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DR. DREW

Is My Kid at Risk?

Aired December 18, 2012 - 21:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


DR. DREW PINSKY, HOST: Thank you, Nancy. Our prayers do indeed remain with Newtown.

And when you think of these communities victimized like Aurora, Oregon, Newtown -- again, victimized by troubled young men going on shooting rampages in public places, I want to take something -- move the story forward tonight. I want to help us all understand how we can recognize potential killers or other problems before they do harm. I want you to, if you`re worried about your kids` behavior, to be able to assess whether that child could be dangerous, and if you know somebody who is in trouble, if you know somebody you`re worried about, what you can do and how to identify these things, we`re here to try to help.

First up, child analyst and psychiatrist, Dr. Harold Koplewicz.

Call us with your questions, 855-DRDREW5.

Dr. Koplewicz, in these massive tragedies -- and I understand these are very rare -- but I want to talk about what is preventing us from preventing these things from happening? What do you see -- what do you think the big weaknesses are in our system today?

DR. HAROLD KOPLEWICZ, PSYCHIATRIST, CHILDREN`S MENTAL HEALTH ADVOCATE: I think that one of the most important things that we have in the United States is a great health care system.

However, when it comes to child mental health or adolescent mental health, we fail miserably. We fail because we have a tremendous amount of stigma that surrounds these disorders, myths and misconceptions. We have a problem with access to care. Your health insurance doesn`t work for your children`s mental health.

PINSKY: Right.

KOPLEWICZ: And last, we`re just not investing enough money in research for more innovative treatments and for better delivery of services.

PINSKY: All right. I agree with all of those things. In fact, I have a feeling I`ll be agreeing with so much of your saying, pardon me ahead of time if I begin interrupting you because I want to keep this --

KOPLEWICZ: OK.

PINSKY: -- I`m sort -- I`ve got a head of steam about all this stuff.

Let`s start -- so, the system for analyst and child kind of broken. Let`s start with, were there areas we can work on that are not systems issues such as parents? My understanding is it takes, on average, two years for parents to bring a kid with a mental health issue to the health care system at all. What`s going on with us as parents?

KOPLEWICZ: Can you imagine that if your child had a rash, in two days, you`d be at the pediatrician`s office.

PINSKY: Absolutely.

KOPLEWICZ: In two weeks, you`d be at a dermatologist`s office.

PINSKY: Yes.

KOPLEWICZ: And yet I believe that because we`re so ashamed of these disorders, we have so much blame so that it`s the mom`s fault, it`s the dad`s fault, it`s the child`s fault, it`s diet, it`s immunizations --

PINSKY: Yes.

KOPLEWICZ: -- that we hope and pray sometimes it`s just a phase.

PINSKY: Look, we`re sort of -- the public is sort of primitive in our thinking about it. As you said, we`re blaming it on their diet, we`re blaming it on their vaccines. When, in fact, these are brain disorders that are well-documented, well-known, and we: (a), we don`t really educate people about them, and (b), allow parents to stay in denial about it.

KOPLEWICZ: Well, I think it`s even worse because it`s almost as though the country treats diseases above the neck differently than diseases blow the neck.

PINSKY: Absolutely.

KOPLEWICZ: So that if you think about how common, how real and how treatable these disorders are, it`s nothing less than shocking that parents don`t -- first of all, when they do see a problem, they wait, and when they finally decide to do something, the system is not all that welcoming. So that, unfortunately, pediatricians aren`t well-trained, so very often, they actually suggest watchful waiting.

And while that might be good for a prostate or a breast when you`re worried about a lump or maybe some kind of tumor, it`s absolutely the wrong way to go when it comes to psychiatric illness.

PINSKY: All right. Let`s you and I take some of the calls --

KOPLEWICZ: I think that --

PINSKY: All right. Go ahead. Finish your thought. Please?

KOPLEWICZ: Well, I was going to say that we really need a place -- I mean, we have been spending a tremendous amount of time building a symptom checker so that parents can go to the site and say, these are some of the symptoms I`m worried about, get an algorithm that asks them more questions and more questions, and within five minutes, at least four or five diagnoses that they can look up.

PINSKY: An idea.

KOPLEWICZ: And then, maybe, if they need to see someone, find someone in their neck of the woods.

PINSKY: Jenny in New Mexico -- Jenny, you got a question for us.

JENNY, CALLER FROM NEW MEXICO: Hi, Dr. Drew.

PINSKY: Jenny.

JENNY: I have a 20-year-old son who was diagnosed with early outset of schizophrenia at the age of 17. My son has never been displayed violent or rage, but at times he`s shown intense anger. My son has been hospitalized many times since his diagnosis and has been put on countless medications.

During his last hospitalization four months ago, his psychologist informed me that there are excellent medications that she thought could really benefit my son.

PINSKY: Right.

JENNY: But because these medications are so expensive, they are inaccessible to him.

PINSKY: Yes, Jenny, so hold.

So, herein lies so many issues in Jenny`s little call here: (a), the accessibility and cost of medication, (b), whether there should be residential management for these people, (c), how do you get people to take their medicine, and finally, (d), it`s an adult child of a parent who wants something to happen here.

What is a parent to do?

KOPLEWICZ: Well, let`s start with the fact that these are one set of disorders where very often the patient isn`t on the side of the doctor. If you think about the fact that you have asthma or you have seizures, you want the asthma or the seizures under control.

