By Molly Freeman
In President Barack Obama’s 2014 budget proposal he is asking for $235 million to fund mental health programs. A portion of that—$55 million—would go toward Project AWARE (Advancing Wellness and Resilience in Education,) an initiative that aims to identify mental illness early in young people and refer them to proper treatment.
Project AWARE is a part of President Obama’s plan to reduce gun violence in response to the shootings in Newtown, Tucson, Aurora, and Virginia Tech. While most of the plan addresses gun control laws and the security of schools, the final part deals with enhancing the US’s mental health care system.
The part of President Obama’s plan focusing on mental health stated the reasoning behind it: “While the vast majority of Americans with a mental illness are not violent, several recent mass shootings have highlighted how some cases of mental illness can develop into crisis situations if individuals do not receive proper treatment.”
Project AWARE would provide training in “Mental Health First Aid” for teachers and other adults who interact with children and young adults. The training would teach participants how to detect and respond to mental illness in young people. In addition, Project AWARE would help school districts work with local organizations, law enforcement, and mental health agencies to make sure students with mental health issues are referred to the services they need.
Other mental health initiatives working alongside Project AWARE would provide funding to train 5,000 mental health professionals to help students and young adults; help schools address the issue of violence with mental health services and violence prevention strategies; as well as start a national conversation about an increased understanding of what mental health actually means.
Darcy Gruttadaro, director of the Child and Adolescent Action Center at NAMI (National Alliance on Mental Illness,) tells BTR that she’s thrilled Project AWARE and President Obama’s other initiatives will bring some attention to mental health care.
“We are very excited that the president is working to raise the national dialogue on mental health issues and we think there continues to be stigma associated with developing a mental health condition,” Gruttadaro says.
She believes this to be an opportunity for the country to discuss and better understand that children and young adults can succumb to mental illnesses, as well as what to do to help someone in the community with mental illness secure services and support.
In regards to Project AWARE, Gruttadaro says, “The key is to initially make sure that we are identifying children who are truly struggling with a mental health condition, and then making sure they get an adequate assessment by a qualified mental health professional.”
In the US there are 20,000 children in need of psychiatric help and 7,500 board-certified child psychiatrists. While cognitive behavioral therapy is an effective treatment for children and adolescents who suffer from depression and anxiety, it is hard to find clinicians who can deliver this kind of intervention to children.
Gruttadaro explains that though medication may be necessary to help control psychosis, young people are interested in therapy to develop skills that will help them cope with the symptoms of their mental illness.
Psychiatric medication has come under scrutiny recently as another response to mass shootings. Police found medications such as Zoloft and clonazepam in the home of James Holmes, accused of killing 12 people in Aurora, Colorado last year. Adam Lanza, perpetrator of the mass shooting in Newtown, Connecticut, was rumored to be on Fanapt, an antipsychotic medication.
In her piece “Free from Harm? Reflecting on the Dangers of the White House’s Proposed ‘Now is the Time’ Gun Control Plan,” Laura Delano, a member of the psychiatric survivor movement, said she was afraid of the effect Project AWARE would have on children.
Delano tells BTR that her experiences in the mental health system from the time she was 14 had detrimental effects on her development as a person. By the age of 27 she was on five psychotropic drugs, had seriously attempted suicide, had been checked into four in-patient hospitalizations, and had no solid relationships or career paths.
“Psychiatry tells you that you can’t trust yourself and that you need to rely on your doctors to take care of you,” says Delano. “You need to set realistic expectations for yourself and you can’t handle too much stress. It’s not your fault; it’s your disease that’s causing you to do these things.”
In response, Delano says she stopped being responsible for herself. She stopped caring about anything, including her future.
“In this existential way, psychiatric labels really devastate your humanity. You forget you’re a human being; you just start to think of yourself as a list of symptoms that need to be drugged.”
Delano is concerned that the internalization of identity that can accompany a psychiatric diagnosis could especially have harmful effects on children and young adults because they’re at a crucial developmental point in their life. To be told that the problem is a chemical imbalance within the brain, and to circumvent any other causes of depression or anxiety, led Delano to lack the initiative to address the other issues in her life.
In their essay “Do Antidepressants Cure or Create Abnormal Brain States?” Joanna Moncrieff and David Cohen found through their analysis that many of the short-term effects of antidepressants can be achieved through other drugs, and that long-term usage does not lead to an “elevation of mood.”
A study posted in the journal PLoS ONE used data from the FDA’s Adverse Event Reporting System and was able to identify drugs that are most likely to be linked with violence. Out of the top ten, seven of these medications are used to treat mental disorders: five are antidepressants, two are used to treat ADHD, and one is used to treat insomnia.
Although Project AWARE and President Obama’s other mental health care initiatives may be taking a much-needed step in improving the mental health care system in the U.S., the focus it has drawn to mental health has also highlighted many glaring problems—not all of which are addressed by the president. However, President Obama has effectively brought the public’s attention to the issue and opened up a discussion about psychiatry and the mental health system.