• Deric Hollings

Nationwide Mental Health Crisis?

[DISCLAIMER]


Qualifying Statement


Generally, I don’t care to qualify my social identity before making statements about a topic (e.g., “As a _________, I think […]”). Still, I realize that doing so has merit in some circumstances.


When addressing various topics in my blog posts, I think it’s appropriate to qualify certain aspects of my identity in such a way. For the current post, I intend on discussing my role in the field of mental, emotional, behavioral, and social health—collectively: mental health.


While my position within the field relates to that of a professional nature, mental health as a whole has largely become a socially-identified characteristic for many people. To illustrate this point, I invite you to perform an internet or social media search using the phrase “my mental health” and observe how much content is available using mental health as an identity.


Additionally, the effect of credentialism—reliance on formal credentials to determine who is qualified to discuss specific matters—results in another form of social identity. Therefore, as a psychotherapist who maintains graduate degrees in counseling and social work, as well as established mental illness diagnoses, I present this blog entry for informational purpose only.


Context


In a recent statement issued from the Biden Administration on mental health, it was declared that “our country faces an unprecedented mental health crisis among people of all ages.” A crisis may be defined as “an unstable or crucial time or state of affairs in which a decisive change is impending.”


I formerly worked in a mental health clinic as a member of a crisis intervention team. We defined a mental health crisis as an event during which all resources or intervention strategies had expired or been deemed ineffective.


An example would be a person determining suicide as the only viable option to relieve suffering, forsaking other coping skills or strategies. I imagine some clinicians, providers, or therapists may disagree with this narrow definition. Therefore, I turn to how the Substance Abuse and Mental Health Services Administration defines a crisis.


Given the ever-expanding inclusion of the term “crisis” by entities describing service offerings that do not truly function as no-wrong-door safety net services, we must start by defining what crisis services are and what they are not. Crisis services are for anyone, anywhere and anytime. Examples of crisis level safety net services seen in communities around the country include (1) 911 accepting all calls and dispatching support based on the assessed need of the caller, (2) law enforcement, fire or ambulance personnel dispatched to wherever the need is in the community and (3) hospital emergency departments serving everyone that comes through their doors from all referral sources. These services are for anyone, anywhere and anytime.


Given this information, one may conclude that the United States (U.S.) is considered by some to be in the midst of a mental health crisis. If this is accepted as the case, what may be done to appropriately and adequately address the matter?


As is oft quoted, Rahm Emanuel, who once served as President Obama’s chief of staff, has been credited as stating, “You never let a serious crisis go to waste. And what I mean by that, it’s an opportunity to do things you think you could not do before.”


Measures such as launching 9-8-8 to replace the National Suicide Prevention Lifeline 11-digit number by July 2022 are currently underway. To me, this makes since, as the Centers for Disease Control and Prevention reports that in 2020, “about one death every 11 minutes” was the result of suicide.


Also in the spotlight is President Biden’s Unity Agenda, which addresses the aforementioned crisis services as well as purportedly expanding coverage and reducing costs for mental health services, and increasing the number of mental health providers in the nation.


Additionally, President Biden signed Bipartisan Safer Communities Act (henceforth referred to as the Act). The policy is said to expand community mental health services, increase telehealth services under Medicaid, support access to mental health services in schools, and other matters.


That’s a start to addressing a crisis, right?


Perhaps there’s a need to further examine how ignorance, naïveté, or even differing definitions of mental health may lead to curious remedies said to address the proposed crisis associated with my field of practice.


A Closer Look


Policy such as a hypothetical Save All the Puppies Act may sound pleasing. Who would be opposed to such a thing?


Still, looking beyond catchy titles designed to activate emotion or provoke a sense of urgency may be useful when assessing the urgency of a mental health crisis. Moreover, using rational thinking when examining proposed remedies is what I aim to accomplish with this post.


Unity Agenda

In his 2022 State of the Union address, President Biden stated of the Unity Agenda, “And let’s get all Americans the mental health services they need — more people can turn for help and full parity between physical and mental healthcare if we treat it that way in our insurance.”


Exactly what does that mean? Let’s turn to the White House briefing room for answers. According to the Biden Administration, among other measures:


“We must fight to ensure that every American can access mental health and substance use disorder care through their insurance coverage, while integrating mental health services and supports into a variety of other settings, online and in the community.”


While I’m uncertain as to why more therapists don’t accept insurance, in a separate blog post I’ve carefully highlighted why I choose not to. For more information, you’re invited to read Insurance Coverage and Lengthy Wait Times.


