The arrest record of Tyler James Robinson, the young man who allegedly shot Charlie Kirk, revealed a long history of mental health issues. Once again, we are reminded of the crisis of mental health problems in this country.

One of the most surprising factors is simply the large number of people with mental health issues. About a quarter of U.S. adults experienced some form of mental illness in recent years. The data is even more striking with youth (12-17) who had about 50% of some type of mental disorder. About one-third of young adults (18-25) experienced some form of mental disorder. We don’t have such high ratios of physical diseases in the public. Clearly, the crisis is widespread.

What are the problems in getting access to treatment? The U.S. faces a critical shortage of mental health providers, especially psychiatrists. The field appears to have a high level of burn-outs. Providers also include psychologists, psychotherapists, counselors, and medical social workers. I have seen a MSW since my insurance started providing tele-health services, and I have found the consultations beneficial.

Perhaps the greatest problem is the high out-of-pocket costs. Many healthcare insurers do not provide mental health coverage. Even if they do, they may have more restrictions than on physical treatments. Because of these restrictions and relatively low payment schedules, many mental health professionals do not accept any form of insurance.

Of course, the gun manufacturers blame the mental health problems for the crisis in gun violence. They choose to ignore the wide availability of guns (2 for every person in the US), poor storage and training in the use of guns, and the irregular registration of guns. These issues were the factors in the creation of the National Rifle Association (NRA.)

When does a mild form of depression (common) progress to become paranoid? The statisticians separate the mild conditions from the serious mental illness -- and the threats of that diagnosis. How can anyone other than a professional determine the likely path of progression, and when does it become dangerous? These are arbitrary without clear distinctions.

The buzzword is “a threat to self or to others.” Only at that point can a person be involuntarily institutionalized. Then, we get into the dismal conditions of many mental health facilities, both public and private. A local facility has had numerous complaints over the years.

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