- The stigma surrounding mental illness is still a big issue, as reflected in the derogatory terms used to describe those with mental health conditions.
- The discussion of mental health often only arises in the aftermath of mass shootings, diverting attention away from gun control.
- However, the majority of mentally ill individuals are non-violent, and most gun violence is committed by non-mentally ill individuals.
- The mental health system in the US is in disarray, with a lack of proper funding and inadequate care.
- Mentally ill individuals often end up in nursing homes, state-run psychiatric hospitals, or even jails.
- Police departments are starting to implement crisis intervention training to divert mentally ill individuals away from jails and into treatment, but these programs are not widespread.
- The entire mental health system needs a major overhaul, as it is currently fragmented and ineffective.

- Social workers play a crucial role in addressing mental health by ensuring individuals have their entitlements and housing needs met
- Instead of just talking about feelings, social workers focus on everything necessary to keep people living independently in the community
- Despite the effectiveness and cost-saving benefits of these programs, they are at risk due to budget cuts and reimbursement issues
- Funding for various mental health programs is essential not only for financial reasons but also to save lives
- Politicians who claim to be motivated to address mental health issues should take action and create a plan instead of using it as a diversion from gun control discussions.

John Oliver explains how our national system of treating mental health works, or more often than not, how it doesn’t.

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The thing actors pretend to have in order to win Oscars.

Now, in real life, mental health can be something of a touchy topic.

And as 1 psychiatrist explains, when we do, we don't talk about it well.

It manifests itself in the ways that we think and talk about the mentally ill, and in the terms, the words that we use to describe them.

Okay, first, hearing a bearded middle-aged man use the term cray-cray may have already killed that word forever.

It's like when your mom says something is on fleek.

Cray-Cray is a terrible name to call someone with mental illness.

Although, it is an excellent name for a cartoon crayfish who just won a scuttling contest.

The point is, we don't talk about mental illness well.

Sometimes, even TV personalities with Doctor in their names can get it disastrously wrong.

Oz, Everybody wants to know, am I normal or nuts?

I mean, seriously, have you gone completely insane?

Completely insane people go outside, suck on a rock, and bark

Sucking on a rock and barking at the moon is not a sign that someone's mentally ill, it's a sign that they are a wolf with an iron deficiency.

But perhaps the clearest sign of just how little we want to talk about mental health is that 1 of the only times it's actively brought up is, as we've seen yet again this week, in the aftermath of a mass shooting, as a means of steering the conversation away from gun control.

This isn't guns, this is about really mental illness.

In many of these shootings, we have people who have, mental disturbances.

Do we need to do a better job in mental health?

Yeah, it seems there is nothing like a mass shooting to suddenly spark political interest in mental health.

Although it's worth noting that Governor Huckabee's state got a grade of D- on mental health care while he was in office.

And you can't lecture people on something you got a D- in.

It's like passionately delivering a speech on proper English grammar by saying, we need to thunk better about how we does word stuff.

And the aftermath of a mass shooting might actually be the worst time to talk about mental health.

Because for the record, the vast majority of mentally ill people are non-violent.

And the vast majority of gun violence is committed by non-mentally ill people.

In fact, mentally ill people are far likelier to be the victims of violence rather than the perpetrators.

So the fact we tend to only discuss mental health in a mass shooting context is deeply misleading.

It would be like if the only time we talked about Coca-Cola, it were in the context of this.

I'm standing here with this ice cold thirst quenching, deliciously satisfying Coca-Cola, and it actually tastes better.

Sure, sure, that happened, and Coke was undeniably involved in it, but most cans of Coke are not that 1, and it would be unfair if every time you thought of Coke, you thought of that.

But if now is our only opportunity to have a public discussion about mental health, then perhaps we should do it.

Because in 2013, an estimated 43.8 million American adults dealt with a mental illness.

And an estimated 10 million of us suffer from a serious mental illness each year.

That's almost as many people as live in Greece.

