So, here we are…an understaffed, under-budgeted, over-insurance controlled system, with exhausted people trying to take care of decompensating people. ~DRH, Taking Off The Armor
The shooting in Lewiston, Maine hit close to home on multiple fronts. I am originally from the East Coast (New Hampshire, raised; Maine, college), I am a Veteran, and I was intimately involved with mental health care collaboration for the Guard and Reserve service members when I was in the military.
As the information began to trickle out, I found myself becoming more and more frustrated and heartbroken. This should have never happened.
Documents show Lewiston mass shooting suspect had been on law enforcement's radar for months
Law enforcement in Maine received multiple reports in recent months of the Lewiston shooter's paranoia and…
First, let’s address the elephant in the room. This was a Veteran with extreme mental health illness. The majority of Veterans dealing with mental health are not this extreme, nor are they dangerous.
Second, I have no doubt the police followed their policies, his unit made the appropriate requests, his family raised awareness appropriately, and the mental health care given was according to evidence based standards. Yet, it was not remotely enough. Even systems, and people within the system, with the best intentions fail. Why? How?
That answer is complex and I’m not sure any one person has a comprehensive resolution. However, there are a few pieces I witnessed over and over that I feel heavily impact the success or struggle of a person.
There is an order of operation for mental health care that exists but often does not occur. I have used the analogy of building a box many times when working with commanders to help them understand the importance of this order. Before we get into the details, I am abundantly aware mental health care is not perfectly linear, nor is there one perfect fit for every person. However, when there are steps from acute down, there is a reason for it.
Inpatient is the location where a person is taught what the tools (skills) are to be able to build a box (emotionally regulate). It is where they realize they…