And so, the patient runs to the doctor and says, please help me. Please give me new medicines, give me new treatments, give me a new inhaler, and so you and the patient are on one side, the asthma or disease is on the other.

Unfortunately, these diseases because they affect the brain and affect the thinking of the patient, very often they`re in denial or they say, no, no, no, I`m not sick, I`m not starving myself. No, I`m not --

(CROSSTALK)

PINSKY: I`m not doing drugs, I`m not doing drugs, I`m not drinking. Denial madness.

KOPLEWICZ: Right. It`s exactly the same place where you and I come. Addiction is the same thing.

So, the parents have -- one thing you don`t want to wait for is when your child turns 20 because you have less and less control as soon as they hit the age of 18. But the other piece is that there is no doubt that the system is really broken. The fact that your health insurance will cover dialysis, will cover a deviated septum so you can get a nose job, and yet, our health system, our insurance, until we get Obamacare, by the way, which will cover kids under 18 for mental health.

PINSKY: Dr. Koplewicz, I hope so because I`ve been hearing parody conversations for my entire practice, for 20 years. And when parody comes in, it`s magically somehow different.

I want to take another quick call. Kirstin in New York -- Kirstin.

KIRSTIN, CALLER FROM NEW YORK: Yes, hi. How are you?

PINSKY: Please go ahead.

KIRSTIN: My problem is my daughter was diagnosed extremely early. We had all the support in the world, from family, everybody, she was diagnosed with early onset bipolar, ADHD, severe anxiety. And my problem is, is that I actually am a stay-at-home mom, I have the support systems, and I have gotten nothing but refusal to address her issues.

And that is terrifying to me. I am in with the school system, I am in with everybody. And they have actually apologized to me.

These doctors have said to me, I commend you for being married, still, to your husband because these problems are so hard.

PINSKY: Of course. They break marriages apart. They rip families apart, absolutely.

But this is something we are going to get into in the next block a little bit.

Doctor, go ahead and answer that question for her, if you would.

KOPLEWICZ: Well, I think the important part is you really want to be partners with schools. And very often, you hear of mothers like the shooter where she`s pulling the kid out of school because she doesn`t -- the school just won`t make the accommodations.

And I have to think about this just for a second. Take a moment to think that if your kid was coughing or spitting or bleeding in school, the school would immediately say, we have to do something about it because it might affect the other children.

And yet if a kid is socially isolated or looks menacing or odd, basically we try to ignore that child and hope that kid can get through school as quickly as possible and essentially get out of the neighborhood and not be in our school.

PINSKY: Isn`t it the problem that we are -- first of all, we rationalize these things, we claim we can`t judge them and we`re so P.C. We`re not willing to look at the difference between healthy and unhealthy.

KOPLEWICZ: Well, I have to tell you, the political correctness is really kind of upsetting. If you look at this blogger Liza Long, who wrote, "I am Adam Lanza`s Mother" and basically said, I have a 13-year-old. I could be anyone`s mother with the problems I`m dealing with my son. The failure of the system, the failure of the medicine goes on and on.

And then there`s a backlash that someone said, how could you write about this? You`ve ruined your child`s reputation.

It is really amazing to me that you could ruin your child`s reputation for having the psychiatric disorder but not ruin his reputation for having diabetes or any other illness.

PINSKY: That`s right.

KOPLEWICZ: That`s where political correctness really gets me, because at the end of the day, it`s more children not getting the help they need.

PINSKY: Absolutely agree with you.

Next up I`m bringing in an attorney, Georgianna Kelman who specializes helping troubled kids. If you have one of these issues we`ve been discussing, call us, 855-DRDREW5.

And also, I believe I`m going to have Steve Perry, an educator, to really talk about the school`s role in all this.

This is a very complex issue, but here`s the deal. There`s been a tragedy. We cannot let it happen again. We`re going to look at solutions and try to give you what you need or your community needs to make a difference.

(COMMERCIAL BREAK)

PINSKY: All right. What we`re trying to do here is after this tragedy is move this forward to make a difference. I don`t know about you, but I can`t look at another little coffin, I can`t look at another beautiful face.

I have to make a difference. I have to answer questions about not just why but what can we do? We always ask ourselves, could we have done more, could somebody -- the parents, the police? I want to hear from attorney Georgianna Kelman, she focuses on special needs children. I`ve also got Steve Perry, a school principal.

All right. Georgianna, last night, we took a call from a man whose 15-year-old son was threatening her, she`d been in the system, she`d taken advice from doctors, but she had nothing, from her opinion, that she could do to get this kid residential treatment or to get him daily care.

What does a mom do?

GEORGIANNA KELMAN, ATTORNEY, FOCUSES ON SPECIAL NEEDS CHILDREN: Well, what a mom does is, the first thing the mom needs to do is go to your teacher. There`s a beginning point. Express your concerns. Make sure that your teacher goes to your school administrator. Make sure that you ask for a meeting.

If this isn`t getting you anywhere, depending on your child`s behaviors, if your child is having some behavior where you feel there is a danger to himself or a danger to others, you have to call the police. A lot of parents don`t want to do this.

PINSKY: OK. Now, Dr. Koplewicz, that`s -- the law enforcement has become our mental health service of last resort. Because, as you said earlier, the system is broken, I find I`m recommending the police a lot. And I don`t mean to overburden them, but it`s a common -- I find it very commonplace.

And equally common, though, parents won`t do it. That`s where disaster really strikes.