And most of us know a lot more about Greece than we know about our mental health system.

Think about it, you know at least 3 things about Greece.

Its economy is collapsing, Yarny's from there, and Greek yogurt tastes like the ice cream they'd make in a town where dancing is illegal.

And when you look at how our current system deals with severe mental illness, you'll quickly realize it's a mess, and it always has been.

We used to lock people up in asylums, which were often so bad, they were known as snake pits.

And that doesn't sound like an attractive place to live even if you're a snake.

You'd want some kind of snake loft, or snake bungalow.

And then, in the 1960s, President Kennedy signed a bill to try and close as many of those asylums as possible.

Under this legislation, custodial mental institutions will be replaced by therapeutic centers.

It should be possible within a decade or 2 to reduce the number of patients in mental institutions by 50% or more.

And that was a really good idea, because when you see horrible places doing unspeakable things to people, you are supposed to try and shut them down.

That's why there are so few Quiznos left.

But before you get too proud of the fact that we shut those snake pits down, it turns out we never followed through and properly funded the community mental health centers JFK had wanted to replace them.

All of those patients had to go somewhere, and some of the places they wound up are shocking.

For instance, a few years ago, the AP found that nearly 125,000 young and middle-aged mental health patients were being placed in nursing homes.

And it's not a great idea to just stick a young person in with some old people and then hope for the best.

It's like casting Taylor Lautner in the new Best Exotic Marigold Hotel movie.

It's unsuitable for everybody involved in it.

states have been involved in something called greyhound therapy.

And unfortunately, that does not mean getting to hug a trembling dog who's 98% bone and gristle.

The kind with 4 wheels and a broken toilet.

This is Ross and Neal, the only state-run psychiatric hospital in Southern Nevada.

Ross and Neal has been accused of greyhound therapy, a practice critics call unthinkable.

Discharging seriously ill patients too soon, then supplying them with a one-way bus ticket out of town.

I'm sorry, but you cannot just put people you'd rather not see on a bus to another city.

If you could, that's how every breakup would end.

Look, look, Greta, it's not you, it's me, but on the other hand, I think you're gonna really enjoy your new life in Syracuse.

And we have not even got into the most depressingly commonplace that people with mental illnesses can end up.

2000000 people with mental illness go to state and local jails every year.

That's meant there's now 10 times more people behind bars than in state-funded psychiatric treatment.

Finding out jails are our largest provider of mental health treatment is like finding out Lil Wayne lyrics are our greatest source of sexual education.

No, Darren, you can't smack it up, flip it like a spatula.

What does it mean, flip it like a spatula?

Would you like it if I did that to your mother?

Look, look, using the criminal justice system to treat the mentally ill isn't just ineffective, it's expensive and it's dangerous.

Because often when someone is having a mental health emergency, the police will be called.

By some estimates, an incredible half of all incidents involving the police use of deadly force involve a mentally ill person.

And to their credit, some police departments are changing the way they do things, even creating special units like this 1.

These officers are experts in what's called crisis intervention training.

Would you say that you really don't want to die, but you want the pain to stop?

It's all part of a pioneering program where the mentally ill are diverted out of jails and in to treatment.

Okay, well, that seems really good, but calling it a pioneering program is a little heartbreaking.

Pioneering ideas should not be completely obvious things we should have been doing all along.

They should be outlandish things that push the limits of the possible.

-♪ ♪ -♪ Don't look at me like that, Linda!

-♪ ♪ -♪ Unfortunately, only 15% of law enforcement agencies even have crisis intervention training programs, let alone special units.

And taking that training is typically voluntary.

And how can something so essential to your job be voluntary?

We don't let him decide whether or not to wear that costume, because without it, things can get ugly fast.

Our whole system needs a massive overhaul, which won't be easy.

The public safety net for the mentally ill spans Medicaid, which is different across the country, 8 federal agencies who administer 112 different programs that in some way touch on mental health, and the social service agencies in each of the 50 states.

