If you asked me 15 years ago when I started graduate school what I thought a counselor’s main objective was, I would have told you it was our job to help people learn how to cope with the problems in their lives better, to help them utilize their strengths to overcome their weaknesses, and to get them back on the right path of being the person who they should/could be. Damn…just typing out that answer now makes me feel like the most naïve person to ever set out to be a counselor. Now here I am 15 years later and my answer couldn’t be more different. Most clinicians in my field would never admit what I am about to say publicly, but the truth is that I feel like a counselor’s main objective now is simply equip them with a metaphorical bullet proof vest to protect them from society and to plant hope that things will change and they can be part of the solution.
Of course I have never admitted that to my clients but I would be lying if I said that it wasn’t the truth. So why is it that I believe this you ask? Simple…what we are doing is not working and the problems are only getting worse. Too many times after there are high profile suicides, drug overdoses, legal issues, school shootings, etc. we see politicians and my fellow colleagues go on national news programs and talk about how we need more resources for suicide prevention, access to mental health programs, and substance abuse treatment programs. That is all we really hear and on the outside, one would think that if we could just get a few hundred million more dollars for these programs, then we can start really fixing these problems.
The honest truth is that we could spend 10 times more money on all of these resources and we are not going to see them work any better. We are stuck in this mentality that if we only had more money than the problem would go away but as we hold out collective hope for more table scraps of money, we are totally ignoring the truth about our programs and worse yet, what is actually causing these problems. Just think I am a burned out counselor with a cynical point of view? I wouldn’t blame you for thinking that, but just take a look at hard data and you will see what I mean.
Since the 1970’s when the war on drugs was declared, Billions of dollars have been spent on substance abuse prevention and treatment programs. With the growing opioid problem in the country, even more resources and awareness has been put into these programs than ever before. If these programs were indeed the solution and just funding were the issues, then we would expect substance abuse rates would be decreasing and treatment outcomes would be getting better right? Here is the problem, more people are abusing drugs than ever before and the treatment outcomes have not gotten any better. When you have relapse rates for opioids sitting at 80-85% for 20 years and more people using drugs, what would make us think that doubling or tripling the resources would do anything different? Not to beat a dead horse here, but not only are drug use rates going up among younger generations, they are now going up in age groups (50-60) that previously never saw increases in drug use.
If we look at mental health statistics, the data paints an even grimmer picture. Research across the board shows that people feel more anxious, stressed, depressed, and isolated than ever before. Despite all of the awareness and increased funding to mental health & suicide prevention programs, suicide rates have increased 25% over the past 20 years with another study showing a 30% increase since 2000. Another study recently showed that suicide is now the second leading cause of death for teenagers and is in the top 3 leading causes of death among people aged 15-44 worldwide. So think about those numbers for a second, as we have increased awareness and resources, the numbers continued to get worse. On top of all of that, suicide is affecting people from all levels of socio economic status as well which paints an even more troublesome picture. It is easy to point the finger at people who are struggling in life and feel hopeless about ever getting out of their situations. But take a look at all of the recent high profile celebrity suicides and it doesn’t take a rocket scientist to realize that you can have absolutely everything money and fame can buy but it still isn’t enough to keep them happy. For my clients who have all the wealth in the world and are depressed, they often claim that their feelings of hopelessness are exacerbated by the fact that they have everything they have been taught would make them happy and yet they are still miserable.
I think that is one of the reasons that Anthony Bourdain’s suicide struck a chord in so many people’s hearts including mine, was because he seemed to be doing all of the things that we tell people to have in their lives and how to live their lives but yet none of that was enough to keep him around. For some reason, the juxtaposition of people who seemingly have everything and commit suicide or seemingly are living the life and throw it all away because of their addiction paints the clearest picture on how we are totally missing the boat on why all of these problems are happening and continuing to get worse. Think about how many married teachers are losing their jobs and going to jail because of having sex with their students. Literally every week we read about a teacher going to jail but yet the very real specter of losing their jobs, families, children, and freedom isn’ enough to make them change their behavior. How many politicians and business leaders spent their whole adult lives making all of the right moves to get to the places where they are and throw it away because they give in to a sexual impulse or give in to their addictions. These people have everything they ever wanted and yet it wasn’t enough.
Lastly, think about all of the failure to launch stories that have been making the news recently. This is hardly a new story considering I wrote a book on the topic 5 years ago warning about this problem. You have huge portion of young adults who are doing everything in their power to not become an adult and face the real world. Do you know how many times I have heard a failure to launch client explain to me that they do not see the point of going to college and putting all of that effort into it when they see that most people who have done all of that are miserable anyways. Yeah they have money but none of that makes them happy anyways so why do something if there is no point to it, especially if you have a family who is letting you get away with not doing anything.
So what does all of this mean…what point am I trying to make here? The point that I am trying to make is that the data is clearly telling us that what we are doing is not working at all and that we need to stop fooling ourselves with debates about resources that in truth, even if delivered, will do anything more than they already have. When I have brought up these things to my colleagues, while many of them agree with me, none of them will ever say anything about it because if we acknowledge the truth that we know these things are not working and do not have anything else to go with…people will just give up and not use any of the resources. I totally understand that and hope that people will read this and not think that I am saying to not use these resources or that we shouldn’t invest in them. I just view these programs in the same way I view cancer treatment. More people keep getting cancer and we don’t know how to cure it, and we only have options like surgery and chemotherapy which can vary in how effective they are. We know treatment is going to suck and are years away from curing it, but you have no other options so you choose treatment because it’s the only option.
That is where we are at in the mental health field and the longer we ignore the truth, we never have the honest conversation that will give us the ability to have a conversation about what really is causing all of these problems. The current programs are not effective because at best all they can do is try to fix something after it has already been broken. It is like a firefighter trying to put out a fire while the arsonist is still there lighting new fires or a cancer doctor treating a patient for lung cancer while they are still smoking and working in a coal mine. The problem is society…our culture…our entire world that we have created for ourselves. Suicide, addiction, failure to launch, etc. are less primary diagnoses but more a result or side-effect of the very world we live in. People are asking counselors and all of these programs to fix something when the very environment that brought them to us in the first place doesn’t change.
I am not going to use this letter to go into the specifics about what changes need to happen because all that will do right now is get people to make this political and instead of talking about what we can all agree on, we will instead take sides, point fingers, and argue and nothing will change. There will be a time for that discussion but right now everyone needs to understand that something much bigger is going on here and we need to be talking about that. Change happens slowly over time and that change can begin with a conversation such as this. Every single one of us needs to take a look in the mirror and ask what are we willing to do to start addressing the problem. We cannot fool ourselves anymore because we have already lost too many people to addiction and suicide. How many more people do we need to lose before it is time to have this conversation? I for one am done watching people die or slowly die…enough is enough.
We are all the problem…but we are also all part of the solution. If we can all agree that society is the problem, let’s meet there so we can have the next conversation about what we need to change and how we can change it together.
