In this guest column by UTMB’s Dr. Victor S. Sierpina: As we all consider the year ahead and pray for peace on earth and good will to men, one important step we can take is to work at whatever level we can to improve the care of the mentally ill. Our mental health system is truly dysfunctional and unless we fix it, no amount of gun laws, school security, police presence or metal detectors in schools and public gathering places will solve this epidemic with its chilling, deadly effects.

The not so silent epidemic

The increase in mass shootings has revealed a tectonic weakness in our nation. Like an earthquake in the making, such events are often tremors and pre-shocks of bigger problems. 

No, the world did not end on 12.21.12. No, the NRA is not to blame. No, such horrific tragedies don’t mean that our nation’s moral fiber is in the sewer. 

However, a civilization is measured by is how it treats its most vulnerable, needy members. Do we put them on an ice floeto die or leave them in the middle of a prairie when they are no longer useful members of society?This may have been a reasonable rule in nomadic cultures, but not in ours. 

Here is the issue: mental illness is vastly undertreated in our country. Our system refuses to take responsibility for managing the legions of young and old that suffer from chronic conditions such as bipolar disease, schizophrenia, autism, major depression, borderline personality, psychoses, and other mental conditions. 

The stigma of admitting to mental disease gets in the way of treatment. Coverage by insurance for inpatient or outpatient treatment is often seriously limited.Other chronic conditions such as cardiovascular disease or cancer are often fully covered. As a result, the mentally ill are often untreated and thus become unemployable, impoverished and homeless. This is an unfathomable tragedy.

In many ways, we are where we were in the medieval era when insane people were locked in cages. Now, with the number of psychiatric hospital beds at less than 10 percent of previous levels, we have new, modernized cages. 

We call them prisons.

 It is estimated that well over a third of current prison inmates in the U.S. are there because of actions related to their mental illness. Rather than offering compassionate, humane and scientifically based treatment, they are cast in a cage with truly violent, anti-social criminals. The die is then cast and they are condemned to be branded as convicts, unemployable, and scarred by the exposure to reprehensible murderers, rapists, armed robbers, drug dealers and others. 

Not that violent offenders shouldn’t be removed to protect society. No, this is more of an issue of inadequate resources and commitment to care for those with mental illness and to prevent such social and personal tragedies from occurring. Over the last decade or two, think about all the mass shootings and murders of innocent children, adults, politicians, diners, shoppers and so on. While wild-eyed terrorist fanatics may have been the cause of some of these massacres, more often than not, it was attributable to a mentally unstable person performing an irrational act of violence, driven by internal demons and a mind deranged. 

As we all consider the year ahead and pray for peace on earth and good will to men, one important step we can take is to work at whatever level we can to improve the care of the mentally ill. Our mental health system is truly dysfunctional and unless we fix it, no amount of gun laws, school security, police presence, or metal detectors in schools and public gathering places will solve this epidemic with its chilling, deadly effects. 

Dr. Victor S. Sierpina is the W.D. and Laura Nell Nicholson Family Professor of Integrative Medicine at the University of Texas Medical Branch.