KOPLEWICZ: Well, you have to remember that currently, the juvenile justice system is the largest mental health system we have in this country. And what has happened is that since you can`t make a patient go for treatment, you can`t make someone take medicine if they need it, what happens is the parents are left in the situation where a child has done something so dangerous or so out of control that threatens them or threatens the rest of the family that they take that moment to call the police, so the police take the child to an emergency room.

The problem is that the emergency room is a stopgap measure.

PINSKY: Yes.

KOPLEWICZ: If the child is acutely suicidal or acutely homicidal, they can get admitted.

PINSKY: Yes, but that`s it.

KOPLEWICZ: But then, the problem is the system doesn`t work where -- right, we don`t have enough residential care. Not inpatient but residential care, or a flexible system that says you can come every day to this clinic.

PINSKY: Right.

KOPLEWICZ: And if we have to see you for three or four hours, we`ll use social workers, we`ll use psychologists --

(CROSSTALK)

KOPLEWICZ: To make this work.

PINSKY: There`s nothing like that.

KELMAN: But there is --

PINSKY: Particularly not for the underinsured or the underserved. There`s just not.

Let me ask you this, Dr. Koplewicz, (a), people are very fearful about medication. Would you address that, number one? And number two, what do you speculate happened with this shooter? Do you have any theory?

KOPLEWICZ: Well, let`s start with the second question, and the fact is that, you know, it`s interesting. No one can give a diagnosis to someone that you haven`t met. But quite clearly, this is a very troubled kid. When you listen to the fact the kid was out of school, the child was seen as socially isolated, someone is giving one diagnosis of some kind of developmental delay like Asperger`s.

It doesn`t make a difference what the recipe was, we see that it`s a kid struggling with some kind of psychiatric issue and a mother struggling to try to get him help. And then the lethal component is that they have guns in the house.

PINSKY: Yes.

KOPLEWICZ: The interesting part is medicine.

Recently, today, I heard on some newscast that the young man was not taking medicine, like somehow that was good, so we couldn`t blame the psychiatric medications for causing this. And this is really quite troubling because the medicines we have are pretty effective. They have been studied, so if you look at medicines for attention deficit, for impulsivity, for hyperactivity, those psycho stimulants, when given properly, have been effective in 80 percent, 85 percent of the time. There hasn`t been a single death caused by this.

PINSKY: And psychosis, for psychosis.

(CROSSTALK)

KOPLEWICZ: If you look at -- well, the other medicines like, right, anti-psychotics can make you stop hearing voices, can hear -- can make you actually live in the present and let you out of a psychiatric hospital.

And when you look at SSRIs like Prozac, those medicines stop obsessive-compulsive disorder, and they stop, by the way, depression, so that we saw for the first time a decrease in suicide rates once Prozac came out on the market and once when we put a warning label on it, we actually sort of increase again on suicide attempts and suicide completions.

So, the fact that -- again, the stigma about having these diseases, because they affect the brain really I think affects our feeling about psychiatric medications. I think the other place we have to spend money is that we`re learning about the brain. The fact is that with functional MRIs and with enough investment, we can start seeing the difference between a typical brain and a child with a specific illness.

PINSKY: Yes.

KOPLEWICZ: And also eventually, if treatment really works, the brain should look different pre and post-treatment.

PINSKY: Right.

(CROSSTALK)

KOPLEWICZ: When it becomes real, I think, all of a sudden, a lot of that stigma might go away.

PINSKY: I hope.

Now, I mentioned a woman being threatened by her son. Her name is Michelle and she`s back on the phone with me right now.

Michelle, you were telling a horrible tale about trying to reach out for resources and your son was still threatening you. Can you -- can you give us a little thumbnail of that?

MICHELLE, CALLER FROM KANSAS: Yes, Dr. Drew, what happens is he gets so angry that he just -- he threatens, and he has a really hard time controlling himself. But when we take him somewhere for help, like to the hospital or something, they`ll say, well, did he hurt you or did he do anything? And it`s usually a verbal threat or just jumping up and down or angry or tantrum, but it`s very, very scary and since he didn`t actually physically do anything, then they send him home.

PINSKY: And then, Michelle, the police won`t do anything, either, if he just threatens things as well.

(CROSSTALK)

PINSKY: Georgianna, go here.

KELMAN: If I can jump in here --

PINSKY: Yes. What do you? I`ve only got about 30 seconds, so please, then I have to take a break.

KELMAN: This is daunting to me because the school, again, should be stepping in here. There is no reason for her to go to the hospital or the police constantly. This child should be in different placement.

Have you gone to your school? Have you told them what`s going on?

PINSKY: Hold on, Georgianna, I`ve got to take a break.

KELMAN: OK.

PINSKY: And Steve, Steve Perry, our educator, I`m going to have him respond to that because how much more burden can we put on the school, Steve? I`ve got to take a break. I`ll have you respond to that in just a second, and hopefully give people more tips about how to deal with this, and what about when the child becomes an adult? You have an adult who -- you are the parent of who now has rights and they`re dangerous. What do you do?

Be right back.

(COMMERCIAL BREAK)

PINSKY: There is just so much I want to get into here, and I promise you if we don`t get into it tonight, the issue of adult care, as a parent taking care of an adult with mental illness, a child, we`re going to get into issues of conservatorship and these things, how hard they are to get, now, what we need to do to make them easier.

