When tragedy occurs and makes the news, as a mental health professional, I have the opportunity to share my insights. In the case of the Germanwings tragedy, FOX News Channel’s; ‘Your World With Neil Cavuto’ called upon my expertise as a Psychotherapist to share my thoughts as to what can be learned.
Without dialogue how can we consider how to increase the potential for preventing such tragedy from occurring again? In my opinion, discussing this painful event is not an exclusive focus on the airplane industry. Rather, it brings to the surface the reminder that there are topics of which need further attention, and that is the topic of: mental health awareness. The topic of: duty to warn. The topic of: taking mental health seriously. The topic of: what is the employer responsibility, clinician responsibility, and employee responsibility?
During my interview and discussion with Neil on FOX News, a few of my key talking points included the following:
Duty to warn or not to warn?
HIPAA plays a role in the creation of fear for medical and health care professionals, affecting their judgement as to what information is to be shared and what is not to be shared. What is legally acceptable to be shared vs. what is ethically acceptable to be shared? Distinguishing between duty to warn or not to warn, is an important decision that clinicians make every day.
Clinicians need to feel safe to disclose their concerns to the appropriate person or people in cases of ‘at risk’ for self harm or harm of others.
Perhaps there needs to be further training for care professionals on how to make the decision when to take it upon one’s self to disclose information to an employer (for example) vs. not vs. leaving it up to the patient to self disclose.
What’s an employer’s responsibility?
The importance of employers of industries that hold the lives of others in their hands to have a plan in place for how to handle cases of mental illness is a topic that needs to be further explored. More specifically, cases of depression in which there is an employee with suicidal ideations, a history or present indicator of suicidal plans conceived needs to be considered and determined how best to handle to protect those lives. For an example, what the mental health status is of an employee; how often is that checked, and how is that evaluated – are concepts to consider.
Employer’s plan in place combined with clinician’s plan
When an employee who has a recent history of suicidal tendencies, and that employee is responsible for many lives, if that employee is going through a life transition, I would recommend a psychological evaluation and counseling be a part of the agreement in order to work at the place of employment. Let us take a moment to consider what we have learned about the Germanwings co-pilot. According to report, his girlfriend recently broke up with him and she’s pregnant with his child. This is a no brainer- right here, this scenario. When a person has suicidal tendencies and he is experiencing this kind of turmoil, this can dramatically affect one’s mental health and thus one’s response to these life challenges. If there is a plan in place as per employment responsibility for a monthly mental health status update, including the individual and family appointment, and combine that with a medical plan that the clinician is to provide documentation of duty to warn directly to the employer, not simply relying on the person to self report, this increases the chances for the person to get the help they need. This also increases the chance for lives to be safe and saved prior to such a tragedy from ever occurring.
Psychological evaluations the way in which they are currently designed lacks in a systemic approach, as it is only focused on the individual. It is my assertion that the family system is something to consider in the evaluation process, to ask them questions, not simply to talk with the one employee only. Psychological evaluations I believe needs improvement. For an example, a therapist who has the opportunity to meet with the nuclear family during an evaluation will have the experience to observe not only verbal response, but also the body language of the various family members. To consider those results in conjunction with speaking with the individual we are referencing, provides for a fuller picture.
Take ownership of one’s illness and behavior
Persons of whom have mental illness – it is imperative that they take ownership of their illness and how that affects others. The philosophy that a person who is depressed with suicidal ideations must have a safety plan in place for how to deal with those thoughts, to protect others, is imperative.
Although my suggestions does not guarantee tragedies will never happen, I believe it is my obligation as a mental health professional to continue to think outside of the box, and to say the things others may be afraid to say in an effort to continue to evaluate and re-evaluate current systems in place.