英语访谈节目:立法者很难界定最需要帮助的个人

PARAMJIT JOSHI:I think the most important thing is really to provide the services in the school systems by having counselors, by having psychologists, mental health social workers in the school setting, because that's where children spend most of their day.

It's easily accessible. And, in fact, there was a mental health in school act that was proposed in the 112th Congress that put forth funding for this particular intervention. And I'm hoping that this sad, horrific event will make us rethink supporting this particular bill, so we can put the resources in the school system.

JEFFREY BROWN:What about that, Barry Rosenfeld? What are the possibilities there? What are the limitation there?

BARRY ROSENFELD:Well, I certainly would agree and applaud the president for the idea of expanding mental health services.

It's an indirect solution to a much more present problem. I think that, of course, the more we can improve general mental health functioning among kids, among young people, among adults, among our returning war veterans, the better we are at the macro level.

But we still have that same problem of individuals who most need these services being very, very hard to identify. And once the difficulties have started to crystallize, I don't know that we are going to have very much success by having an extra counselor in the school.

I think we have got to put a lot more resources into understanding violence to begin with. I'm always shocked by how little of our, for example, National Institutes of Health money goes towards understanding violence and understanding the causes and the treatments for it.

We have just not prioritized the understanding side of things and the prevention side of things. So I certainly applaud the mental health services.

JEFFREY BROWN:Go ahead, Dr. Joshi.

PARAMJIT JOSHI:But, at the same time, it's a well-known fact that 50 percent of those who have eventually a mental illness start before the age of 14, and about three-quarters have mental illnesses by the time they reach 24.

So, in my mind and from my perspective, mental health is really a children's issue. And so if we can catch them young and we can intervene early on, I think we will go a long way in not seeing adults becoming aggressive, violent, because we will be able to treat some of the illnesses early on.

JEFFREY BROWN:Well, let me ask both of you, starting with you, Barry Rosenfeld.

All these things we're talking about, about identifying people with problems, then there's the question of reporting and how that might work and if you get the right people and if you cast too wide a net. Tell us a little bit what you see in what the president talked about, what in your state, in New York, they're looking at. What is possible and what are the concerns there?

BARRY ROSENFELD:Well, I think there's a lot of concerns and I think there's a few possibilities.

And, of course, we all want to identify potentially violent people. The idea, though, that we're going to cast this very wide net of anyone that raises any concern and have limited resources as to what to do with that, I worry quite a bit that we're going to be increasingly infringing on people's rights out of this fear that, well, what if this is the one person? What if this is the needle in the haystack?

So, I think there's a lot of potential ramifications. I think there's a lot of concerns that it will inhibit people from getting mental health treatment if they feel like going and talking to their doctor about, for example, thoughts to hurt themselves. Well, we know that there's a link between the desire to hurt oneself and the actions against other people.

So are we going to deter people from seeking treatment for their depression because they don't want to be hospitalized as potentially homicidal? I certainly don't—I certainly think that it's a well-intentioned approach, but I don't know that it's going to solve a lot of these problems in terms of capturing the one person, that needle in haystack, as it is, that we're really interested in.

JEFFREY BROWN:Well, Paramjit Joshi, what do you think about the concerns about reporting?

PARAMJIT JOSHI:You know, I would agree that the net is being cast really wide, and it very well may deter people from coming forth to talk about how they're feeling.

It's sort of walking a really fine line about keeping the public safe and at the same time protecting their privacy. And with children and adolescents, we get consent from the parents to be able to treat young patients. So, in some sense, it's a little less of an issue with our children and teenagers as it is with the grownups.

But I do agree that it might really deter people from speaking very openly to their psychiatrist and their other mental health providers about what's really going on in their mind.

BARRY ROSENFELD:If I could add something...

PARAMJIT JOSHI:Sure, please.

BARRY ROSENFELD:If I could add something, I think that we do have a real risk with children and adolescents.

Someone is identified in the school, and now are they going to be sent out of the school, so now they're not able to return to the school because the psychologist expressed concern? That could impact an incredibly large number of children, I think, many of whom, the vast, vast majority of whom aren't a risk.

JEFFREY BROWN: Let me just—just briefly, Dr. Joshi, of course, at the same time, there's all this need to find these people and to identify them and to let authorities know.

PARAMJIT JOSHI:Again, as I said earlier, it's sort of walking a fine line, balancing the individuality and the privacy of the patient and at the same time keeping folks safe.

So, I think we have to be deliberate. We have to be thoughtful about how we proceed. And we will have to see how best to really identify, at the same time be able to provide services. But my sense is, before we even get to the point of severe aggression in some of these youngsters, hopefully, we can catch it early so it doesn't get to that point. And that's where early identification and prevention comes in.

JEFFREY BROWN:OK. We will leave it there.

Paramjit Joshi, Barry Rosenfeld, thank you both very much.

PARAMJIT JOSHI:My pleasure.

BARRY ROSENFELD:Thank you.

PARAMJIT JOSHI: Thank you.