"Treatment for Jared Lee Loughner could have made a difference -- no question," Dennis D. Embry, a licensed psychologist and head of the PAXIS Institute in Tucson, Ariz., told United Press International.
"Although Arizona has good laws that allow for mental evaluation many people don't know how to access it and there is a cost factor because some health insurance doesn't cover treatment -- for mental illness we have rationed care in the United States -- insurance companies determine how much mental health treatment a person gets, if any."
Embry said he and many at the PAXIS Institute -- which implements programs to help families and schools prevent mental disorders -- know Rep. Gabrielle Giffords, D-Ariz., and many in her office.
"As a prevention scientist and psychologist involved in violence issues as well as mental illness prevention for more than 20 years, I was certain of the profile of the shooter on the day of the shooting. He will be a young man and have a history of behavior problems that go back in time," Embry said. "He will have markers of instability, impulsiveness and ruminating or obsessive thoughts. More than likely, he will have had problems with drugs or alcohol and his school experiences will show run-ins with staff and students. The young man will likely have some political obsessions."
Watching the Sunday morning talk shows the day after the shootings, Embry took exception to many of the comments such as George Will saying on ABC-TV that of the "308 million people in America, a few of them are 'unhinged.'"
Embry, an author of more than 40 books and training materials, said the every day, presumed deranged individuals commit hundreds of isolated events, but they just don't make national headlines.
These people need treatment, but often people don't know how to approach them.
"We use what we call a 'compassionate noticing stance,' because it does no good at all to tell someone "You're acting crazy,' or 'You're delusional,'" Embry said. "Better to say, 'I've noticed you've been holding back, disengaging from people and I care for you,' and then you wait for some hemming and hawing and usually the person agrees."
This type of discussion is best done during a walk -- the person does not feel trapped as he or she may in a closed room talking over a desk, Embry advised.
"Then say, 'I wonder if something painful is troubling you?' wait for a response, and ask if he or she has ever considered finding a way to ease that pain," Embry said.
Children and teens often turn to marijuana or alcohol to manage their uncomfortable thoughts -- which can make mental issues much worse, Embry said.
"Typically, we ask, 'If we can help ease the pain how would that help you?' and usually the response is 'I could do what I have always wanted to do,'" Embry said.
"Then say, 'I've looked into some things myself to ease pain, because I am a human being too,' and give them some choices and ability to move toward treatment. Go to the National Alliance of Mental Illness and ask them for someone to work with."
However, better than getting people treatment is to prevent mental issues before they become acute.
Most Americans don't know the rate of mental, emotional and behavioral disorders has been increasing among U.S. youth for more than 20 years and the numbers are significantly higher than in 22 other developed countries, Embry said.
A 2009 report by the National Research Council and Institute of Medicine said a review of three longitudinal studies concluded nearly 40 percent of young people have had at least one psychiatric disorder by the time they are age 16 but only 21.3 percent of those 12–17 received treatment or counseling for mental, emotional and behavioral disorders in 2006.
"An increasing number of mental issues in young people are in fact preventable" the report said. "The proverbial ounce of prevention will indeed be worth a pound of cure and could potentially save billions in associated costs by avoiding or tempering these disorders in many individuals."
The report cites two proven strategies to prevent or reduce mild to serious psychiatric disorders that account for much of child psychotropic medications -- the Good Behavior Game for the classroom and the Triple P System for families.
Despite the cost-efficiency -- a marginal cost of about $15 per child in the population -- these strategies are not paid for by any healthcare plan in America, even though it easily costs $2,200 per child per year for psychotropic drugs, Embry said.
"We really don't provide prevention when it comes to mental health, we pay for medications and sometimes we pay for therapy, but we don't pay for schoolwide or communitywide mental health prevention programs even though they have been shown to be effective," Embry said.
Embry said much of this increase in mental issues in the last 20 years affecting children and teens stems from a cultural shift that has been invisible to policymakers as well as the public.
Factors such as sleep deprivation, bad nutrition, lack of exercise, substance abuse and a lack of positive reinforcement all contribute to mental health disorders, Embry said.
"It's easiest to prevent mental disorders at the lowest grade levels and while the recommendations may sound simple -- exercise an hour daily outdoors, get enough sleep, eat a good diet that includes enough vitamin D and fish body oils -- is like telling people to wash their hands to prevent physical illnesses, it sounds simple but it is effective," Embry said.
"I can show you that a physically and mentally healthy person can begin to act psychotic if they are sleep deprived and among U.S teens, sleep deprivation is an epidemic and electronic media have made it worse."
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