Dear Fox News: SHUT UP!

Dear Fox News:

OHHHHHHH... You made me say, "Shut up!" And, that is on the long list of things my mother did not allow us to say! We were also not allowed to "contradict." It is very hard to say, "NO! That is not true!" when you are not allowed to contradict.

Can't you show some respect for the 20 children whose lives were stolen  by refraining from lying about anything to do with that? I think that would be reasonable. Lie about anything else.

Last night, Bill O. talked about a subject that I happened to know a little bit about. I treated myself to a taste of Bill O'Reilly frightening the already frighten right-wing about how "Obama"  is going to be infringing on our constitutional rights by requiring or allowing (he seemed unsure) doctors and nurses to ask patients about gun ownership.

He seemed to be implying that I go in for a PAP test. I am lying all relaxed in what my friend calls "The Flying Wallenda" position. The doctor presses forward and says, "So, Vivian, do you own a Smith and Wesson?"

This is an issue that could have been explained in about 3 minutes or less by a mental health professional. It has nothing to do with President Obama. It has nothing to do with new gun safety laws. It is relevant to discussions of mass shootings.

It does require informed opinion and expert advice -- not Bill O'Reilly.

I am going to share my understanding of mental health practice from my own experience. This is not mental health nor legal advice -- obviously! This is the internet!

PLEASE be aware than most mass murderers are not mentally ill although there are exceptions.

PLEASE be aware that most mentally ill people are not dangerous and are more likely to be victims of crime than to commit crimes. The term "mental illness" encompasses such diagnoses as depression and anxiety.

PLEASE be aware that such dangerous characters as "sociopaths" are not what we think of as "mentally ill." They know who they are, where they are, what is happening, and what they are doing. And, most sociopaths never commit murder.

So, I am not an expert in mass murder. I worked for some years as a Psychiatric Social Worker. I have worked in a private hospital, a state hospital and a university hospital in 3 different states and in an out-patient clinic. I haven't worked in awhile, but most fundamentals have remained the same. I have clarified this information with an independent party who concurs with the facts.

First.  Mental health practitioners already have a duty to restrain patients who are a danger to themselves or others and a duty to warn 3rd parties of danger. This has been acted upon every where that I have ever worked in every state that I have ever worked since I began working decades ago.

Mental health practitioners are not clairvoyant but, if there is evidence that a patient is mentally ill and  an imminent danger to themselves or others, that knowledge will be acted upon. 

This doesn't mean that every creepy jerk in the community can be detained.

[However, people are often shocked to find out that it isn't illegal to be mentally ill. If a person is mentally ill but is not dangerous to themselves or others, they cannot be detained.]

In the real world, this would mean that if, in private psychotherapy practice, a client told a therapist that he was thinking of committing suicide, the therapist would do a very in-depth interview about any suicidal thoughts & plans which would include asking how s/he was contemplating suicide, if s/he owned any weapons, and detailed information about them. 

This is standard operating procedure and has been for decades. A therapists would also ask for a  contract from the person not to harm themselves in anyway whatsoever. This is also SOP.

If the patient were determined to be suicidal, the police and crisis intervention would be called and a court order obtained for the patient held for an assessment.

If the person were in the hospital, a court order would be obtained to keep the patient for further observation.

If a patient made threats toward another person, in an hospital setting or a clinic setting, likewise the mental health practitioner would pursue that in-depth in an interview to determine if it were a casual comment ("I'm just so mad I could...") or if the individual is thinking about it realistically.  If the patient is mentally ill and a danger to others, then the legal steps would be taken to carry out the duty to restrain and the duty to warn the 3rd parties.  

This has been a SOP for decades and has nothing to do with President Obama or with new gun safety laws. 

MY GENERAL PREFERENCES: (These are just my never humble recommendations and many people will disagree.)

Psychotropic medication should be prescribed by and people with with mental health problems should be treated by experts in the field of mental health -- and not by primary care providers. I might make the exception for someone experiencing a short depression with no complications. Obviously, many people disagree with me and family practitioners, internists, pediatricians, etc. all prescribe psychiatric medications.

Children with ADD, ADHD or other disorders being treated by pediatricians or other primary care providers should be seen by mental health providers if the problems are not quickly and fairly easily resolved. Again, many people disagree with me on this.

All children and teens who are having significant problems should have a complete physical exam, a psychological evaluation, and may need a neurological exam. (Yes, my husband is a psychologist.) I understand that school systems may not recommend this because they might then have to pay for it. Yes, it is expensive. There are some less expensive screening tests. 

The assessment children get at school is an educational assessment -- NOT a psychological evaluation. It will not reveal your child's psychological problems -- or lack of problems. The psychologists employed by schools are not clinical psychologists.

If you or your child has serious mental health problems, make sure you are seeing someone in therapy with a background in psychiatry/mental health and not just in problem solving counseling. Ask! 

There is a pervasive view that we have too many people receiving too much medication and too much treatment. I suspect that we have too many people seeing the wrong practitioners, receiving too little assessment and receiving too little of the correct medication and treatment. JUST MY BEST GUESS!

As always, JMNHO!

With love and hope for a brighter future,

Vivian