Now, Steve Perry, you heard Georgianna say that she felt that we ought to put more on the schools. How do you feel about that?

STEVE PERRY, PH.D., FOUNDER, CAPITAL MAGNET PREP SCHOOL: That`s a good opinion. Unfortunately, it`s not rooted in fact. The fact is there`s a limit to what we as a school can provide.

I`m going to make the same phone call to the same mental health facility that anyone else is going to make, and I can say, hey, not only am I principal, I`m on television ,and you need to take this person in. And they`re to say, we understand, we`re big fans of your work. However, this kid has not committed a crime. And as a result, all we can do at best is some level of outpatient care, we can give him an hour`s worth of treatment here.

The school teachers in many cases are trained to teach content. That`s what they do. In fact --

KELMAN: That`s the problem.

PERRY: In many cases they become certified by taking just one special ed course. Even if they took 30 percent of them, the school is designed to educate. And, at some point, we have to recognize that there are some things that do exist beyond the scope of the school.

As was discuss earlier --

KELMAN: I have to interrupt here.

PERRY: -- there needs to be intermediate care.

PINSKY: Georgianna --

PERRY: There needs to be care in between "you`ve committed a crime" and in between what the school can do. We can give you social work services and do. We can give you support services and do.

KELMAN: It is not about social work services.

PINSKY: And I will say something --

KELMAN: It is not about social service services.

PINSKY: Well, Georgianna, let me say, though, I -- one of the chairs I`m involved with is a therapeutic school. Those residential therapeutic, scholastic environments can be extremely effective, but, my God, are they expensive? And to get the government to participate, it really ends up that communities funding these things.

KELMAN: Let me just say one thing for one second.

PINSKY: One second.

PERRY: For one student, it`s $120,000 a year for one student.

PINSKY: Very expensive.

KELMAN: And that`s the elephant in the room. It is always about money. Money is the root of all of this.

Having said that, though, are you familiar with idea, the Individuals with Disabilities Education Act. There is federal funding available for the states that subscribe to this act and most states do.

You, as a principal, know very well there are a myriad of placements for these children from general education all the way up to an institution.

(CROSSTALK)

PINSKY: Hang on, hang on, play nice, you guys. Steve, I want to hear more about that because I wouldn`t know how to access that.

I want to take a quick call from Angela in South Carolina -- Angela.

ANGELA, CALLER FROM SOUTH CAROLINA: Hi. My name is Angela. I have a son, I have a full-time job. I have great insurance. I`m in the U.S. Air Force.

I have a 15-year-old son. At 11 years old he was bullied by another student because he is -- we haven`t had him diagnosed correctly. From the time he was four years old we have been in and out of institutions. At 11 years old, he was hit by a car by a child who chased into the street because they knew my son was strange.

He was hit by a car, flown by chopper to a Philadelphia Hospital.

PINSKY: Awful.

ANGELA: We immediately brought him back home. He was terrified of this child. We brought it to the school`s attention, the child was charged --

PINSKY: Angela, I`m sorry, I`m running out of time. What is the specific question? I will get to the answer after the break.

ANGELA: There is no question. He was in residential treatment for a year. When we brought him out, I brought an army with me from the residential program to the school.

PINSKY: Did it work?

ANGELA: The school refused.

KELMAN: Absolutely.

ANGELA: The school absolutely refused to put him in a residential school system where there was for him in that school district. They flat out refused with --

PINSKY: I`ve got to take a break. I`m sorry about that. I`ll take a break right now. We`re going to try to get more into that and try to pick that apart and find out where the system is breaking down. Be right back.

(COMMERCIAL BREAK)

PINSKY: OK. We are really on to something here. I`m going to ask my panel to please keep their responses short, I`m going to ask my callers to be as brief as possible. I want to get to as many calls as I can. Who wants to respond to Angela?

Georgianna, would you get into that?

KELMAN: I would love to respond.

PINSKY: Go ahead, please.

KELMAN: And to respond to you, Steve, and some of the statements you`ve been making.

There is help, absolutely. There is federal law that mandates schools to provide children with special education needs for the services that they require. Those services can be anywhere from a general education classroom to an institution to residential treatment. And it is your responsibility as a special education director or a system principal that oversees the IEP teams which is who determines that these children are eligible for special education to provide those service.

PINSKY: Hang on. OK, got it, Steve. Is there an IEP in your school? And if not, is that where things were broken down?

PERRY: Of course, every single school, it`s the federal law, you have to have an IEP. But here`s some practical limitations. In the event that this child needs acute care, meaning that they need counseling services, they need group services, the school itself cannot provide that. There needs to be secondary outsourcing. And that`s the conversation.

KELMAN: Absolutely not.

PINSKY: Hang on, guys. We`re hearing those are positions.

Shelly in Ohio -- Shelly.

SHELLY, CALLER FROM OHIO: Yes, I have two bipolar children, one child has been to the hospital seven times in a year. He`s had a lull for a year and it`s coming back. She`s hearing voices.

PINSKY: Yes.

SHELLY: What should I do? (INAUDIBLE)

PINSKY: OK. Well, the hospitals do help. Dr. Koplewicz, this is really the issue.

How old the kids, Shelly, by the way?

SHELLY: Sixteen and 23.

PINSKY: OK. So, Dr. Koplewicz, we have a great example here. We have an adolescent, she can mandate care. Of course, insurance will determine how long that child will stay in the hospital. Never long enough by the way. And she`s got an adult child.