Except, that's an insult to clusterfucks.

Because at least in them, there's the potential of a satisfying ending.

This is more of a frustrating cluster dry hump of some kind.

--LAUGHTER AND APPLAUSE --And that's not to say There aren't programs that work.

Let's look at just 1, Assertive Community Treatment.

It's designed to let those with serious mental illnesses live in the community by providing regular in-home visits and help coordinating assistance in things like housing and employment.

Listen to just 1 social worker explain how it can work.

What makes mental health might not just be a visit to your psychiatrist, it might also mean having your entitlements in place, or it might mean having your rent paid on time.

So Instead of meeting with a person and talking about how they're doing, how they feel, once a month or twice a month, what we do is everything that it takes to keep people in the community living independently.

Everything it takes sounds like a much better option than what we've apparently been trying, which is nothing, not anything, very few things, not much, and prison.

-♪ ♪ -♪ ♪ And yet, in many states, assertive community treatment programs are in jeopardy thanks to everything from budget cuts to Medicaid reimbursement problems.

Despite the fact, a study found that these programs pretty much pay for themselves, which is fantastic.

You know, government programs are like graduate students on a first date.

If they are able to pay for themselves, it's a fucking miracle.

There are many more designed for many different levels of need.

And we, as a society, we have to figure out how to fund them.

Not just because it makes fiscal sense, but because it would save lives.

And if I remember rightly, there are some politicians who claim to be pretty motivated to address this problem.

Because if we're going to constantly use mentally ill people to dodge conversations about gun control, then the very least we owe them is a f**king plan.


Speaker 0: -♪ ♪ -♪ ♪ Mental illness. The thing actors pretend to have in order to win Oscars. Now, in real life, mental health can be something of a touchy topic. We don't like to talk about it much. And as 1 psychiatrist explains, when we do, we don't talk about it well.

Speaker 1: Stigma still is a very big issue. It manifests itself in the ways that we think and talk about the mentally ill, and in the terms, the words that we use to describe them.

Speaker 2: For instance.

Speaker 1: Whacko, psycho, cray-cray. Okay.

Speaker 0: Okay, first, hearing a bearded middle-aged man use the term cray-cray may have already killed that word forever. It's like when your mom says something is on fleek. It's done. It's just over at that point. But second, he is right.

Cray-Cray is a terrible name to call someone with mental illness. Although, it is an excellent name for a cartoon crayfish who just won a scuttling contest. You did it, cray-cray! You won the race! The point is, we don't talk about mental illness well.

Sometimes, even TV personalities with Doctor in their names can get it disastrously wrong.

Speaker 2: On the next Dr. Oz, Everybody wants to know, am I normal or nuts? Should you be worried?

Speaker 3: This behavior

Speaker 4: is... It's not normal.

Speaker 5: Have you gone completely insane? I mean, seriously, have you gone completely insane? Completely insane people go outside, suck on a rock, and bark

Speaker 6: at the moon.

Speaker 0: What the fuck is wrong with you? Sucking on a rock and barking at the moon is not a sign that someone's mentally ill, it's a sign that they are a wolf with an iron deficiency. You're thinking of anemic wolves, Dr. Phil. You're getting confused.

But perhaps the clearest sign of just how little we want to talk about mental health is that 1 of the only times it's actively brought up is, as we've seen yet again this week, in the aftermath of a mass shooting, as a means of steering the conversation away from gun control.

Speaker 2: This isn't guns, this is about really mental illness.

Speaker 6: In many of these shootings, we have people who have, mental disturbances.

Speaker 7: Do we need to do a better job in mental health? You bet we do.

Speaker 0: Yeah, it seems there is nothing like a mass shooting to suddenly spark political interest in mental health. Although it's worth noting that Governor Huckabee's state got a grade of D- on mental health care while he was in office. And you can't lecture people on something you got a D- in. It's like passionately delivering a speech on proper English grammar by saying, we need to thunk better about how we does word stuff. We need to get it did.

