More, More, We're Still Not Happy
Would More Mental Health Care Spending Merely Be Doubling Down On Failure?
Is this country’s approach to mental health helping or hurting people?
Are we making progress or just getting progressively lost?
In the wake of the Apalachee High School shooting, we do well to examine how we are, as a country, addressing mental health challenges within our communities. Something clearly failed in Barrow County, Georgia. We should want to figure out what went wrong and why.
The easy part about the much needed conversation this country needs on mental health is to sound the call to alarm.
Why are we not, as a society, confronting these signs and symptoms? Why are we not, as a society, realizing that our friends and our neighbors are spiralling down into crisis, even as we watch it happen? Why do we continue to rationalize and excuse inaction when people are spiralling down into crisis, only to splutter with feigned rage when that crisis then explodes all over corporate media?
There is no getting around the sobering reality that, as more details about Colt Gray’s troubled young life emerge, there were too many people simply standing on the sidelines—aware, but either not engaged or not effectively engaged.
When there are indications that Colt Gray was bullied at school in addition to being alternately abused and neglected at home, it takes no great insight or analytical brilliance to deduce that not enough happened to arrest his downward spiral.
The father added: 'It went from one thing to another... I was trying to get him on the golf team... [they were like], "Oh, look, Colt's gay. He's dating that guy."
'Just ridiculed him day after day after day.'
It is also troubling that the father was arrested for “knowingly” having facilitated Colt Gray’s violent act while others who also had knowledge of the boy’s deteriorating psychological state are not similarly being called to account.
One thing that seems absolutely certain in this entire tragedy is that such justice as it lies within the power of mere mortals to enact will be at best unevenly enacted.
It is also an inescapable reality that had there been effective mental health interventions in Colt Gray’s life as the troubles within his life mounted, this tragedy would not have occurred. That this tragedy happened at all is all by itself a damning indictment of how this country handles challenges of mental and emotional health.
However, if we are to have the much-needed conversation on mental and emotional health, we must also acknowledge the obvious reply from those who advocate for our country’s current mental health care systems: “look at all that we are doing! We’re not doing ‘nothing’!”
Let us therefore consider some of the data regarding our mental health care systems.
It is surely significant that mental health care job growth in this country is expected to outpace overall job growth a few times over.
Even social worker jobs are projected to enjoy significant growth in the coming decade.
However, we must not draw the conclusion that there is particular focus even within healthcare on mental health professions. Both the current and projected employment levels even for health care occupations within the 20 fastest growing employment sectors moderates that perception with some perspective.
In terms of percentage growth, within those same fastest growing occupations, the mental health professions are not the one’s growing the fastest. Far from it.
As we can see from just the fact that the same data which projects 19% growth in mental health jobs over the next decade projects 40% growth in nurse practitioner jobs establishes that there is far from a concerted push for expanding mental health services in this country.
Health care overall is a growing employment area, but within health care mental health is growing relatively slowly.
We can see that this is indeed the case when we read about schools in New York City losing funding for school psychologists and social workers—victims of the ending of COVID-related federal funding.
Unsurprisingly, this has been met with more than a little concern from a variety of advocacy groups.
“When children don’t get the services they need upstream, their needs become more intense and more complex, and then they end up in ERs and hospitals,” said Alice Bufkin, associate executive director for policy and advocacy at the nonprofit Citizens' Committee for Children of New York.
This latest school tragedy gives such words a starkly prophetic hue.
Nor is the perceived shortfall of mental health workers confined to New York City.
Colorado is facing similar challenges in fully addressing that state’s demand for mental health services.
A recent report by the University of Minnesota highlighted a perceived significant underserved need for mental health services within the state’s K-12 schools1.
With respect to student mental health:
• As described above, principals selected addressing student mental health challenges as the leadership activity posing the “single greatest challenge” to them more than any other activity in 2023.
• As described above, principals selected addressing student mental health challenges as the leadership activity posing the “single greatest challenge” to them more than any other activity in 2023.
• 45% somewhat agreed or agreed with the statement, My school or district is able to provide adequate support for students experiencing mental health challenges.
• The three most-selected perceived root causes of student mental health challenges were: trauma experienced firsthand (primary trauma) (74% of respondents selected this option), student engagement with social media (59%), and mental health challenges of caregivers (40%).
It is fair to say that, within schools especially, there is at least awareness that the need for mental and emotional health services is growing.
Research is confirming what a great many have long understood to be the case: loneliness and social isolation are not merely indicators of poor mental and emotional health, but have negative implications for physical health as well.
