The degree in which mental health and dementia are recognized largely depends on culture. In some cultures, such as the Asian population, it is not a topic of discussion among family members. Even in the U.S., the conversation of mental health is wildly debated, and continues to drag on year after year with nothing being done about it.
The U.S. has a long and sordid history of institutionalizing patients with mental illness, a hint of mental incapacity, depression or even dementia. Society has gotten better, with the newer generation, striving to make sense of mental health in America, but we are in no way there yet. All we have done is trade in one "Institution" with "Skilled" nursing, "Assisted" Living and; "Revolving" mental health facilities. Whilst there are more state "Regulations" and inspectors to ensure the proper care of residents who are mentally incapacitated in these facilities; they only act as alternative "housing," not a "solution."
Unfortunately, as a "society," we have ignored as a collective the vast issues of those with mental incapacity. NOW, we are paying the price for our ignorance with an epidemic of gun violence. Dementia, is also a progressive mental state that we know nothing about. YET, we hear so much about it. The ONLY true test for Alzheimer is during autopsy; but NO doctor will ever tell you that; at least not the ones we came across. Yet, "Alzheimer" is such a buzz word and a rallying point.
No one really can conclusively tell you what causes mental "instability." "Experts" will conjecture, but NO one really has the hard evidence. It is also not an ELECTABLE topic, so politicians will rarely talk about it, UNTIL there is a tragic sequence of events such as #VirginiaShooting.
The police don't want to get involved either. They will most likely call the "Bus" or "Rescue" and have these people transported to the local hospital for "evaluation." The media doesn't want to touch it since it is such a "touchy" subject with a lot of moving parts; not interesting enough and; does not sell air time or newspapers.
Most general hospitals don't have the expertise or all the FACTS to deal with mental health issues, YET they won't admit to their own short comings, either. They may call in other agencies, such as the Department of Elderly Affairs (DEA) for seniors; who also lack the proper resources and skills. The DEA has no checks and balances and no overseeing body. They are not interested in the truth. They are ONLY interested in incarceration. In most instances, these agencies will OVER REACH and pull down the WRONG branch.
Meanwhile, the patient will once again, FALL THROUGH the cracks on EVERY body's watch.
You also have organizations like Gateway that facilitate their own "version" of a mental test. Their quest, it seems, is to find out if you are "Homicidal" or "Suicidal." This determines if you go to a mental health facility for further evaluation. You can get there FASTER, if you lightly push a nurse during the course of your stay in hospital. Unfortunately, administering such tests have no meaning for a person of a different culture, where cultural nuances will come into play and; where language is NOT universal. You CANNOT fit a square peg into a round hole and; unless you speak "their language," the test is MEANINGLESS!!!!
Unfortunately, ER doctors and nurses have way too much "Self-appointed" and "Self-obsessive, "God-like" powers to make decisions, without family consent; where they hide behind policies with no concrete documents (when specifically requested) AND; don't know what to do next so; patients languish in "Observation" until they "figure it out." "Observation" is a made up hospital administrative term that means that the patient is in a room, but not "Technically" admitted. In other words, an OXYMORON!
We have done nothing but put a BAND-AID on mental health and dementia issues in the U.S. We relied too HEAVILY on hospitals and our own physicians unable to efficiently deal with these issues. We have professionals and elected officials passing the buck AND it appears all the media wants to do is sensationalize the story, by bringing in "experts" to "arm chair quarterback" why the gunman did what he did.
If EVER there was insanity...THIS IS IT!