How should she approach each of these kids and how different are these problems?

KOPLEWICZ: So, I think we should quickly realize that bipolar disorder is a lethal illness. It`s got the highest suicide rate of any psychiatric illness. Kids very often self-medicate. I think when you have a 16-year-old, there`s two things you want. You want them not to only to be treated but you want them to be educated.

Do you want them to own the disease? So, they are not bipolar. They are someone who has an illness that needs to be managed, and they have to recognize it. And it`s very hard for 16-year-olds to do that.

PINSKY: Yes.

KOPLEWICZ: But if you don`t start doing that, then, when you`re 23, you`re going to have a child who`s going to relapse many, many times before they finally accept it.

PINSKY: And I love --

(CROSSTALK)

PINSKY: -- being on the illness is on the side of the -- the patient illness are one side against the doctor, which makes it. You know, when the system isn`t working and the parents aren`t deeply involved and you`ve got the patient poorly invested, you kind of see the nature of the problem here, don`t you?

KOPLEWICZ: And you also have to recognize that this -- you could have the biggest return on investment because 75 percent of all serious psychiatric illness starts before the age of 24, 50 percent before 14. So, we think -- go back to the rash. If you get a rash, you treat it fast, it causes no problems.

You let a rash go on, you get an infection, it changes your whole life. These things have to be done early.

PINSKY: OK. Let`s go to Michelle. It`s a different Michelle. She`s in Kansas. Michelle?

MICHELLE, KANSAS: Hi, how are you?

PINSKY: I`m great. What do you got going on?

MICHELLE: Well, I have a 19-year-old that has been diagnosed with autism, and he`s had all the behaviors that we`re all hearing about. I just simply have a statement, and I just want to point out there to advocate for us, parents, that it`s a struggle out there, especially when you`re scared of your own children.

PINSKY: Are you afraid -- hang on -- are you afraid your son is going to hurt you?

MICHELLE: Yes. I`m afraid he`s going to hurt myself or anyone else in my family.

PINSKY: OK. Hold on, Michelle, hold on. Dr. Koplewicz, OK, so "A," she`s suddenly hearing about autistic spectrum violence. That`s not a usual deal. Help people understand that, number one. And then number two, let`s get to this issue of conservatorship.

KOPLEWICZ: So, let`s start with number one. Asperger`s or autism spectrum disorder, those kids don`t have any higher rates of violence or aggressive behavior than any another kids, particularly, any other kids with psychiatric illness. There are others that have higher rates. The second thing we have to recognize is these are chronic illnesses.

And they take endless amounts of time and attention. And what really bothers me is when we blame mothers and fathers.

PINSKY: Yes. It`s another victim. Now, we have another victim.

KOPLEWICZ: These parents actually -- they really need a medal, because having an average child, you only have to be an average parent. You can mess up a lot. But when you have a kid with one of these really difficult psychiatric disorders, you have to be an exceptional parent. You`re always -- it`s 24/7.

PINSKY: Yes. Georgianna --

(CROSSTALK)

PINSKY: Yes. I`m going to ask Georgianna a question about the conservatorship, because we kind of touched on this last night.

GEORGIANNA KELMAN, ATTORNEY: Yes.

PINSKY: I am frequently advocating conservatorship. It`s sort of good of the individual who you`re making the conservatorship for, not to be punitive, to help them, help themselves, but it is costly, it`s impossible, people don`t know about it, it`s cumbersome, it takes forever.

KELMAN: Right.

PINSKY: What do we need to do to change that system?

KELMAN: At this point, in her particular situation, that is the only recourse that she has. You`ve got to gain conservatorship. You`ve got to petition the court for it. And it is a little bit of a daunting process. There`s a lot of protocol, lot of guidelines. You`ve got to get an attorney. The court has to appoint an independent counsel for your conservatee. You`ve got to be able to prove that your --

PINSKY: Georgianna, Georgianna, I`m sorry. That`s now -- listen, good advice to Michelle, but what are we going to do with this system that nobody can access? It`s too (ph) in cumbersome. What needs to be done now to change that?

KELMAN: That`s the problem. That`s the $64,000 question, what can we do to change it? At this very moment, between you and me, there`s nothing we can do.

PINSKY: What do you want the legislators to do?

(CROSSTALK)

PINSKY: What do you want the legislators to do?

KELMAN: We can take measures now to protect our kids in school. We can take action tomorrow that helps our kids in school to protect them from mentally ill children and mentally ill adults that can harm them.

(CROSSTALK)

PINSKY: OK. All right. Go ahead.

KOPLEWICZ: And I think as we`re looking at the fiscal cliff, you should know that in the past decade, mental health budgets across the United States have been slashed by about 10 percent, and if we go off this fiscal cliff, one of the major things to get hit are state grants for after-cares and special long-term facilities.

KELMAN: That`s an education --

(CROSSTALK)

KOPLEWICZ: We`re either going to address this problem and recognize that it`s essential, but it`s also going to be expensive and it`s going to be hard. But it`s very doable. We need a public education campaign to explain this. We have to get better and more flexible treatments, and we need to invest in science. All of it doable but, nevertheless, expensive.

PINSKY: And Steve, I`ll give you the last word in a second, Steve, but I just want to say this one thing. And, we need to be disencumbered by the legal system. I heard somebody say today that the gun laws will never change because as soon as we begin requiring someone who`s purchasing gun to answer questions about their past, oh, my God, we`ve invaded their privacy.

