Tuesday, November 5 2013 5:28 PM EST2013-11-05 22:28:33 GMT
See an extended interview with the parents of convicted killer Mark Becker and find out how mental illness may have played a part in Becker's thinking when he murdered A-P football coach Ed Thomas.More >>
See an extended interview with Joan and Dave Becker, the parents of convicted killer Mark Becker. They talk about how mental illness played a role in the murder of A-P football coach Ed Thomas.More >>
GARNAVILLO (KWWL) -
With every major mass shooting come the inevitable questions about mental illness, gun control and how to help people with mental illnesses so they don't fall through cracks in the system.
Mental health professionals agree that the vast majority of people with mental illnesses are not violent.
Justice Krambeer is one of the people suffering from a gap in Iowa's mental health care system. The 19-year-old now lives with his mom and younger sister in Garnavillo, but he's had other homes.
"Four different psych wards many times," he listed. "I've been to Prairie View, I've been to jail, I've been to Fort Dodge at the rehab."
Krambeer has a mental illness called a cluster B personality disorder.
"I'll freak out and start just panicking about small things," Krambeer said, sitting on a couch in his mom's living room Friday afternoon. "I don't know why I do it, but I just do."
He left Prairie View residential care facility in Fayette earlier this year, saying he felt the 24-hour in-patient care was too confining for him.
"I was getting to the point where I was getting pretty angry," Krambeer said. "I didn't want to be there anymore. I hated it. You're not around your friends, you're not around your family. You're just stuck."
As someone who needs neither emergency care nor 24-hour surveillance, Krambeer is among the group of people Dr. James Potash says is falling through the cracks in Iowa's mental health care system.
Potash is chair of the University of Iowa's department of psychiatry.
"We need this so-called intermediate level-of-care kind of facility," Potash said. "Those just don't exist in anywhere near the numbers that they should."
Potash has spoken publicly with Todd Pettys, University of Iowa College of Law professor and associate dean for faculty, about the intersecting issues of mental illness and gun rights.
Earlier this month, the two sat down together with KWWL for a joint interview on the subjects.
"People who have serious mental illnesses have a higher risk for violence than the average person," Potash said.
Pettys, who is an expert in constitutional law, said, "it's going to be a pretty serious mental illness to reach the point at which one no longer has a constitutional right to possess the firearm."
Some people with mental illnesses - particularly those with schizophrenia - can have delusions that someone is trying to hurt them, Potash said.
"What sometimes happens is, they respond to that by striking first, before, in their minds, they get struck or attacked themselves," he said, adding that he believes it's people who fall into that category who shouldn't have a firearm at their disposal, both for the public's safety and for their own.
"As important as the Supreme Court has said this right is-- to possess a firearm in the home for self-defense, here's the threshold beyond which we are no longer comfortable letting people exercise that right," Pettys said hypothetically, explaining the decision involved in denying somebody the right to own a gun. "That's a difficult line."
It's a line the US Supreme Court has left largely up to states, Pettys said.
On the law enforcement end of this discussion, Dubuque police chief Mark Dalsing said he tells his officers to expect to interact with mentally ill people on a daily basis.
"If somebody's delusional, it can be a little more obvious," Dalsing said. "Issues involving long-term depression and stress and PTSD, you know, those are the ones that aren't as obvious."
He said recognizing and treating a mental illness before it leads to violent acts is the best course.
"There comes a time when people have to become active bystanders and they just can't sit back and say, 'It was none of my business,'" Dalsing said. "Maybe that might be the only way that we're going to prevent some of this stuff."
Once there's a diagnosis, however, treatment isn't always easy to come by.
"Iowa, in particular, is 48th in the country in number of psychiatric beds per capita," Potash said. "Those are beds that, I think, we really need, to care for the most severely ill."
In order to reduce the number of violent acts committed by people with a mental illness, Potash said, "we need to continue to move in the direction of reducing the stigma that surrounds psychiatric illness and, in addition, we need to continue to work on developing better treatments."
A better mental health care system is necessary for people such as Krambeer, who is, for all intents and purposes, confined to his mother's house in Garnavillo, which is a small town surrounded by miles and miles of farmland.
"I don't go anywhere. I don't do anything," he said.
He said his doctor has told him he's not mentally healthy enough for full-time work, so he has tried applying for part-time jobs, with no luck.
"Nobody really wants to hire me. That, or there's just not enough work around here," he said. "Who wants to hire somebody who will freak out in social situations and over small things?"
The situation is bleak for Krambeer, who said he lost his Medicaid and could wait more than a year on a decision about Social Security eligibility. In the meantime, he's worried about having access to the prescriptions he needs to treat his mental illness.
"Right now I just feel like, 'Why do I exist?'" Krambeer said. "I just sit around all day. It's the same thing as being in the facility. It's the same thing as being in jail. Same thing as being anywhere that they lock you up at. You just sit around and do nothing."
He said he believes a group home would be an ideal situation for him.
"They have staff check up on you, yet you're more independent. You could get a part-time job," he said. "You contribute to society and you feel good about yourself."
While he's grateful for all his mom is doing for him, he can't help but feel he's currently sitting at a dead end.
Krambeer's journey also highlights another problem in Iowa's mental health care system. He spent nearly three weeks in the Clayton County jail last year, while officials tried to find a treatment facility with room for him. He had no criminal charges against him at the time.
Mental health professionals say many inmates in Iowa's prisons and jails have at least one mental illnesses.
Legislation aimed at redesigning Iowa's mental health care system passed last year. Part of it now requires law enforcement agencies to provide their officers with training for how to deal with people with mental illnesses.
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