Posing solutions for mental health issues

Evan Kwik was a relatively unknown 20-year-old Encinitas resident until a few weeks ago, when he wounded two Sheriff’s deputies and ended his own life. 

Evan had been suicidal and violent toward his family in the months leading up to his death, and was reportedly struggling with depression and drug abuse. Evan’s mother even filed three restraining orders against him. He was also briefly hospitalized for mental health symptoms.

Clearly, these occurrences both predicted her son’s impending suicide, and begged authorities for help in getting Evan treatment. The very treatment her son was refusing to get for himself. If a mother’s desperation wasn’t enough to prevent this incident, what would have been?

As mental health professionals, we have seen many of the most mentally ill individuals refuse the help they so undoubtedly need, leaving their families to pick up the pieces. Evan’s family knew he was struggling but without his consent, they couldn’t get their adult son help.

About one in five Americans has a mental illness; of them, only 60 percent get treatment. In fact, people with the most severe illnesses are the least likely to get help. The truth is that people with mental health concerns are more likely to be victims of violence than to commit acts of violence. That being said, they are also more likely than your average person to commit violent acts and to hurt themselves. In San Diego alone there is a suicide every day.

So how do we prevent violent acts like the one in Encinitas while also protecting the vulnerable mentally ill population?

One solution that we hear time and time again is that it should be easier to put mentally ill individuals in the hospital. In fact, this is something that occurs regularly in San Diego County as well as in other parts of the country. At first this solution makes a lot of sense, as it takes unsafe people out of the community and it forces them to get the help they obviously need.

However, the problem with forced hospitalization is twofold. First, hospitals have limited capacity and resources. That means that the cost to taxpayers is high and the treatment provided is short-term (e.g. often less than three days). Second, hospitalizing someone against their will necessarily infringes on basic human rights. Where would society be if anyone could be removed from their home based solely on the reports of family and friends?

In fact, in Evan’s case, he was hospitalized twice for very short periods of time, but this did not improve his symptoms or his safety in the long run. It did not prevent him from shooting two deputies and killing himself.

The solution we propose is simple: be proactive. In order to be proactive, we must commit more resources. When families ask for help dealing with a mentally ill family member, there should be enough funding, support, and mental health professionals to meet their need.

The In-Home Outreach Team, also known as IHOT, does just that. IHOT engages individuals with severe mental illness, who have resisted getting treatment for themselves. Designed and implemented by San Diego County and Telecare Corporation, IHOT consists of three regional teams: North Coastal, Central, and Eastern regions. When an individual with a mental illness has behaviors that concern those around them, IHOT can be called to intervene. Unlike traditional mental health care, IHOT doesn’t wait for the individual to come to their office. Rather, IHOT delivers services in the community, home, hospital, jail, and more. Trained mental health professionals and peer-support specialists work with the family (or other concerned individuals) to identify ways to maintain safety. Perhaps most importantly, IHOT uses their knowledge, skills, and experience to sway the mentally ill individual to participate in treatment.

IHOT has been around for less than a year but the early statistics are promising. IHOT has dramatically increased the likelihood that a person who is hesitant to get help for their mental health symptoms will actively engage in the treatment process. By getting these otherwise disengaged people into treatment IHOT is proactive in preventing violent acts like the one our community just experienced.

While IHOT has begun to demonstrate their success, it still has very limited resources to meet such an important need. IHOT needs the money and staff to help more San Diegans and to prevent unnecessary tragedies like the one in Encinitas. We will never know for sure whether IHOT’s involvement would have prevented Evan’s death or the injuries of the deputies who responded, but it’s possible that if his family had gotten the help they needed by an early-intervention program like IHOT, than Evan might be alive right now.

If someone you know is suffering from a mental illness and needs help, call the San Diego County Access and Crisis Line at 1-888-724-7240.

Carrie Eichmann, Julia Samara, and Matthew Stephens, Masters of Social Work students at San Diego State University

 

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