Wednesday’s mass shooting in Parkland, Florida, reminds us once again of the tug-of-war between gun rights activists and mental health advocates over who’s responsible for these tragedies. Each side points to the other as the death toll mounts. The day after the shooting, which killed 17 people at a high school, Donald Trump played into this dichotomy, urging people to report erratic behavior to authorities. The press responded by focusing largely on gun laws.
I hope reporters won’t be duped into this thin binary. Journalists have a duty to bring this blur into focus. I hope they peel back the layers and reveal the greater tragedy here: No matter how many authorities we call when we see someone acting strangely, little is likely to be done. The truth is, we’ve effectively abandoned the public mission to care for people with mental illness in this country.
Countless stories are just waiting to be told, from every town and city in America. Here are some ideas for every reporter to consider, regardless of where they live or the size of newsroom:
- Where does a person go when in psychiatric crisis in your town? Are there enough emergency beds?
- What has happened to your county’s mental health budget over the last 10 years?
- Is the police force in your town trained to deal with people in a psychiatric crisis?
- Are there adequate programs to screen children at risk?
- What kind of funding is there for research and treatment?
None of it is glamorous. Much of it is heartbreaking. All of it is urgently needed.
I spent more than a year combing through county budgets and sifting through patient admissions data to be able to determine that Milwaukee County, Wisconsin, had the highest rate of psychiatric readmission in the country.
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It was not the story of the sobbing mother standing by her son’s grave that spurred the state legislature to overhaul the system. It was the data that revealed that one woman had been admitted 196 times in six years, the equivalent of once every 11 days. Taxpayers weren’t getting a return on their investment. We quoted county officials making the same lame and hollow promises year after year. And then we ran their pictures and telephone numbers. Hopping-mad readers took it from there.
Reporters who cover the Parkland massacre and subsequent mass shootings need to abide by the cardinal rule they learned the first day of journalism class: Follow the money. That’s the spine of nearly every great story. It is certainly true here.
Where does a person go when in psychiatric crisis in your town? Are there enough emergency beds?
Was Nikolas Cruz, the 19 year old charged with the murders, in treatment for mental illness? If not, why not? We now know that he was troubled for years and bragged on social media about wanting to be “a professional school shooter.” As Howard Finkelstein, Broward County’s chief public defender, put it, “Every red flag was there and no one did anything.” Now that’s a story.
Who knew about his problems, when did they know it, and what were they doing about it? Stigma and health privacy laws make it hard for reporters to get answers. Still, they need to keep trying.
As I tell my students all the time: Don’t take “no comment” for an answer. Reporters need not tiptoe around the subject of mental illness like it’s impolite to do so. People are dying out there in an invisible, slow-motion epidemic. Very sick people are being turned away at the hospital door, left to live in the streets or languish in jail. Remember The Sacramento Bee’s stories in 2013 about the psychiatric hospitals putting patients on buses and shipping them to Las Vegas or homeless shelters?
Rigorous journalism leads to better mental health care. Exposés in the 1940s and ‘50s pulled back the curtain on the horrors of what went on behind locked psychiatric hospital doors. In the noble effort to close those “snake pits,” patients were herded out of hospitals. But when the spotlight dimmed, so did the public will for reform. Most of the community healthcare centers that were promised were never built.
So, the burden of caring for these sick folks fell to their local health boards. As all seasoned reporters know, these arcane bureaucracies don’t draw intense interest from editors or scream sexy headlines. Clickbait, they ain’t. As attention waned, so did these programs from a lack of funding. Then along came the recession of 2008, wiping out any reserves they may have had left. Once again, the sickest were left holding the short stick.
And then there’s insurance, the toughest story to sell of all. Until eight years ago, insurance companies could deny coverage for mental illness. One woman I interviewed had a daughter with a head injury and a son with bipolar disorder. She had coverage; he did not. This was all perfectly legal. Even with parity, insurance companies still deny claims with questionable justification. And, boy, do they ever. An exposé by 60 Minutes found one doctor who was paid $25,000 a month to review the claims of anorexia victims desperately seeking care. He denied every single one.
And now that the Affordable Care Act is being chipped away, the people who finally had their mental healthcare covered are in danger of losing it again.
Recent journalism has yielded some stunning work as the consequences of these policy fails play out. Some recent examples:
- Sarah Smith for ProPublica, on how some inmates in Mississippi wait as long as 1,200 days for their mental competency exams.
- Rosalind Adams’s series for BuzzFeed revealed how a for-profit company was trapping people into care they likely did not need.
- Joaquin Sapien’s follow-up of Clifford Levy’s Pulitzer Prize–winning stories exposed the unsafe and unsanitary conditions of group homes in Coney Island.
Like most things done well, these stories took a lot of time and often excruciating effort. Adams talked to more than 1,000 people for her stories (many of whom hung up on her). Smith called sheriffs in all of Mississippi’s 82 counties and made multiple trips there to interview 33 people, almost half of them more than once. Sapien spent many cold nights perched on dilapidated doorsteps, shooed away more than once by cops who had come to recover dead bodies.
It’s so hard to move the needle.
Today, half of the 8.3 million people in America with mental illness get no treatment—either because they are afraid to ask or their insurance won’t cover them. A person with mental illness is now 70 times more likely to be in jail than in a hospital. The Treatment Advocacy Center, which lobbies for more hospital care, counts 11.7 beds for every 100,000 people with mental illness. All 50 states now have more people with serious mental illness who are in jails and prisons than in the relatively few remaining psychiatric hospitals.
“Whether or not this troubled young man had a mental illness or needed mental healthcare, the reality is that Florida’s mental health system is unimaginably broken,” says John Snook, director of the Treatment Advocacy Center. “We need to come to grips with that fact and how we fix it.”
Our weary eyes are on Parkland, Florida. In a week or a month, they’ll be on some other place.
We can’t be lulled into the quick, easy story of carnage or swayed by the cheap opportunism of those looking to advance their own political agendas. We can’t stop with the interview of a grieving parent or the platitudes of politicians’ “thoughts and prayers.” Reporters need to dig in on this story and investigate unholy alliances that put profit over people’s lives. We have to call out those who are supposed to help but turn their backs instead.
If we are going to make any meaningful difference, we need to stay and ask hard questions long after the blood-stained classrooms have been hosed down and the grief counselors retreat.
Meg Kissinger is the Joan Konner Visiting Professor at Columbia University’s Graduate School of Journalism. She teaches an investigative reporting class on the mental health system. Kissinger won the George Polk Award for her coverage of Milwaukee’s troubled behavioral health system and a Robert F. Kennedy National Journalism Award for her examination of the nation’s imminent danger standard.