.

The News Media gladly gives mass shooters metaphorical achievement scores on how well you did; by rewarding your act with more air time the "better" your crime was. Shooting a bunch of people at a mall? that's anywhere from Bronze, Silver or Gold depending on the body count before you self-out. But school children, 6-7 years of age, and their teachers; That's a News Media Double-Platinum Trophy right there.

And yet, ironically, again, the real message behind the mass shooting, the pure rage behind the act, is sweeped under the rug. Its easier to blame a un-tangable object that is obscure and still felt/looked at with reserve by most of the populace instead of trying to make understanding of the real message. Because its not the reason that matters, its the end result and the who. The News Media tries to say they care about the why.. but they know they don't care, because the why never sells the ratings.

And thus, the cycle will continue.

90sgamer:

Mygaffer:

90sgamer:

Well said. I did not acknowledge that there are other benefits. What are they? Mind you, I am not interested in the health and wellbeing of individuals. What I am interested in is the benefit to society as a whole. I feel welfare and similar social programs are justified because the expense of not providing those programs is even greater. I can't think of how a mental care program will save us money, therefore, on to you, Mister, to provide some input.

You may not care about the well being of individuals but I do. If someone you know or you yourself are affected by mental health that attitude may change. But neither of can know that today.

In any case I do not want to live in a society where I walk by homeless and mentally ill people every day, it brings me down. I live and work in a nice area, Contra Costa county but right by where I work there are several homeless people, several of them mentally ill. It brings down my standard of living seeing that human suffering every day.

Due to my experience with mental health I know that a lot of smart, driven and talented people can be brought low by mental health issues. Many of those people could directly contribute to society with proper treatment. Look at Howard Hughes, a driven man who accomplished a lot that ended up peeing in jars locked in a hotel room. Bottom line I put a lot of weight behind this statement, "A nation's greatness is measured by how it treats its weakest members."

EDIT: In any case it does not matter at this point, the mandate is health care for everyone, the only thing left to see is the extent to which mental health services will be made accessible.

Thank you for the reply. It would seem that your position is based on an emotional response to the visual presence of homeless and mentally ill (how do homeless fit into this topic? They seem unrelated). You touch on a more practical concern regarding lost productivity as well. I must disagree with the emotional component and the claim of lost productivity.

Emotions have no place in legislation, especially legislation as broad an expensive as a national mental health care plan. Emotional responses are meant to guide your immediate survival, but are not a sound basis for long term planning.

Lost productivity is regarded as a slippery argument to make because it applies to so many things. Abortion: you can't abort fetuses because you might be killing off what could be a contributing adult. Death Penalty: many criminals are highly intelligent. We should focus on rehabilitation, pardons, then allow them to be contributing members of society. Immigration: We should let whoever comes into the country be a citizen, find work and pay taxes. Who knows how many immigrants will be intelligent and productive? Public education: Every citizen should receive free or subsidized higher education. Many people who are too poor to afford enrolling in a university have a very high potential. Welfare: People could be contributing adults if we just eased the burden of their existence to such a degree that instead of working two jobs they can work just one, while going to school part time. We'll pay for school too, as noted above. Health Insurance: So many people die a year or are unable to be productive because of illness. Of those that die, some were or could have been productive. Therefore, we should foot the bill for all or most medical expenses.

Obviously we have to draw the line at where "lost potential" is no longer a valid reason to do things, otherwise you'll be footing the bill for every else's education, kids, healthcare, mental care, and supplemental income. I propose we never accept that argument. It's largely hypothetical, which makes a cost-benefit analysis (ratio of dollars spent to productivity gained from treated individuals) impossible.

In response to your edit: just because there is currently a law that mandates health care does not make subsequent discussion of the subject "not matter." Laws change frequently.

Laws don't change that frequently, not in this country. In any case I find your supposition that emotions have no place in lawmaking to be factually incorrect. Laws are just one way a society expresses its values. They are not made by balancing equations of cost and monetary benefit. A system of laws is enacted and enforced to enforce cultural values across a society.

One of those values is helping the sick. You seem to pretend to be an emotionless android, disregarding human suffering and "emotions meant for short term survival". Fortunately most American's do not take your same outlook on human suffering or the treatment of physical and emotional injury as a cost/benefit analysis.

Luckily in the democratic republic I live in I have many ways to try and effect our system of laws. Through polling, demonstrating, letters to elected officials, grassroots and non-profit organizations, voting, and of course through spending my money on issues and campaigns.

You may not care about seeing homeless people on the street everyday, I do. So I support policy that looks to reduce the occurrence of homelessness. The two primary conditions linked to homelessness are addiction and mental illness, although technically addiction falls under the latter category. I want to make clear that I am not just concerned about mental health issues among the homeless, I focused on that since you asked for some benefits that would arise from greater access to mental health care. Reducing instances of homelessness is one of those benefits. Homeless people are also part of our society, so your claim that my example is just an emotional response completely ignores the very real benefit to those members of society who are currently suffering from untreated mental illness. I assume you don't even consider them as part of your equation on societal benefits.

I really don't know why you would argue against increased access to mental health services though. Are you a Scientologist who thinks the whole field is quackery? Do you not think people with mental health issues deserve to have access to care? Just how big would the cost be of making more services available?

To me you sound a lot like a Tea Party member, quick to make the other guy justify his position while not offering any justification of your own position. You tell me why mentally ill people in this country should not have access to mental health services. The US already has one of the lowest tax burdens of any developed nation. So is it really a cost issue or something else?

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