Improving Mental Health Should Be a National Priority

FEB. 23, 2018

By Mary Giliberti, J.D.


As someone who takes calls from families experiencing mental health crises, my heart goes out to the families and friends of those who died last week in Parkland, Florida. We know that they are suffering terribly and they, along with the rest of the country are desperate to understand how this could have happened. The conversations inevitably turn to guns and mental illness. Some will try to use mental health as a reason not to talk about guns. We believe that talking about mental illness does not preclude a conversation about guns. We offer these recommendations on mental health because we are an organization of people affected by these conditions.

Mass shootings, particularly those that involve our children, generate an onslaught of media attention and public outcry. When mental illness is part of the dialogue, these shootings can and do contribute to negative attitudes and perpetuate stereotypes against people with mental illness so it is important to be clear about the facts. One in five Americans has a mental illness and with treatment, people with even the most serious conditions are no more likely to be violent. If you consider that 20 percent of teens have a mental illness, that means that hundreds of students at any large high school may have a mental illness. They need to be supported and encouraged, not blamed and shamed.

That said, a small subset of people with mental illness whose symptoms are not treated may pose an increased risk of violence. These risks may increase when substance abuse or past trauma are involved. Violence towards self is particularly a concern, as suicides are the second leading cause of death for our youth. 

What can we do to address the mental health needs of students to keep them all safe?

  1. Increase mental health awareness and availability of counselors in schools. Rather than isolating or punishing youth with mental health challenges, all students should be encouraged to seek help for themselves or a friend. Adults can do their parts by establishing trusting relationships with students, especially those in need. Suspending or expelling students should be avoided at all costs, because doing so only exacerbates the situation and further isolates the person.

  2. Expand the availability of intensive mental health services for youth exhibiting behaviors or symptoms of more serious mental health conditions. Since schools and school personnel are often best able to identify young people who are most at risk, these services should either be available within the school setting or easily accessible through the school. Coordination between the school and mental health system is paramount to success. Good models for these types of coordinated programs exist in Minnesota and elsewhere. Early episode psychosis programs and other evidence based care should be available nationwide.

  3. Train law enforcement officers, school resource officers, teachers, and counselors on how to identify students in crisis, how to de-escalate crises, and how to link students with mental health services and supports. Early intervention when symptoms first appear can make a huge difference in helping students recover and get on positive trajectories for their lives.

  4. Finally, states should consider adopting laws authorizing gun violence prevention restraining orders that establish procedures for removing firearms from individuals who may pose a risk of violence to themselves or others. While the relationship between mental illness and gun violence is very low, we need reasonable options in circumstances where people are at high risk.

As a society, we still too often isolate and avoid young people who are exhibiting signs of the possible emergence of mental illness rather than responding assertively and compassionately to help them recover. Although most situations do not end in violence, it is sad that we only seem to pay attention when violence does occur. In fact, improving mental health services should be a national priority not because of violence, but because it is what is needed to help students who are struggling get their lives on track. It’s time we commit to implementing strategies to engage young people in help before crises occur.


Mary Giliberti is CEO of NAMI.


MAR, 05, 2018 08:38:43 PM
Patricia Hinrichs
No wonder politicians, media, schools, and law enforcement have never heard of NAMI and have misconceptions about mental illness ! NAMI is in denial that mass shootings have anything to do with mental illness, want to keep that hush hush for fear of "stigma'. The only stigma is ignorance and the refusal of NAMI to discuss the fact that mental illness can indeed sometimes trigger violence. By not speaking out and speaking the truth, NAMI loses the opportunity to help, educate, and gain support for the much needed funding of mental health services. The NRA is offering free help to schools. Not the right kind, but they, not NAMI, are on national TV offering help. The Stop School Violence Act is proposing training NAMI already offers now. NAMI says nothing ! The NAMI websites and twitter almost act as if the Florida shooting never happened. NAMI should be front and center after two weeks non stop national coverage about school safety, mental illness. NAMI should be a household name by now, not something the President and the Douglas school psychologist has never heard of.

FEB, 28, 2018 05:45:38 PM
Sandra Betancourt
I am with you on each and every point spoken in this blog. As a mother of a teen with mental health issues I understand that the problem lyes in identifying students at a young age and providing services that will help them. Often the Educational Sysytem meets a parent with resistance instead of help. My son was assaulted for an entire year by his teacher in the 4th grade. By the 5th grade my son was suacidle and by the 6th grade had fleeting thoughts of hurting his peers due to the constant bullying. The reports are there in black and white and still no help. Today my son is in the 8th grade and still has problems but the school refuses to help him in any way.