“The President’s fiscal year 2023 (FY23) budget will propose that all health plans cover robust behavioral health services with an adequate network of providers, including three behavioral health visits each year without cost-sharing.”


As a Rational Emotive Behavior Therapy (REBT) clinician, I’m trained to quickly engage clients within the first session. Nonetheless, building therapeutic rapport is something that often takes more time than a single session.


Per one REBT provider, “I generally suggest two or three weekly sessions at the start.” Another source suggests “most REBT clients require only 10 to 20 therapy sessions to accomplish their treatment goals.”


What can be done with President Biden’s proposed three sessions per year?


“To maintain continuity of access, the Administration will work with Congress to ensure coverage of tele-behavioral health across health plans, and support appropriate delivery of telemedicine across state lines.”


Perhaps one place to begin with this proposal is explaining why it’s considered legal and ethical for me to treat a client using teletherapy in Texas, though if I do so in the surrounding states of New Mexico, Oklahoma, or Louisiana, I’ve somehow violated rules associated with imaginary geographical lines.


Bipartisan Safer Communities Act

Among other matters, a summation of the Act purports the following:


“Provides additional funding to the FBI to administer new process checks in NICS [National Instant Criminal Background Check System] and grants to help states upgrade criminal and mental health records therein.”


There is reasonable skepticism of the government being able to collect and maintain mental health treatment records of citizens. For instance, the Department of Veterans Affairs and Social Security Administration have been accused of maintaining records of U.S. citizen “financial incompetence with restricting the 2nd Amendment rights.”


Under 18 U.S.C. § 922(d), it is unlawful for any person who “has been adjudicated as a mental defective or has been committed to any mental institution” to own or possess a firearm. My examination of the term “mental defective” leads to extensive results.


According to the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF), the following mental health elements restrict access to firearms—with noted affirmative defenses:

· a person presenting as a danger to self or others

· one who lacks the mental capacity to manage one’s own affairs

· a person who is found insane by a court in a criminal case

· one who is found incompetent to stand trial or not guilty due to a lack of mental responsibility

· an individual who has been involuntarily committed to a mental health institution

· one who is involuntarily committed to an institution for other mental health purposes

· a person involuntarily committed to an institution for drug use


Per another source, there are said to be a number of myths related to the Act, as the resource expresses the following:

· This does not create a national, federal red flag law

· This legislation does not require or incentivize states to adopt red or yellow flag laws

· This bill would force states with red flag laws to adopt due process procedures, such as the right to an in-person hearing and an unbiased adjudicator, before they could spend any grant funding on those programs

· In order to have a firearm taken away, a person will first have [to] go through an adjudicatory process

· The bill does not mandate mental health checks

· Unless you are convicted of domestic violence, this will have no impact on your gun rights

· Even if you are convicted of misdemeanor domestic violence against a non-spouse, you will automatically get your gun rights back five years after the end of your criminal sentence


You may wonder why I’ve chosen to focus on Second Amendment-related matters in a post about a mental health crisis. After all, I’ve been reliably informed that “mental health is about feeling good,” not scary pew pew sticks.


I have two responses to that line of thinking. One, as an REBT practitioner, I’m not concerned with helping people feel better. I help individuals get better.


Put another way, one source appropriately states, “Clients often think that therapy consists of pouring out one’s heart to the therapist and receiving sympathy. ‘Sympathy from a therapist or cathartic expression of one’s emotions can help clients feel better, but it does not teach them the skills to get better... [Y]ou have friends to help you feel better, and you have a rational emotive behavior therapist to help you get better.”


Two, aside from fear of a diagnosis impacting security clearances or state licenses, prospective clients often ask me about the potential of sociopolitical or legal unintended consequences of treatment. This includes the impact on both enumerated and unenumerated rights.


Consider the Supreme Court of the United States having recently issued a decision in the Dobbs v. Jackson Women’s Health Organization case. Many people believed they had an unenumerated right to abortion.


What was the response of many U.S. citizens concerning a challenge to the Roe v. Wade case? Some people began to draw comparisons between abortion and gun rights. For more information on my response to the decision, I encourage you to read my blog post entitled Controversy and Challenges to REBT.


For the sake of the current post, I will set aside the very clear language of the Second Amendment that in part states, “[T]he right of the people to keep and bear Arms, shall not be infringed.” After all, this is a post about mental health and not sociopolitical or legal matters.


Rather, I would like to expand upon what some people interpret from the Act, as it relates to red flag laws. This matter has been addressed by a number of my clients.