And the aftermath of a mass shooting might actually be the worst time to talk about mental health. Because for the record, the vast majority of mentally ill people are non-violent. And the vast majority of gun violence is committed by non-mentally ill people. In fact, mentally ill people are far likelier to be the victims of violence rather than the perpetrators. So the fact we tend to only discuss mental health in a mass shooting context is deeply misleading.

It would be like if the only time we talked about Coca-Cola, it were in the context of this.

Speaker 6: I'm standing here with this ice cold thirst quenching, deliciously satisfying Coca-Cola, and it actually tastes better. Now, more than ever, Coke is it.

Speaker 0: Sure, sure, that happened, and Coke was undeniably involved in it, but most cans of Coke are not that 1, and it would be unfair if every time you thought of Coke, you thought of that. But if now is our only opportunity to have a public discussion about mental health, then perhaps we should do it. Because in 2013, an estimated 43.8 million American adults dealt with a mental illness. And an estimated 10 million of us suffer from a serious mental illness each year. 10000000!

That's almost as many people as live in Greece. And most of us know a lot more about Greece than we know about our mental health system. Think about it, you know at least 3 things about Greece. Its economy is collapsing, Yarny's from there, and Greek yogurt tastes like the ice cream they'd make in a town where dancing is illegal. You know at least 3.

And when you look at how our current system deals with severe mental illness, you'll quickly realize it's a mess, and it always has been. We used to lock people up in asylums, which were often so bad, they were known as snake pits. And that doesn't sound like an attractive place to live even if you're a snake. You'd want some kind of snake loft, or snake bungalow. I don't know.

I'm no real a snake agent. And... And then, and then... And then, in the 1960s, President Kennedy signed a bill to try and close as many of those asylums as possible.

Speaker 3: Under this legislation, custodial mental institutions will be replaced by therapeutic centers. It should be possible within a decade or 2 to reduce the number of patients in mental institutions by 50% or more.

Speaker 0: And that was a really good idea, because when you see horrible places doing unspeakable things to people, you are supposed to try and shut them down. That's why there are so few Quiznos left. But... But before you get too proud of the fact that we shut those snake pits down, it turns out we never followed through and properly funded the community mental health centers JFK had wanted to replace them. All of those patients had to go somewhere, and some of the places they wound up are shocking.

For instance, a few years ago, the AP found that nearly 125,000 young and middle-aged mental health patients were being placed in nursing homes. And it's not a great idea to just stick a young person in with some old people and then hope for the best. It's like casting Taylor Lautner in the new Best Exotic Marigold Hotel movie. It's unsuitable for everybody involved in it. And some states

Speaker 2: have been involved in it. And some

Speaker 0: states have been involved in something called greyhound therapy. And unfortunately, that does not mean getting to hug a trembling dog who's 98% bone and gristle. It's an even worse kind of greyhound. The kind with 4 wheels and a broken toilet.

Speaker 2: This is Ross and Neal, the only state-run psychiatric hospital in Southern Nevada. Ross and Neal has been accused of greyhound therapy, a practice critics call unthinkable. Discharging seriously ill patients too soon, then supplying them with a one-way bus ticket out of town.

Speaker 0: I'm sorry, but you cannot just put people you'd rather not see on a bus to another city. If you could, that's how every breakup would end. Look, look, Greta, it's not you, it's me, but on the other hand, I think you're gonna really enjoy your new life in Syracuse. And we have not even got into the most depressingly commonplace that people with mental illnesses can end up.

Speaker 8: 2000000 people with mental illness go to state and local jails every year. That's meant there's now 10 times more people behind bars than in state-funded psychiatric treatment.

Speaker 0: That is terrible. Finding out jails are our largest provider of mental health treatment is like finding out Lil Wayne lyrics are our greatest source of sexual education. No, Darren, you can't smack it up, flip it like a spatula. Where did you even learn that? What does it mean, flip it like a spatula?

