SAN ANTONIO - – After the Uvalde school shooting, like many mass shootings, mental health became a topic of discussion among politicians after the public demanded change in gun laws.
That discussion can be broad and vague, so KSAT went to the experts to ask what they believe is needed.
Dr. Jessica Sandoval is a child and adolescent psychiatrist with UT Health San Antonio who supervises at the Center for Health Care Services, as well as the Cyndi Taylor Krier Juvenile Treatment Center. She also works in the outpatient community clinic for Roy Maas Youth Alternative.
Dr. Christopher L. Wallace is a psychiatric consultant to the emergency department at University Health in the main hospital and is a UMC, or university medicine associate psychiatrist.
They’re two leading psychiatrists from two different health systems, focusing on two different patient groups. Yet, they have the same stance on the correlation between mental health and mass shootings.
“I really want to get away from linking mental health and mental health care to tragedies like we’ve had recently,” Wallace said.
“I think that there are two separate conversations,” Sandoval said. “I think that there is much good that can be done, but the vast majority of school shooters actually do not have a diagnosable mental illness. Actually, people who have a mental illness are more likely to be victims rather than perpetrators of violence.”
Sandoval said that there needs to be more funding for the global mental health of children, regardless of violent tendencies.
“We have too many kids who wait months and months and months for appointments,” she said. “We have too many kids who can’t access care and specialized services that they need because we don’t have enough specialized therapists. (We need) to be able to have mental health parity so that we have more doctors who are able to afford taking insurance. And that would help reduce some of the wait times.”
Sandoval also said having a more diverse workforce would lead to better care.
“Being able to have trainees, residents, fellows, physicians that all represent the communities that they’re taking care of so that people feel more comfortable to come to us because we have a better sense of what they’re going through, how they’ve been raised,” she said.
Sandoval said that might lift some of the stigmas that Wallace agrees keep people from managing their mental health.
“I think the bottom line is that mental health support services are woefully lacking in the state of Texas. And that usually means funding, where we’re running about 50th out of 50 states for funding services,” Wallace said.
He said lack of funding affects levels of services and staffing, leading to the three- to six-month waiting lists patients see at both public and private clinics.
“Much of it is having a place to send them from the emergency department after we’ve judged that they need to be admitted to a hospital or some other form of treatment. It’s having access to those outpatient services and also for inpatient services. We don’t have enough of either in San Antonio,” Wallace said.
For a city the size of San Antonio, Wallace said we should have about 750 adult psychiatric beds available. He said we’re running just shy of 300.
Unfortunately, that same trend runs through the state and even the country.
“I think funding to be able to be preventative would be the most important,” Wallace said.
Part of that is breaking the stigma surrounding mental health.
“A normalizing of, ‘It’s OK to have feelings. It’s OK to have bad feelings.’ People should be talking about those things that can be in school. It can be in churches, wherever they find support. Otherwise, they can find support for mental health,” Wallace said.
Sandoval believes drawing correlations between mental health and mass shooters exacerbates stigma.
“The concern is that when we use this really stigmatizing language to say the shooter is mentally ill, that might put barriers for people who do have mental illness from coming forward. There are going to be a lot of people that might need some increased support and services but don’t want to be associated with that type of person, and that does a disservice to everybody,” Sandoval said.
Sandoval and Wallace want people to know there is help out there. They said if you have a primary care physician, start there. If you have insurance, a lot of times, they have employee assistance programs.
If you don’t have either, there are free programs available through organizations like the National Alliance on Mental Illness (NAMI).
For mental health help or information on supporting someone else, call NAMI San Antonio at 210-734-3349, or live chat with experts on the website.