There is yet another national conversation underway about mental illness in wake of the Fort Lauderdale airport shooting on Friday.
Did the man with the gun at the Fort Lauderdale airport -- a man who asked for help, only to be released -- suffer from mental illness?
"In this case, it does very much sound like there was untreated mental illness and yes, they should have provided more comprehensive services to that young man," said Pamela Gionfriddo, CEO of the Mental Health Association of PBC.
Another question is: Will something change this time?
Florida ranks 49th in the nation in how we fund mental health services. Many of the programs we do have in the area are thanks to the Mental Health Association of Palm Beach County.
"We have a system that was basically devastated by funding cuts in the 1960s and 1970s," said Gionfriddo. "[People] have a right to healthcare. They have right to get the treatment they need. And that's what we're not providing right now because the funding as been taken away."
Despite their financial challenges, she hopes help is on the way.
"This is really the most frustrating type of work to do because for so long, there really hasn't been any meaningful mental health reform," she said. "It would be much better if we could move our thinking upstream a little bit so we can start putting our dollars into prevention and earlier intervention. So we can prevent these types of tragedies and improve these people's chances of recovery."
Gionfriddo only knows what she's heard about Esteban Santiago -- but she's familiar with his story.
She says too often, the system waits too long to help someone.
"Most of the money we're spending is on crisis deep-end services for people we could have identified earlier, we could've provided help to earlier," she said. "But instead, we're spending a lot of our dollars on the most intensive hospitalization, incarceration. If we instituted more programs that identified people early and get them the help they need, we can address this issue before stage 4."
But change is on the way. President Barack Obama signed legislation in December to accelerate the fight.
"It's the most far reaching mental health reform legislation that we've had in the last 50 years," said Gionfriddo.
HR 2646, or Helping Families in Mental Health Crisis Act of 2016, streamlines the way money passes through to local community programs and focuses on early prevention.
Palm Beach County already has a program called Be Merge, which screens children and young adults for mental health concerns through their doctor's offices.
"By asking people nine simple questions, we can determine whether they are moderate to severe on things like depression, anxiety and so forth," said Gionfriddo.
Gionfriddo believes the system cannot rely on the mentally ill to recover on their own.
"My hope is that people will realize we can't just hospitalize someone for four days and expect them to be recovered. We have to provide ongoing support, peer mentoring and ongoing counseling."
While the Mental Health Association provides many services to the mentally ill across Palm Beach County, the West Palm Beach VA Medical Center specifically helps veterans and their needs.
"Unfortunately people do have mental health issues and it can be an effect sometimes because of the traumas and stressors that they might go through in the military. They might be having current problems that are exacerbating those issues," said Dr. Elizabeth Bosarge, PTSD program manager.
Dr. Bosarge shares the warning signs for mental illness in veterans.
"If they're having changes in their sleep patterns and eating eating habits, changes in their personal grooming, if they seem to be isolating themselves a great deal or have lost interest in their usual activities," said Dr. Bosarge. "If they tell you that they're hearing voices and seeing things or if they complain of unusual thoughts, those are some of the warning signs we would look for."
Dr. Bosarge said if families see those signs, they need to come in immediately for counseling, therapy, and medication services.
Click here to learn more about those services.
"I know it can seem kind of scary to come in but we have trained professionals many of our staff are veterans themselves. Many of our staff have been through similar problems and have been working on their recovery," she said.
There is a VA Crisis Hotline number for veterans to call if they are having mental health problems and need help right away. That number is 800-273-HELP or 800-273-8255.
The Mental Health Association also has hotline number that anyone can call if they need someone to talk to: 561-801-HELP (4357).
Also, this April 20 and April 21, MHAPBC is hosting a speaker series called "In the Age of Violence: Helping Children and Families Cope", which will be specifically addressing mental health and the tragedies we've seen too often.