FEB, 28, 2018 02:36:19 PM
susan nichols
Thank you for your knowledge and for NAMI. I never saw the signs as my son struggled through high school. And I didn't want to believe something could be wrong with him this past year that ultimately lead to his incarceration now. He is only 21 and has been in jail for nearly 5 months because he left the state because he had nowhere to live and didn't know what to do. They just saw it as a violation of his probation. He is now on his 3rd. public defender. I am trying to get in contact with him, but he is not returning my calls. My son was ordered a mental health evaluation, but I cannot see the results or discuss them with anyone because he is considered a "legal adult'. My son is paranoid and afraid now to talk at all in fear of what will happen next to him. I believe my son purposely got himself put in solitary lockdown because he was so intimidated by the other inmates! He has been in lockdown for over a month already and can't have any visitation. He is only let out for an hour a day! HOW can that possibly rehabilitate him?? or anyone for that matter?? I feel so helpless to help him. His next court hearing is on March 8th (a day before my birthday). Our jail system is a failure for the mentally unstable and needs desperate attention. Signed; "A very sad and desperate mom in Colorado"

FEB, 28, 2018 01:27:25 PM
I agree that mental illness should be a national priority and we should start treating it with actions and the respect that all illness. receive.Guidelines never solve the problems. Our main agenda should be getting the problems of mental illness solve. Nationally We are concern when something happen. We give money to other programs and mental health get the lowest in the nation.

FEB, 28, 2018 12:40:42 PM
Well written, Mary. However, I was disappointed that you didn't include a reference to NAMI school education presentation Ending the Silence and law enforcement training, Crisis Intervention Training.
Both are huge in ability to change attitudes regarding mental health issues.

FEB, 28, 2018 11:31:12 AM
Joy Hobbs
The problem with restraining orders are that they are very often used as a vindictive weapon against innocent people. Never will support any legislation.

FEB, 28, 2018 09:06:25 AM
Debra Carter
I would like to know how I can join forces to help mental health youths
I live in Ft Myers Florida

FEB, 27, 2018 05:39:58 PM
Romonna Knotts
Thank you for this information. I find this to be helpful for my family members. Everyone should read this. Please keep posting. We need to break the silence on mental illness.

FEB, 26, 2018 02:36:54 AM
Michele A Grammatikas
Dr. Gilberti,

Amazing strategies! I thank you and applaud your efforts!!!

As I heard about the school shooting I was horrified. As terrible as it sounds I related to the mentally ill "sicko" who changed the world for so many, particularly the family and friends of those who passed. I pray for their comfort and hope they find spiritual peace somehow. I pray that the traumatized children affected will be received well throughout their lives as early life experiences have tremendous impact on one's future.

I pray that they share their SUFFERING with love and open encouragement not just now but throughout their lives as these murders will definitely affect many future events and the way they will react to their problems and the stress of life in the future. Hopefully, they will have a peer worker, one with a similar life experience checking in on them for the rest of their lives, helping, comforting, overcoming their problems.

Hopefully, they will seek help with future stresses and struggles (problems come to us all) and remember the murders are affecting the way they deal with these struggles in the future. Hopefully, they will not be compelled to hold in pain or fear reaching out because they don't want to be cast into the "them" realm of those SUFFERING with mental illness.

However, since one in five are already SUFFERING from mental illness it is HIGHLY likely that by their teenage years they have already learned not to discuss their mental anguish. Honestly, in this society who can without being shunned?

Hopefully, those affected by the shootings in Florida will become Peer Worker volunteers sharing their life experience with others in need. This will help them as well as others. Hopefully, they can weed the SUFFERING out of the silent and save someone's sanity.

Dr. Gilberti, the plan for early education is the key. Go for it! I propose Peer Workers, not armed teachers with more guns, in our schools, K-12 seeking out the SUFFERINGS of life.

I wish you all the success in the world with that strategy as that is the one that will shape our future society.


-Michele, Ring My Bell
Peer Worker: ready, willing, and able!!!

FEB, 25, 2018 01:29:02 PM
Elizabeth Carone NAMIBuffalo&Erie County
Thank you for stating a sensible response to mass shootings.