The attorneys will sue. It will never go anywhere. That`s unconscionable. The same thing is true of how we approach this system, in general. We`ve got to be able to do our job, and we, Dr. Koplewicz, are encumbered by the privacy issues and the rights issues that really endanger the patients and the community. Steve, I want to give you the last word. Go ahead.

STEVE PERRY, PH.D., SCHOOL PRINCIPAL: You talked about some of the social issues around identifying children, but one of the issues that we`re not talking about is the over identification of minority children, specifically, minority boys, and one of the reasons why so many parents who are minority parents feel like the system is, in some way, out to get them.

And it`s these issues that cloud the conversation, then we haven`t had the conversation about minority parents --

(CROSSTALK)

PINSKY: Steve, here`s what I want to do. I want to pick up right there tomorrow because that is a massive issue. Thank you, doctor, by the way, Dr. Harold Koplewicz, Koplewicz, I keep mispronouncing your name. I beg your pardon. And Georgianna and Steve, thank you all. Dr. Koplewicz is the president of the Child Mind Institute.

Again, Georgianna Kelman and Steve Perry. We`re going to do this again tomorrow night because this is a conversation we`ve got to keep moving forward. There`s a lot here. We`ll take as many calls as I possibly can.

All right. So, when we hear the names like Columbine, Aurora, Wisconsin, how did the survivors of those shootings react when they`re exposed to yet another attack and this media onslaught that were all being exposed (ph) to do. We`re going to speak to some survivors and what they think needs to be done, up next.

(COMMERCIAL BREAK)

PINSKY: I`m joined now by some people directly affected by other mass shootings. Tom Mauser`s son was killed by Eric Harris at Columbine High School. He is the author of "Walking in Daniel`s Shoes." I have Amardeep Kaleka. I pronounced that correctly, did I?

Absolutely.

PINSKY: Your dad was killed in the Wisconsin mass shooting in August. And joining us by phone, Kira Rowland. She was shopping in an Oregon mall last weekend. We were just reporting on that story, and we talked to Kira.

And Kira, I guess, you actually went back to the mall today. You were with your child, and we saw the picture of you with your child there. And this all went down with you with your child and you went back to that mall for the first time since the shooting. What was that like for you?

VOICE OF KIRA ROWLAND, WAS IN OREGON MALL DURING SHOOTING: Yes, ironically, I was going -- planning on going to the mall today to see if I could actually go in and kind of just start the healing process and to just start to move forward.

PINSKY: Let me say, Kira, first of all, you sound like a different person today.

ROWLAND: I do.

(CROSSTALK)

PINSKY: Nice to meet you as you actually are.

ROWLAND: Yes.

(LAUGHTER)

ROWLAND: -- without tears and shakiness.

PINSKY: Yes. But number two, I don`t necessarily recommend people re-expose themselves to traumatic environments, unless, it`s really something you wanted to do. So, I imagine you felt strongly about this.

ROWLAND: I did. And you know, I had some support with me. My friend, Rob, went with me. And I was pretty shaky in the car just to walk up and go ahead go in there. Once I got there, I was telling my story to him about, you know, where I was and what happened and what went down. I was shaking.

PINSKY: And Kira, has all this exposure to the Newtown disaster affected you?

ROWLAND: Absolutely.

PINSKY: Yes.

ROWLAND: I think that once I heard about Connecticut Friday morning is really when I started to kind of just -- the PTS kind of just kicked in and I was able to cry, I guess, you could say. Like my -- I was so stunned that after I heard about that I just -- that`s when everything kind of just let out and, you know, I just -- it was much harder that day.

PINSKY: Yes. I`m sure. It`s just got to be awful. I mean, for somebody who`s not been through it`s been awful.

ROWLAND: Yes.

PINSKY: Tom, I want to go to you. You were in the White House today and you actually met Eric`s parents. Is that right? Can you tell me about that and what you accomplished in the White House?

TOM MAUSER, TEENAGE SON, DANIEL, KILLED AT COLUMBINE H.S.: Well, first, the White House, we met with the president`s chief of staff to talk about -- we had victims of gun violence. They were talking about we wanted to see this conversation happen.

PINSKY: Were they supportive?

MAUSER: Oh, definitely. Very much so, yes. We`re very pleased. As for Eric Harris --

PINSKY: Yes.

MAUSER: Yes.

PINSKY: Go ahead.

MAUSER: As for Eric Harris, it was about eight years after the tragedy at Columbine, I decided, you know, I can`t go on like this and not have any interaction whatsoever with the parents of the young man who shot my son. So, I wrote a letter to Mr. and Mrs. Harris, as well as a little bit later, I wrote --

(CROSSTALK)

PINSKY: What did you learn by meeting them?

MAUSER: Meeting them, they were all too human. You know, you go into it, you want to think, boy, these are people who you`re going to talk to you`re going to say, well, no wonder something went wrong there. I can see what happened there, and it wasn`t. They were ordinary people, soft-spoken people. And you looked and you thought, what went wrong here?

PINSKY: Did you gain some insight?

MAUSER: A little bit of insight, I think, perhaps, you know, to the extent that, yes, they at least had their son going to counseling. But they said they really had no idea it was this bad, and they kind of blamed it on the doctor. You know, we were just kept in the dark.