Would you like it if I did that to your mother? No, you wouldn't. You wouldn't, Darren. So don't say it. Look, look, using the criminal justice system to treat the mentally ill isn't just ineffective, it's expensive and it's dangerous.

Because often when someone is having a mental health emergency, the police will be called. And that can end tragically. By some estimates, an incredible half of all incidents involving the police use of deadly force involve a mentally ill person. And to their credit, some police departments are changing the way they do things, even creating special units like this 1.

Speaker 7: These officers are experts in what's called crisis intervention training.

Speaker 4: Would you say that you really don't want to die, but you want the pain to stop? Would that be... Okay.

Speaker 2: And you're

Speaker 4: willing to get some help today?

Speaker 7: Yeah. This woman agrees to get help.

Speaker 4: We'll go in there together. You'll ride with us. We're in an unmarked car.

Speaker 7: It's all part of a pioneering program where the mentally ill are diverted out of jails and in to treatment.

Speaker 0: Okay, well, that seems really good, but calling it a pioneering program is a little heartbreaking. Pioneering ideas should not be completely obvious things we should have been doing all along. They should be outlandish things that push the limits of the possible. Like a fitted sheet that's easy to fold. Or marshmallow airbags.

Or a sex doll without such judgy eyes. -♪ ♪ -♪ Don't look at me like that, Linda! I'm lonely and we both know it! -♪ ♪ -♪ Unfortunately, only 15% of law enforcement agencies even have crisis intervention training programs, let alone special units. And taking that training is typically voluntary.

And how can something so essential to your job be voluntary? Take the mascot for the Tampa Bay Rays. We don't let him decide whether or not to wear that costume, because without it, things can get ugly fast. It's important for doing his job right. And look, that's just a tiny fix.

Our whole system needs a massive overhaul, which won't be easy. The public safety net for the mentally ill spans Medicaid, which is different across the country, 8 federal agencies who administer 112 different programs that in some way touch on mental health, and the social service agencies in each of the 50 states. It is a clusterfuck. Except, that's an insult to clusterfucks. Because at least in them, there's the potential of a satisfying ending.

This is more of a frustrating cluster dry hump of some kind. --LAUGHTER AND APPLAUSE --And that's not to say There aren't programs that work. Let's look at just 1, Assertive Community Treatment. It's designed to let those with serious mental illnesses live in the community by providing regular in-home visits and help coordinating assistance in things like housing and employment. Listen to just 1 social worker explain how it can work.

Speaker 9: What makes mental health might not just be a visit to your psychiatrist, it might also mean having your entitlements in place, or it might mean having your rent paid on time. So Instead of meeting with a person and talking about how they're doing, how they feel, once a month or twice a month, what we do is everything that it takes to keep people in the community living independently.

Speaker 0: That's fantastic. Everything it takes sounds like a much better option than what we've apparently been trying, which is nothing, not anything, very few things, not much, and prison. -♪ ♪ -♪ ♪ And yet, in many states, assertive community treatment programs are in jeopardy thanks to everything from budget cuts to Medicaid reimbursement problems. Despite the fact, a study found that these programs pretty much pay for themselves, which is fantastic. You know, government programs are like graduate students on a first date.

If they are able to pay for themselves, it's a fucking miracle. And look, again, that's just 1 program. There are many more designed for many different levels of need. And we, as a society, we have to figure out how to fund them. Not just because it makes fiscal sense, but because it would save lives.

And if I remember rightly, there are some politicians who claim to be pretty motivated to address this problem.

Speaker 2: This isn't guns, this is about really mental illness.

Speaker 6: In many of these shootings, we have people who have, mental disturbances.

Speaker 7: Do we need to do a better job in mental health? You bet we do.

Speaker 0: Okay, fine. Do it then. Because if we're going to constantly use mentally ill people to dodge conversations about gun control, then the very least we owe them is a f**king plan. I

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Mental Health: Last Week Tonight with John Oliver (HBO)