The Central Palm Beach County Chamber of Commerce held a luncheon on Thursday, Sept. 13 focused on mental healthcare in Palm Beach County. The two keynote speeches were from Dr. Marisa Azaret, psychology division director at the Nicklaus Children’s Hospital, and from the county’s largest provider of mental health services — Palm Beach County Sheriff Ric Bradshaw.
Chamber Chair Robbin Lee, CEO of Wellington Regional Medical Center, introduced each of the afternoon’s speakers.
Bradshaw explained that his department is the largest mental health provider in the county, noting that 85 percent of mental health issues involve the PBSO, and his agency deals with 3,700 mental health cases a year, which amounts to between 10 and 12 a day.
However, this brings about many challenges. “Deputies don’t have the skills or intricacies for mental health treatment,” Bradshaw said. “Five years ago, I went to the legislature for money to start a mental health program. They approved $1 million, but the governor vetoed it… I did it anyhow.”
The program launched with seven experts that had either a master’s degree or doctorate in psychology or social services.
“Seven doesn’t scratch the surface,” Bradshaw said. “I am going back to the legislature. I want 21 teams.”
Bradshaw stressed that mental health services needs more emphasis and funding both in Palm Beach County and across the nation. For example, he commented on the case of Nikolas Cruz and last February’s school shooting in Parkland.
“Someone knew ahead of time. He fell through the cracks. The signs were there,” Bradshaw said. “There were too many pieces. He should have had proper treatment in proper facilities.”
Bradshaw added that the PBSO’s mental health unit dealt with Cruz’s brother in Lantana through Florida’s Baker Act. “That’s how the system should work,” he said.
Bradshaw added that 10 different minors in Palm Beach County have come in contact with the department’s mental health unit since the Parkland shooting. “If we don’t come together and pay more attention, [school shootings] are going to keep happening,” Bradshaw said. “Let’s change it.”
Bradshaw touted the new Student Protect app, which so far has been downloaded 20,000 times. He said it has already been used successfully and noted one example where the app was used to a catch a pedophile riding a bicycle in front of a local school repeatedly.
“It’s a sad state of affairs when I have to handle these problems,” Bradshaw said. “I don’t think it’s my job to be the biggest mental health provider in the county. I don’t like it. It’s not the right way to do things.”
Bradshaw then turned to the issue of gun control. He called for a database that includes mental health information and pointed out that many shootings involve guns obtained legally due to a lack of available information on a purchaser’s mental health history. He did not say specifically what information would be collected about members of the public who come into contact with the mental health system.
“An AR-15 is an assault rifle,” Bradshaw said. “It’s not for hunting — not for pinging cans. There is no way to know if someone has mental health issues when they are buying a gun or applying for a concealed weapons permit… It’s not the instrument — it’s whose hands we put it in. A knife, gun, rock or car can all be used as weapons by someone with a mental health issue.”
In her presentation, Azaret stressed the simple mantra, “mental illness is common — without mental health, there is no health.”
She has more than 30 years of experience with pediatric psychology and is the Emmy-winning host of Vive la Salud con Dra. Azaret on CNN Español.
“Of the 74.5 million children in the United States, an estimated 17.1 million have or have had a psychiatric disorder, more than the number of children with cancer, diabetes and AIDS combined,” Azaret said, quoting the Child Mind Institute. “Half of all psychiatric illnesses occur before the age of 14, and 75 percent occur before the age of 24.”
Azaret explained that according to the Centers for Disease Control, the most common disorders affecting children are ADHD, conduct problems, anxiety and autism. Adolescents — classified as ages 12 to 17 — are also affected by illicit drug use/substance abuse disorder, alcohol abuse and cigarette dependence.
According to the American Psychiatric Association, suicide is the leading cause of death among adolescents. Often, children’s interaction with others leads to bullying behavior.
“There is a serious problem with bullying,” Azaret said. “The numbers are scary. There is a tremendous increase in elementary school and middle school bullying. Kids don’t talk — they don’t have the language.”
Azaret went on to list the effects from untreated mental illness. These included worsening of the problem (chronicity), somatic complaints, worsening of chronic conditions, poor social and behavioral development, poor academic performance, poor self-esteem and unhealthy life choices.
Mental illness and the family is another factor that Azaret touched on, explaining that parental mental illness leads to an environment that is inconsistent and unpredictable, and also provides inherited risks.
“If the parent is not treated, it is extremely difficult to treat kids,” Azaret said. “It is impossible to [promote mental health in children] without seeing the parents.”
Statistics presented by Azaret showed that only 20 percent of those needing access to mental healthcare receive necessary services.
Azaret outlined her future goals, including expanding relationships with community organizations, advocacy groups and grassroots organizations, adding that the three biggest challenges are poor interagency communication, limited insurance coverage and reimbursement, and fighting stigma.
“Mental illness is not a personal failure,” Azaret said. “In fact, if there is failure, it is to be found in the way we have responded to people with mental and brain disorders.”
Dr. Lori Lane Hansen, a podiatric surgeon with the LA Podiatry Group and chair of the Central Palm Beach County Chamber Medical Board of Governors, also spoke at the luncheon.
Hansen pointed out that there are now more safety officers than counselors in schools, which she claimed contributed to the Parkland shooter “slipping through the cracks.”
Hansen cited the American School Counselors Association recommendation of a ratio of one counselor per 250 students needing to be met. At present, the ratio is one counselor per 444 students, according to the Department of Education.