PINSKY: Reasonably so. I mean, the system failed him. Now, Amar, you actually were in Newtown last night. And I was saying during the break that the last thing they need is more media people there. I mean, that`s why I`ve elected to stay back and try to help make sense of this thing, but somebody who`s been a survivor can really have a big impact.

AMARDEEP KALEKA, FATHER KILLED IN SHOOTING: Absolutely. And I`d tell everybody, every survivor they should touch ground there because they need help with the grieving process. They need help --

PINSKY: What did you find out? What did you learn? What did you see?

KALEKA: I mean, it is definitely darker than we could ever imagine. It`s one of those things that it`s perverted beyond recognition to think of all those kids. And when you see their names and you see their pictures, it`s just --

PINSKY: And the memorials. The memorials on TV are more than I can take. I think it would take my breath away just standing in that square.

KALEKA: But the first thing I would tell people is don`t glance away. This is the truth. This is happening. It is not a movie. It is not batman. It is happening right here, right now in our country, and we need to go out there and fix this problem.

PINSKY: OK. So, I`m going to take a quick break, and we`re going to pick back up with what you think the fix is. And of course, hopefully, I`ll have a little moment for a call or two, 855-DrDrew5. Be right back.

(COMMERCIAL BREAK)

PINSKY: Something I`m advocating for all of us I`m trying to do here on the show which is service, faith, and connectedness. We`re trying to stay connected, but we`re trying to make a difference. We`re trying to move this story forward so this slaughter will not have happened in vain. Amar, you wanted to say something. You wanted to talk about solutions.

KALEKA: Well, I think one of the major solutions that we all have to consider is there`s a disconnect. I used to be a teacher and one of the first punishments they tell you is, a kid is acting out, take him out of class.

PINSKY: Yes.

KALEKA: That is isolation. That is the beginning. That little problem where we`re isolating people and disconnecting them from other people --

PINSKY: Yes.

KALEKA: -- I think it`s turning into a larger disconnect.

PINSKY: I agree with you. My own personal belief is the first disconnect is in the family.

KALEKA: Absolutely.

PINSKY: And unless, we learn to have intimate connection and sustain it, we`re in big, big trouble. That`s where empathy is grown, by the way, in that connection. I want to try to go to some calls. Harry in Pennsylvania -- Harry.

HARRY, PENNSYLVANIA: Hi, Dr. Drew. The reason why I`m calling is I feel for the families in Connecticut, because over the past years, I have buried most of my children who have been murdered. My daughter (INAUDIBLE) my son who was murdered at Western Pysch (ph) Institute in Pittsburgh. Ex- patient walked in showing signs of violence, walked in with baseball bats.

He threatened doctors, he was even 302d at one point, and nothing was done. And my question is, how many red flags have to be (INAUDIBLE) for mentally ill person to be taken seriously and to be treated before they can just walk through into the hospital and open gunfire, shooting and killing my boy?

PINSKY: Harry, I`m so sorry. And I know exactly what you`re asking. Again, we`re going to try to continue those kinds of questions tomorrow night. Tom, I`ll throw that out to you. You`re lobbying in the government. You`re trying to make changes so this kind of thing can`t happen. How do you respond to somebody like Harry?

MAUSER: There are many red flags. And let`s face it, we are not a nation of interveners. We`re a nation of individualists, and when we have troubled people like this, the tendency for the government and neighbors is to say, well, just let these people deal with it on their own. No, we all pay the price for that when it happens.

PINSKY: I absolutely agree -- we`ve got to build community, but we also have to build awareness. And we are so into this ethos, this mindset. Who are we to judge? I can`t judge. We can judge, we do know. And we need to not just judge but report it and take action.

MAUSER: Absolutely. There`s no way you can do anything in terms of treatment without actually having that first discussion or labeling, you know?

PINSKY: Absolutely right. And people recoil. How dare you label somebody? It`s to understand it, to help it. Tom, you were trying to say something there.

MAUSER: No, go ahead.

PINSKY: OK. Debbie in Colorado -- Debbie.

DEBBIE, COLORADO: Hi, Dr. Drew. I had a brother that was diagnosed with acute schizophrenia 29 years ago. And my parents at that time struggled with the health care system for two years. They couldn`t get help. They were in and out of hospitals. There was no program. No halfway houses, and they couldn`t even get medicine.

Eventually, my brother shot and killed two of my brothers and then tried to kill me. So, my question is, what has really changed in 29 years that we see the same issue and the same problems and the same struggles over, over and over again?

PINSKY: Debbie, you`re -- you guys just breaking my heart. I feel overwhelmed by the magnitude of these stories. Tom, is there something our leaders are trying to do here?

MAUSER: Well, after listening to the previous sections of the program, it seems like we`re not doing very much. It really is pretty depressing. Now, it makes me more -- even more convinced to continue on the gun control front because it`s clear that we`re not going to be solving the mental health part of it any time soon.

Not to say we shouldn`t be working on that in a big way. It`s got to be a two-pronged approach, but it`s really -- we come up with all these great medical advancements, but when it comes to the mind and the treatment of mental illness, we`re really, in some respects, in the dark ages.

PINSKY: We really are. The problem is we`ve been through what we used to call the decade of the brain. And we`ve been through all that. It`s our country, our culture that`s in the dark ages, don`t you agree?

KALEKA: Absolutely. I think we know so much about this right now, and people aren`t going out and advocating it or pushing it. And, the gun approach is definitely a solution or a point to go at, but there`s a three- pronged attack. It`s corrections, it`s in the family, it`s even in our religious culture, it`s everywhere.

