IOWA CITY, Iowa - In the wake of Friday's mass killings in a Connecticut elementary that left 28 dead, Iowa mental health providers are arguing that now is the time to talk about increasing funding for and access to mental health services.
"The discussion really has to come around to how are we going to begin to look at mental health services as something that are necessary and valuable and how are we going to fund them," said George Estle, CEO for Tanager Place, a Cedar Rapids-based treatment facility for behavioral and psychiatric disorders.
Soon after authorities identified Adam Lanza, 20, as the man who shot his way into Sandy Hook Elementary in Newtown, Conn., on Friday and proceeded to gun down 6- and 7-year-olds inside, news began to emerge about his past and his mental health.
Media outlets reported that Lanza had Asperger's syndrome, a form of autism that is characterized by social awkwardness. Mental health advocates have urged the public not to link Asperger's with extreme violence, and professionals like Estle have asked whether Lanza had a more significant illness that could have been addressed to prevent this outcome.
"For someone like this Adam Lanza to do something so horrific, there has to be something going on that we don't know about," Estle said. "I'm sure there are a million different variables that affected this outcome, but somewhere, there is a mental illness issue."
Estle said funding for mental health care has been unraveling in this country for decades, and it's something that needs to stop now. In Iowa, he said, the issue is pronounced for children with mental health issues. And, she said, there are huge disparities in services available in rural and urban areas.
"We are one of only two outpatient centers in the state that specialize in children," Estle said. "And it's just not enough."
Estle said tragedies are going to happen, and there's nothing to be done to prevent them all. But, he said, there are ways to lower the probability that tragedies will occur.
"If we had easier access to mental health care for children, that would reduce the probability," he said, "We certainly can lower the probability. That we can do."
Gary R. Gaffney, associate professor of psychiatry at the University of Iowa Hospitals and Clinics, said he has noticed a a gap in services for people with mental illness once they reach adulthood. His patients, for example, might be receiving services in the school district but find care harder to access once they leave.
"I think about that every day, what can we do?" he said. "The services for adults do drop off, and I don't expect it to get any better because of budget cuts."
Gaffney, who has paid particular attention to the incident in Connecticut because his wife grew up 15 miles away and still visits family there, said he doesn't think increasing mental health funding would prevent tragedies like the one at Sandy Hook.
Instead, he said, he would like to see the conversation focused around safe gun ownership.
"Lock them up," he said. "Mental illness always has been and will be with us. The prevalence might even go up, so one has to take safety procedures and learn how to deal with lethal means at home and at work and at school."
Gaffney, who works with patients with Asperger's syndrome and autism, said the diagnosis is extremely trendy right now and that the UI hospital has "tons of referrals" for it.
"It has picked up recently, but I don't think the number of cases has actually increased," he said, adding that people are misdiagnosed with Asperger's all the time. "Fifty percent of those referred have some other diagnosis."
He said people with Asperger's and autism are far more likely to be victimized than to be perpetrators. In his 31 years in the field, Gaffney said, he's heard threats but never seen anyone resort to violence.
The Autism Society recently issued a statement reiterating that sentiment and calling inferences linking autism with violence "wrong and harmful" to the more than 1.5 million people with autism in the United States.
"Individuals with autism and those with other disabilities are more likely to be victims of violence than the perpetrators," according to the Society. "Many of the individuals with Asperger's syndrome who have committed crimes had co-existing psychiatric disorders."
That's why Stephen Trefz, executive director of the Community Mental Health Center for Mid-Eastern Iowa, said he thinks better access to all sorts of mental health services would prevent some people from taking extreme measures.
Just like urgent care facilities are popping up for acute health problems like colds or ear infections, Trefz said, he would like to see the same available for mental health issues.
"I would venture to say that if access to behavioral health care was as accessible, someone could come in and get things addressed in a timely fashion," he said.
Trefz praised the Iowa City Community School District for being "ahead of the curve" by providing screening tools for behavioral issues and said he'd like to see that statewide.
"Any increased concern about providing behavioral health care and funding across the board would be a great thing," he said. "And if the strategy could help us with behavioral issues as well as looking at the culture of violence and getting assault weapons off the street, that would be a benefit too."