MONTGOMERY, AL (WSFA) - The science of mental health care has made great strides in the last century. Ineffective and sometimes cruel treatments are now a thing of the past. But many Alabamians in need of care are still slipping through the cracks because of a lack of funding.
Those who are without health insurance or who rely solely on Medicaid often do not have access to essential services. And the stigma that still surrounds mental illness often leaves them feeling isolated and alone.
"In this country, tragically, the largest mental health hospitals are the prisons," says Alabama's newly-appointed mental health commissioner, Lynn Beshear.
Beshear says the state needs more crisis centers to address situations in which mentally ill patients are a danger to themselves or to their communities. She says there are too few centers in Alabama equipped to take patients in times of emergency.
Montgomery's clinic, for example, has only 40 beds to cover four counties.
"We probably need three times as many to handle all the people who are in crisis," explains clinic director Donna Leslie.
Leslie says the beds at her facility are always full. And that leaves police officers who pick up mentally ill patients in crisis with only two options -- jails or emergency rooms. Leslie says neither choice is ideal.
"Just today, we spent all day trying to get someone out of the emergency room and into a crisis bed," she admitted.
Beshear says her department needs more funding from the legislature to expand services.
"A person should not have to be arrested to get mental health care," she states.
In addition to crisis services, Beshear says transitional housing must also be expanded. Otherwise, some mental health patients will find themselves back in crisis.
"Once they are stable, got their medication straight and don't need to be in a hospital setting," Beshear says, "then we need to have a place for them to go to continue their recovery."
According to one estimate, 1 in 25 Americans has a serious mental illness like schizophrenia or extreme bipolar disorder. In Alabama, that equates to nearly 200,000 people, many of whom do not know how to seek treatment or do not have access to treatment.
Most agree that the first step toward better care is education. Mental health professionals say it is essential to eliminate the idea that mental illness is somehow shameful or a sign of weakness.
"There's a lack of understanding that it's an illness," Beshear says.
"It's not a bad thing or scary thing, but people think it is," agreed Leslie.
Mental health professionals recommend a course entitled 'Mental Health First Aid.' They equate it to taking a CPR class. The 8-hour course costs $50 and is open to anyone in Alabama. It teaches participants how to identify and respond to someone who may be developing a mental health problem.
The course is taught in locations statewide and more information is available online.
Mental Health First Aid: Click here for more information
SCHOOL-BASED MENTAL HEALTH CARE
A school-based mental health care program is also in need of additional funding. The Alabama Mental Health Department launched the program after the Sandy Hook school shooting in 2013. And this year's school shooting in Parkland, Florida has brought renewed interest in the program.
The program places licensed therapists from local mental health authorities in school settings. Beshear says the therapists are better equipped than guidance counselors to offer in-school mental health services to students in need.
But four years into the program, only a fraction of Alabama's student body benefits from it. Currently, licensed therapists are only available in 36 of Alabama 170+ school systems. Beshear says the added therapists are key to safer and better-performing schools.
Is your school system included in the state's school-based mental health program? Here's the answer:
"If we get schools safer in every way, not just physically safer, but mentally safer, so that access to care is available to them in the school, that alone is going to change the atmosphere in the school," Beshear contends. "Graduation rates are going to go up. Truancy is going to go down. All these other problem situations are really the result of a child having a cry for help."
Guidance counselors say those cries for help often come from students who are experiencing problems at home. Or they are the result of bullying, which is much more pervasive now than in previous generations. Cyberbullying on social media now follows students 24 hours a day, 7 days a week.
"They never get away from it," says Jerie Browning-Lewis, a guidance counselor at Elmore County schools.
Browning-Lewis says the number of students who struggle with mental illness is on the rise. The key to preventing violent outbursts is intervention as soon as symptomatic behavior is identified.
"You can have depression, but not be clinical. You can have bipolar tendencies, but not be critical," she explains. "And then something can happen that can cause that 'break' between being able to control your behavior and not being able to control it."
But experts say guidance counselors and licensed therapists cannot be relied upon to identify every cry for help. Everyone in a school environment -- from teachers to custodians to cafeteria workers -- must be part of the solution.
That also includes school resource officers. SROs are trained law enforcement officers who are assigned to patrol school campuses.
According to the National Association of School Resource Officers, only about 20 percent of schools have them.
Contacting your school's guidance counselor is a good first step toward identifying mental health resources. The state also offers the following resources for more information.
Alabama Mental Health Advocacy Line: 1-800-367-0955
National Suicide Prevention Lifeline: 1-800-273-8255
But the most important influence on a child's life is his or her parents. Experts say mothers and fathers must make a conscious effort to immerse themselves in their children's lives.
"Know your child," Browning-Lewis insists. "And if something is different, if you notice a change, follow up on that."