PINSKY: Well, you know what, let`s talk about the religious piece, because people are -- you know, when you look at Twitter and things, people want that part to help them. I think it really can help. I think -- should we be -- I`ve always encouraged a faith concept. Maybe we should be really pushing people into a more organized religious environment where there`s something to contain some of this.

KALEKA: Just simply put, religion is a third perspective.

PINSKY: Yes.

KALEKA: It is an objective perspective.

PINSKY: But it helps.

KALEKA: It helps.

PINSKY: It really helps.

KALEKA: Counseling, too?

PINSKY: Yes, sure.

KALEKA: Like when you have an objective perspective helping you kind of engage the issue?

PINSKY: But there`s no resources for that. The churches are there. We can go -- people can access them now, and really, if nothing else, guys, it will help you heal through this horrible trauma and try to make sense of things. You know, medicine is not a realm for philosophy. We don`t make sense of stuff.

We don`t answer why, we answer what and what led to it and that kind of thing, how to prevent, how to treat, but the whys, the bigger philosophical whys, that, I suggest, you take up with your clergy over the philosophical text.

Thank you to Tom Mauser, Kira Rowland, and Amar Kaleka. I`m going to take a quick break. We`ll be back right after this.

(COMMERCIAL BREAK)

PINSKY: All right. I`ve got just a brief couple minutes here. I want to finish up with some calls. Cindy, Cindy are you there?

CINDY, TENNESSEE: Hi, Dr. Drew.

PINSKY: Cindy, what do you got?

CINDY: I`m the mother of a 16-year-old son with autism and bipolar, and he`s very balanced. He`s been hospitalized about 15 times since he was seven years old.

PINSKY: OK. So Cindy, you`re right in the bull`s-eye of what we`ve been talking about tonight. Does he take his medication?

CINDY: He does, yes.

PINSKY: Is there anyone helping you find sort of residential environment or is anybody suggest that or have you resisted that?

CINDY: He`s been in multiple residential placements. Of course, insurance sends him home if he`s been good for a couple of days in a row. This year, the state charged me with neglect and abandonment after he assaulted me and sent me to the hospital, and the police took him to a hospital, dropped him off, and when I refused to pick him up after I was beaten that night, they charged me. So, the system is fighting against parents like me. They`re doing everything they can.

PINSKY: Can you get -- so for me, a story like this, this may sound cool, but it`s not cool. It`s for the well-being of this kid. He would be happier and thrive in a sustained, residential, therapeutic education environment for a long time, maybe indefinitely. Is there anything like that you could access or are you aware of any services out there that can get you that? This is really what we`re talking about here.

CINDY: No. His school`s IEP program (ph) provides a good placement for him from 8:00 to 3:00. They contacted with the --

PINSKY: That`s good. Is that helping? Is that helping?

CINDY: Well, he seems safe from 8:00 to 3:00, but it doesn`t keep me and society safe from three o`clock. My son has even said that he would rather be in a facility long term --

PINSKY: When somebody contains them, they feel better. Listen, all I can say is, this is the frustration for me, because here you are, you use law enforcement, you use your resources, you use the school. You`re in an OK situation, but you know in your heart of hearts, this is the compensate (ph). You`ve got to find -- there are some privately funded sort of communities that are out there that are charitable organizations that have some federal funds, some local funds and some chartable funds.

I know there are great ones in Los Angeles. Please take advantage of something like that and work hard to find that, because that`s your only solution. Christina in Georgia -- Christina.

CHRISTINA, GEORGIA: Hi, Dr. Drew.

PINSKY: Christina.

CHRISTINA: Yes. I`d like to say I have a brother who`s been mentally ill for 35 years. He`s been diagnosed with schizophrenia, manic depressive, and bipolar issues. And I want to say that the mental health industry in this country is horrific. He`s been in hospitals in New Jersey and in Florida, and he`s now homeless. And we cannot get any help for him. We`ve even written letters to the governor and the senator and all that.

PINSKY: A lot of the homeless are people like your brother.

CHRISTINA: Yes.

PINSKY: Who would he be placed somewhere? Would he -- if they sort of, you know, restricted his rights a little bit --

CHRISTINA: Yes, He was placed somewhere and they took his disability check and they kicked him out November 1st.

PINSKY: Right. So, there`s no place good for him --

CHRISTINA: No. No. And we can`t get help for him or medication or anything.

PINSKY: Do you think -- let me ask you something, as a family member or something like this, do you think there should be state hospitals for people like your brother?

CHRISTINA: Yes, and there used to be when he was first diagnosed at an early age, at 19, he was in a couple of state households (ph) in New Jersey --

(CROSSTALK)

PINSKY: But he was good there. He thrived there.

CHRISTINA: Yes. He was never --

(CROSSTALK)

CHRISTINA: -- they correct (ph) him for three days. That`s not enough.

PINSKY: I agree exemplary. Listen to those stories, people who are legislators. Listen to that.

CHRISTINA: Unbelievable.

PINSKY: Thank you for that call. I also want to thank Dr. Harold Koplewicz, Georgianna Kelman, Steve Perry, Tom Mauser, Kira Rowland, and Amar Kaleka. Thank you all for watching and calling. Very interesting show. We`re going to keep this moving forward. I`m all about that. I cannot beside myself. "Nancy Grace" up right now.

END