Because I practice in Texas, I will address the possible issues associated with the Act, though we currently do not have red flag policy in this state. Per one source, the Act will “close the loophole for those convicted of domestic violence misdemeanor crimes.”


Wonderful, right?


When you think of domestic violence/intimate partner violence (DV/IPV), what comes to mind? This was a major consideration in the John C. Depp, II v. Amber Laura Heard case. I have a lot I would like to say regarding this matter, though it’s better suited for a later time and format.


According to the ATF, in part, a “misdemeanor crime of domestic violence’ is an offense that: Is a misdemeanor under federal, state, or tribal law.” What qualifies as a DV/IPV misdemeanor crime in Texas?


Per my ignorance-informed perspective, DV/IPV is covered under Texas Penal Code, Title 5, Chapter 22, § 22.01 and reportedly applies to “assault against a family member, household member, or a current or past dating partner.” As well, there are noted consequences within the state for guilt related to this form of abuse.


Seems fairly straight forward, right?


Per one source, “Assault can also include poking someone in the chest during an argument, getting in someone’s space, or brushing up against a person in a sexually suggestive manner.” I wonder how many people reading this blog entry have ever gotten into someone else’s space.


Moreover, I’m curious about what elements may apply to you regarding how DV/IPV is characterized elsewhere. We may even place you aside, dear reader, and determine how President Biden—who has called for action regarding the mental health crisis—measures up.


Though not necessarily a criminal matter in Texas, one source lists further elements some people associate with DV/IPV emotional and economic abuse. Among these are:

· The individual name calls or demeans you – See Parker & Scherer

· The individual denies that certain events, discussions, arguments, etc. ever occurred and tries to make you appear to be mentally unstable – See Feuer

· The individual wants access to your phone, passwords, social media, email, and etc. – See Lockhart & Moran

· The individual prevents you from going to work – See Finnegan

· The individual decides when and how you can use cash, bank accounts, or credit/debit cards – See Gleason

· The individual requires justification for any money spent – See Heltman


I carefully selected each of the aforementioned examples and respective references, because each of them applies to President Biden—the individual promoting a mental health crisis and associated remedies.


Conclusion


Though a Save All the Puppies Act may serve as a seemingly well-intentioned policy, the fine print may promote saving doggos from neighbors so that they may be placed in an overcrowded animal shelter. Imagine it’s your pupper we’re talking about here.


Think what you will about the man and his legacy, Ronald Reagan may have been on to something when he stated, “The nine most terrifying words in the English language are: I’m from the Government, and I’m here to help.”


The U.S. government has a habit using hyperbolic rhetoric to stir emotions for calls to action. Consider the following:

· War on poverty – How goes the struggle among socioeconomic classes, houselessness, unemployment, etc. that was addressed in 1964?

· War on drugs – Have we prevailed in a fight against substance use, abuse, and dependence since 1971?

· War on terror – Think about how well almost two decades of invasion and occupation in the Middle East turned out, with Joe Biden’s disastrous withdraw from Afghanistan, as conflict with an unidentified ideological foe was declared in 2001.


Is the U.S. government and its proposals outlined herein truly the action you want to address a so-called mental health crisis? You may support a compilation of sensitive mental health records or efforts to deprive inalienable rights for persons other than yourself.


Nonetheless, I wonder whether or not you would want a leader—whose policies thus far allegedly align with traits of DV/IPV—to be entrusted with revoking your enumerated or unenumerated rights, based on whether or not you sought treatment for a mental health condition, or if you got into someone else’s space.


Is that an answer to a crisis or creation of one?


In Formula One, it is said that a “red flag is shown when there has been a crash or the track conditions are poor enough to warrant the race being stopped.” When it comes to governmental meddling in the lives of my clients, it’s time to wave a figurative red flag.


If you’re looking for a provider who values your liberty and freedom, while also advocating for your mental health needs, I invite you to reach out today by using the contact widget on my website.


As a psychotherapist, I’m pleased to help people with an assortment of issues ranging from anger (hostility, rage, and aggression) to relational issues, adjustment matters, trauma experience, justice involvement, attention-deficit hyperactivity disorder, anxiety and depression, and other mood or personality-related matters.


At Hollings Therapy, LLC, serving all of Texas, I aim to treat clients with dignity and respect while offering a multi-lensed approach to the practice of psychotherapy and life coaching. My mission includes: Prioritizing the cognitive and emotive needs of clients, an overall reduction in client suffering, and supporting sustainable growth for the clients I serve. Rather than simply helping you to feel better, I want to help you get better!


Deric Hollings, LPC, LCSW


Photo credit, fair use



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