Even corporate media is starting to concede that our society’s younger generations especially are not doing all that well, emotionally and psychologically.
However, these realizations serve to highlight an uncomfortable truth: what we have been doing with respect to mental health and providing access to mental health services is not getting it done.
How has our society come to a place of generally declining mental and emotional health in the same time span when there has been significant growth in health care and social assitance workers?
More importantly, how has this happened even as this country’s spending on mental and emotional health services has risen since 2001 as a percentage of real Gross Domestic Product?
Child care jobs in particular have since 2001 risen significantly relative to overall employment.
We are spending more. We are hiring more. We are focusing more….and yet we are getting worse outcomes?
We are spending more as a percentage of GDP—a greater and increasing portion of our economy is devoted to mental and emotional health services than before—and yet we are no happier, and certainly no healthier.
The mental health crisis in this country emerges not because we are doing nothing—but because what we are doing demonstrably is not working.
If all we do as a result of incidents such as Apalachee High School is double down on current mental health services and programs, there is an outsized risk we are merely doubling down on failure. Our current mental health services and programs undeniably failed with respect to Colt Gray—whatever interventions did happen did not achieve the desired outcome.
The goal of all health care, whether physical or mental, is improving the individual person’s overall quality of life. While “quality of life” might not be easily quantified, it is fairly easy to determine if a person considers their quality of life to be good or bad, getting better or getting worse. One merely needs to ask them.
If current approaches to mental health care have not prevented the mental health crisis that has been repeatedly reported even by corporate media, we need to consider the very real probability that current approaches to mental health care are not working.
We need to think long and hard not just about how much of our society’s resources should be devoted to treating mental health issues, but how our society goes about treating mental health issues.
We must not forget that Apalachee High School was not just another school shooting tragedy. It was also yet another warning that our systems of mental health care are failing us. Even as our spending on these systems has increased, even as we have hired more and more people to work within these systems, our systems of mental health are still failing us.
It makes no sense to devote increasing resources to systems that are not working as they should. It makes no sense to devote more and more spending—taxpayer-funded and otherwise—to our current systems of mental health care if we are not seeing the improved results we want to see.
We absolutely do need to have an ongoing dialogue in this country about mental health, but the baseline stipulation that needs to be understood in order for us to have that ongoing dialogue is that much of what we’ve done thus far has not worked as it should.
The baseline stipulation needs to be that we need to rethink how we are delivering mental health services in this country. We need to step completely outside the bureaucratic box and craft new proposals, new programs, and new thinking on mental health overall. If we’re not willing to not merely entertain but focus on thinking outside that bureaucratic box, we are not having the serious discussion on mental health this country needs to be having.
What we have been doing with regards to mental health did not prevent Apalachee High School from becoming the latest in a far too long list of school tragedies. That means whate we have been doing with regards to mental health has failed us in the worst possible way.
Whatever else we do with regards to mental health in response to Apalachee High School, let’s not double down on failure. Let’s not continue repeating the same mistake of doing that which is not working.
We can do better. We just need to figure out how.
Kemper, S., Pekel, K., Evenson, A., Seabrook, R., Fynewever, N., & Zhao, Q. (2024). Report of findings from the second biennial Minnesota principals survey. Center for Applied Research and Educational Improvement, College of Education and Human Development, University of Minnesota.
Shouldn't we be happier by now after 20 years of radical left-wing leadership? Where's the joy we're supposed to have from the neverending legacy of the Great Black Hope? This is such a letdown.
All good points. The real question should be why are so many kids mentally ill or autistic or 'gay'? Something has changed and it's ruining our kids. But when you live in a culture that says everything is normal, how do you even treat mental illness? Just because you are 'born that way' doesn't mean it's normal! You have to help these kids find their way to functioning within the lines. Also, to your article, they are spending more on INSURANCE, but these so called mental health facilities and 'counselors' are often terrible at their jobs and make the kids even worse, OR they get paid very poorly. The demand for 'counselors' is very high, but few of them are truly qualified. Trust me, been there, done that. Could not get help for a family member who needed it. Has been very precarious. Did you know that if you tell your 'therapist' that you have suicidal thoughts they can force you to go the Emergency room for evaluation, but once you get there all they do is ask you how you're feeling then let you go? That is exactly the procedure. Most smaller towns have zero residential mental health facilities and that is what many of these kids need. I could go on, but it's just too depressing. These kids either figure it out or they kill themselves or someone else.