Today, I took a late lunch around 3 p.m. at a booth in one of my favorite local spots. The waitress took my order (the usual) and walked across the empty dining room to get my drink. While I waited, I checked a Facebook message from a friend, and upon looking up I was met by a stranger. He stood a little over three feet tall, untucked shirt, tousled hair, gapped-tooth grin, and before I could say a word, he had saddled up next to me. He looked at my phone, and said “hey you have Angry Birds!,” he grabbed the phone from my hands and began to play. I came to find out that he was the son of the restaurant owners and despite their admonishing looks, I assured them that he would be fine joining me for lunch. I welcomed his company for what I can now discern were four distinct reasons. First, as a new father, I would want my son to be as engaging and outgoing as this young man. Second, I’ve been stuck on level 18-3 for about a week and (who knows?) maybe he could beat it. Third, as a mental health professional who works mainly with children and adolescents, I love kids, as I find their company more genuine, and often more interesting, than their adult counterparts. Finally, it was a change from how I usually see kids. When I interact with kids professionally, it is often in an emergency room after they’ve taken a handful of pills, or in their homes that barely pass as habitable. I see the kids who’ve been expelled from school for their second, or third, year in a row. I see the kids that are on their second, or third, foster placement. To spend time with a child who wasn’t distrustful, scared, hurt, or on their last strike was especially meaningful to me, and it got me thinking about a perennial problem.

Every year when the governor submits his proposed budget, agencies and advocacy groups are sent into a tailspin of hyper-lobbying, fundraising, and stirring the public into a tizzy for fear that their funding will be cut. With the budget shortfalls of the past several years, we have all been asked to do more with less and we are annually flooded with predictions of catastrophe, and the ultimatum that “if the state cuts the funding for our project y, then z will happen.” Z is often depicted a horrific scenario in which the worst that can possibly happen will happen, and soon, if funding is not restored. This trend raises an interesting point about fear that we should examine.

Most psychologists theorize that fear is only an appropriate motivator up until the point that the fear-provoking stimulus is avoided. If you think about the evolutionary function of fear, we were programmed with the essential fight, flight, or freeze mechanism. We see a predator, our amygdala goes into overdrive, our system is flooded with enough adrenaline and norepinephrine to power our way out of, or through, the event and then our body immediately starts working to regain homeostasis- reverting to its status quo. Since we’re biologically programmed towards homeostasis, motivation by fear is a short-term fix. Even in cases when the stimulus is severe enough to “hardwire” a fear in the brain, we can create loopholes or accommodations to say “I don’t need to deal with that” or as is the case with policy “I don’t need to deal with that now.” This creates the ever-present question- “how do you promote responsible decision making in an indecisive climate? How do you get people to move when you can’t manufacture fear?”

Undoubtedly, every mental health worker, every social worker, every physician across the state could tell innumerable heart-wrenching stories about patients who’ve been tormented by mental illness. These professionals have all treated the client whose inability to access services profoundly affected their lives, or who’ve reverted to suicide as the only way to deal with the excruciating pain that comes with chronic or untreated psychopathology. What most people fail to realize is that the occurrence of these incidents is much higher than popular opinion would care to believe. Recently, Yahoo! ran a story about how state mental health budget reductions have negatively impacted emergency departments at hospitals as the mentally ill simply have nowhere else to go. Emergency mental health consults in emergency rooms are up 20% in the last three years of our economic recession and it is estimated that one in five adults experience a diagnosable mental illness in a given 12 month period. This percentage is mirrored in children and adolescents, and out of five children who have a mental illness, only one is receiving adequate mental health services. Suicide has risen to be the eleventh leading cause of death in America, and our mental health professionals are struggling to keep up with the needs of those who’ve recently felt the sting of our economic downturn. To bring matters closer to home, The Washington Post recently ran a foreboding article about the governor’s planned cuts for non-mandated mental health services to children and adolescents which members of his own party have described as “shortsighted” and “costing us a lot more in the long run.” It’s simply not enough anymore to scare people with a nameless, faceless statistical mass of mentally ill which, sadly, still conjures images of asylums and the practices of a hundred years ago. While the numbers are frightening, and very real, it’s time to put them aside.

We all know someone who has struggled with a bout of depression, someone who has had a problem with drinking, or a child that has struggled to keep up in classes because of an attention deficit, and it is with those people in mind that we need to shift our approach to changing policy. Think of the person you know who has had a tough time and ask yourself- “don’t I want my friend, my neighbor, or my spouse to receive the care that they need?” On the essential level, you have something at stake in improving the global state of our mental health because everyone would benefit from ameliorating the problems that we, as mental health professionals, are trying to address. Hospital emergency rooms would be able to refocus their efforts on attending to critical medical conditions. Businesses would see reduced healthcare costs, putting more money into the pockets of employers and employees. Our law enforcement agencies would see a drop in the frequency and severity of juvenile offenses, cutting the costs associated with detaining, and housing young offenders. Our departments of social services would be able to become more proactive in addressing the social needs of their communities because there wouldn’t be the constant flood of crises that is currently overwhelming them. Schools would see reduced behavioral incidents, allowing teachers to…well…teach! And families, by receiving adequate care, would be able to move through the continuum of “entitlement services” and become self-sustaining again, eliminating their need for state and federal subsidization.

Many in Virginia might say “well yeah, I want those things to happen but I don’t want to have to pay for it.” Guess what…you already are, and you’re paying for it once the problem grows to the point of warranting an arrest, a hospitalization, or a child being removed from their home. Our society is waiting for mental health conditions to worsen or deteriorate, and we’re routinely saying to people “you’re not bad enough yet to receive help.” Imagine if you went to your physician with a sinus infection and he/she said “we’re going to have to wait for this to become bronchitis before giving you anything, or if you’re lucky- it’ll turn to pneumonia and then we can throw every antibiotic we’ve got at you.” I hope you’d find another doctor. Now imagine that every physician in the state is limited by policy to do the same. What would you do? This is how Virginia is currently dealing with our psychological conditions and it will not change without your help.

Write your congressman, call your representatives and tell him that community-based mental health services are the way that you want to address these pressing social concerns. Our funding is in danger and we are the least expensive, and according to some studies- the most effective way to deal with these issues. We’ve lived in a political climate of fear and “no,” of gridlock, and of pet-projects for long enough and it is time to focus on what we want. We want healthy kids. It will take five to seven different points of contact for your representative to even remember discussing this issue and, by some accounts, more than fifteen contacts for them to act. We’ve got some work to do.

Written by: Justin Berkley