Black and White and Red All Over

July 23, 2018

Where are the crusading editorial boards who decide that the inadequacy of mental health care is such a public health emergency that ongoing investigative journalism is needed?

Editor in Chief

In my generation, a common riddle for 10-year-olds was, “What’s black and white and read all over?” Because you only heard it spoken, you thought the word “read” was actually the color “red,” and the first time around you didn’t know the answer was “newspaper.” Of course, when you were 10 that’s why it was funny the first 50 times someone asked you. Then it was just dumb. I used the word red in my headline because the news folks ought to be red-in-the-face embarrassed and that’s not funny either.

For example, a June 2018 editorial in The New York Times was titled “The Crazy Talk About Asylums.”1 They rightly aired concerns that the solutions to the wave of mass school shootings in the US was not to have more psychiatric asylums, as had been advocated by President Trump following the Parkland, Florida shootings.

The Times did say a number of things that make a lot of sense, but which are hardly “news” in the sense that these are new ideas that are worth attention. They cited the concerns about whether current legal standards for involuntary commitment to care are worth re-examining, the need for more mental health services which embody a true continuum of care, and the need for implementation of mental health parity laws.

In their editorial, the Times raised thoughtful questions about these thorny issues, the answers to each of which might improve access to mental health care. And, in some cases, the availability of services might mitigate the likelihood of another Parkland. Of course, many psychiatrists would say these reforms, which have been ongoing topics of conversation in professional circles for many years, are long overdue. We appropriately ask why it takes an assertion by the President to raise these concerns in such a prominent way as on the editorial page.

Where are the crusading editorial boards who decide that the inadequacy of mental health care is such a public health emergency that ongoing investigative journalism is needed? A single editorial, no matter how righteous, is unlikely to have any effect on public policy. That’s why I think they ought to be red in the face with embarrassment, because the news IS read all over, either online or in print, and journalism with a sustained focus can make a difference.

The other topic I want to emphasize regarding the absence of sustained news coverage is the epidemic of suicide in the US. I wrote about this in my February Psychiatric Times editorial,2 but that was before the CDC released their most recent data which shows that suicide rates in the US continue to climb, now with around 45,000 suicide deaths each year. The majority of those are from self-inflicted gunshots. And while the mass shootings appropriately gain a great deal of coverage, there is little mention that of all the gun violence deaths in the US each year, most of them are suicides.

Until the suicide deaths of 55-year-old fashion designer Kate Spade and celebrity chef and TV star 61-year-old Anthony Bourdain in the same week in early June, I didn’t really see much coverage of the public health emergency that is represented not only by suicide, but by the approximately 10-fold greater numbers of attempts. Where’s the ongoing media coverage of that? The week after these two celebrity deaths, NBC News at least showed the phone number for the National Suicide Lifeline on their nightly broadcast. But that’s about it from the media.

We’re in the middle of a long hot summer, likely to break another heat record, and the public interest in these topics understandably has waned. I was sad about Anthony Bourdain’s death, because I’ve been a fan of his TV shows. But my level of sadness can hardly be compared with the level of lasting distress suffered by friends, colleagues, and families of those who have committed suicide or been killed.

What psychiatrists can do about these ongoing problems is unclear beyond the care we provide for those in severe distress. In some cases, local training programs for police departments have had some salutary effects on individual cases of gun violence or potential suicide. But there obviously hasn’t been an effective national set of policies to address these problems, as I’ve said before.

These omissions are worth pondering, since these days, other than personality politics, there seems to be little beyond the 24-hour news cycle that gets sustained coverage. That’s not good for the body politic, no matter what the issue.

The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress: 1-800-273-8255

References:

1. New York Times Editorial Board. The Crazy Talk About Bringing Back Asylums. The New York Times. June 3, 2018. https://www.nytimes.com/2018/06/02/opinion/trump-asylum-mental-health-guns.html. Accessed June 12, 2018.

2. Tasman A. The Wrong Way on a Long and Winding Road: Suicide in the US. Psychiatric Times. 2018;35(2):Cover.

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