Senator Kathy Sheran at Capitol
SAINT PAUL, Minn. -It's difficult to talk about mass shootings and the ongoing threat of gun violence without addressing the issue of untreated chronic mental illness.
That's why Minnesota lawmakers are approaching the gun issue from several fronts, including expanding access to mental health services.
"We need to continue to hold support systems for families who have told us over and over again that they can see their children are experiencing mental illness diagnoses," Senator Kathy Sheran told reporters Friday.
"They see the symptoms but they're not able to find the support systems anywhere."
Sheran, a Mankato Democrat, is well versed on the subject of the gaps in care. By trade she is a nurse, and spent her career specializing in the care of persons with serious mental illnesses.
She will soon introduce a bill that, among other things, expands the program known as School-Linked Mental Health Grants. It is designed to connect students and their families with mental health professionals.
"That will help serve more children than have ever been served before, many of whom have never had contact because of the lack of resources with the mental health system," Sheran said.
More than 13,000 students have received services funded by those grants since the program began in 2009. Nearly half of those children were found to have serious mental illnesses, according to Sue Abderholden of the National Alliance for the Mentally Ill.
"Most persons with psychotic illnesses first show symptoms during adolescence or as young adults," Abderholden remarked.
"And the moment someone experiences their first psychotic episode we really need to be providing the most intensive treatment that we have, so the trajectory of their lives is positive."
In St. Paul, for example, students at two schools -- John A. Johnson Elementary and Dayton's Bluff Elementary -- can receive services from the Wilder Child Guidance clinic. Wilder is one of 20 mental health providers across Minnesota that received School-Linked Mental Health grants.
"With early identification of symptoms, and early intervention and creation of a coordinated support service for those children and their families we will be able to help prevent the progression and deterioration to more severe symptoms of mental illness," Sheran noted.
Sheran's legislation calls for an additional $10 million for the School-Linked Mental Health grant program, spread over the next two fiscal years. Gov. Mark Dayton favors spending more on the program, but not quite as much as Sheran's bill would provide.
Currently the program serves only 17 percent of all schools in Minnesota. Sheran predicted that figure would rise to 37 percent if her measure were to become law.
Sen. Greg Clausen of Apple Valley, who has spent decades as a teacher and administrator in the public schools, said he supports Sheran's bill because traditional nursing services have been curtailed by years of budget cutting by districts.
He also noted that most guidance counselors are not trained to recognize signs of the onset of mental illness.
"Our high school counselors usually have caseloads of over 500 students," Sen. Clausen explained.
"Their experience, their background role, in many cases is for academic counseling."
Sheran's bill would also allow youths to have mental health case management services from their local county until age 26.
The measure help patients gain access to medications more quickly, by mandating that health plans grant an exception to their drug formulary when patients suffer a first or second psychotic episode.
Some in law enforcement have cited Minnesota's low number of inpatient hospital beds for persons experiencing psychotic episodes. But the average stay in those hospital-based mental health units is eight days.
Most persons will receiving ongoing support, therapy and medications in community based settings such as mental health centers and outpatient clinics.
"If we don't do anything in the community, all we're going to see is people coming in and out of hospital beds," Abderholden said.
"And what we really want to do is keep people stable and healthy in the community."
She pointed out that the overwhelming majority of persons with mental health issues are not violent. And those who do act out violently are twice as likely to kill themselves than they are to take someone else's life.
It's a statistic she's found herself repeating often in the wake of the recent mass shootings, including the one at Accent Signage in Minneapolis and the attack at Sandy Hook Elementary in Connecticut.
Tragedies like those often have a back story that puts a spotlight on gaps in medical and support services for those with chronic diseases.
"If you have cancer they don't say to you, 'Come back when you're stage four and we'll help'," Abderholden said.
"When you have a psychotic illness they say wait until you've failed numerous times. You've got to be hospitalized, been in jail, those kinds of things, before they provide you a little bit of service."
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