FEB, 25, 2018 10:27:54 AM
Rita Tate
Hi Mary,
Though my experience is twenty-five years old, I think the current government's desire to address the mental health needs of our youth is an opportunity to expand the very poor services available to school kids today.
I recall my desperation in trying to find a childhood psychologist...a psychiatrist
for my sixteen year old in 1992. Despite my best efforts, I couldn't find anyone willing to take a new patient and believe me, I called everyone in the phone book.
Finally, I called Anne Arundel Dept. of Education for help. They referred me to a clinical sociologist. Bad idea. Mental illness was "only teenage angst."

While the recent mass shooting in Florida brings a call for better mental health services, I think it is a mistake to downplay the underlying need that remains.
School districts need competent psychologists on staff. You can only help kids
If you can get those students in need timely attention. I hope NAMI will support a campaign to get this implemented. Hire full time school psychologists.

FEB, 24, 2018 12:56:50 PM
Tonisha M. Pinckney, Ph.D
Great article!!! There must be more training and awareness to help families identify signs of mental illness and distress. We as parents need to stop classifying behaviors as "moody teenagers," "s/he is just strange," "teens and parents don't get along," or other ways we dismiss signs of depression, bullying, post-victimization, psychosis, etc. Having a child with a mental illness does not mean we are bad parents. Parents are powerful tools to help identify potential violence in schools, not sources of blame or to be blamed. It takes the entire village to raise a child and keep the children safe. Yes, the schools, pediatricians, police, judges, politician and so on can do more - one thing they can do is work more closely with families in a manner that feels non-threatening (risk of losing child or being punished) and supportive of family values and cultural differences.

FEB, 24, 2018 12:08:11 PM
Divinna Schmitt
This statement is so important and I thank you for sharing these salient points with us all. As a newly appointed NAMI Affiliate board president certified in Collaborative Problem Solving, your words make we want to cheer from the rooftops. Especially appreciated is your focus on mitigating negative stereotypes, the need for facts, and above all the power of relationship. Understanding and compassion help open channels of communication as opposed to mere punishment (euphemistically called "consequences") which manages to teach a struggling kid nothing but hurt, anger, and continued detachment.

FEB, 24, 2018 11:25:30 AM
Another of our rights has been taken Away. No right to defend ourselves. Also, think we all know those stats aren't accurate- those who aren't diagnosed &/or don't use insurance. Trump calls the shooter "sick" about 10 times in 5 minutes. Really sick. Nice diagnostic skills. It hasn't even been established what the shooter has, correct? Interesting that all serial killers are psychopaths who have narcissistic traits, but not ALL psychopaths have NPD. Trump does and is of course dangerous. So triggering to watch him, a supreme narc, try & speak about this. His level of stigma makes me shiver. Recall he royally screwed over his brother who was an alcoholic, and for that very reason. Making the narc family look bad.

This will include those with a diagnosed substance abuse disorder, no?

And what I've really wanted to know for awhile now is how does one get unto this database?
And what is it called?

I saw everyone on disability is either in the database or about to be. This will be me & something tells me there will be more to come...And that it will be misused, hacked. And Trump will somehow never make it in there. Hopefully the extra $ needed to improve mental-healthcare and access to
It will be the silver lining, although I fear this might be revoked or restrictions will probably apply to those with govt insurance. method Anyway, thanks Nami for being there.

FEB, 24, 2018 08:54:54 AM
Jacqueline Jackson
Yes I agree with the statements above. I have a young adult son that has been struggling back and forth with his mental illness.He will do good for about five to six years then he will start back using marijuana and back into episodes of psychosis.Confused and anxious.And it's terrible when this occurs and He is in denial and won't let me take him to get help.Or when I call to get help they say if he not being a danger to himself or others they can do anything .He has to volunteer to go get help how can someone in crisis mode who doesn't believe that anything is wrong with them will go get help I don't understand this mixed up system . It's like they're just waiting for him to do something wrong before they will come . I need someone who cares about the situation to take action before anything happens.We need changed in these areas desperately.

FEB, 23, 2018 05:31:14 PM
Educating the parents to the prodromal symptoms of mental illness is also sorely needed. The parents need to be empowered to know what to look for. In many cases the early signs are often consisted as something the child will outgrow or just "teenage" behaviors.

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