Skip to main content

The Mental Illness Epidemic

There is an epidemic of mental illness in America.  It’s time policy leaders did something about it.
They could start by acknowledging just how widespread this epidemic is.  According to the National Institute on Mental Health, it affects one-fourth of our population – over 57 million adults and over 15 million children. 
Why are the numbers so staggering?
No one knows for sure, but the bad economy, wars, and abuse are all probable factors.
According to a Gallup Poll released last year, the bad economy led to an increase in emotional illness among all adults.  Especially hard hit were those between the ages of 30 and 55, the family breadwinners.
CNN reported in 2007 that one-third of all veterans returning from Iraq or Afghanistan were treated for mental illnesses.  Their children were also affected.  According to a survey of health records released this past month and reported in the New York Times, children between the ages of 3 and 8 with parents in the military had 10% more visits to mental health providers than their peers.
Also in 2007, 5.8 million child neglect or abuse allegations were reported to state child protection agencies.  Almost 800,000 of these were confirmed.
Simply blaming economic and environmental factors isn’t enough, however. 
Researchers have achieved some breakthroughs, but they still don’t know why 17 million adults have serious mental illnesses like schizophrenia, bipolar disorder, and major depression.  These are not caused by economic or environmental factors, and they have devastating consequences.
Homelessness and incarceration are two of them.  According to the National Coalition for the Homeless, 25% of homeless people have severe mental illness, and mental illness is a leading cause of homelessness in our country. 
County jails, where inmates usually stay for under six months either awaiting trial or serving time for minor offenses, are teeming with people affected by mental illness.  Some officials report that up to 85% of jail inmates have mental illness.  They are also three times more likely to have serious mental illness than someone not in jail, and a 2009 study found that nearly one in three female jail inmates had serious mental illness – five times the prevalence in the population as a whole. 
This isn’t acceptable.
Policy leaders need to take this epidemic seriously.
First, they need to do more to identify and treat serious mental illness in children.  The Mental Health Association of Palm Beach County (FL) has offered a creative idea.  It suggests adding periodic mental health screening to pediatric care for all children, to identify and treat mental illness in children at the earliest possible age.  All state legislatures, not just Florida’s, should look closely at this.
Second, they need to decriminalize mental illness.  Simply exhibiting symptoms of mental illness in public can sometimes be cause for arrest, wasting precious resources.  A few years ago, a schizophrenic homeless person was arrested for “sitting or lying on a public sidewalk.”  He missed his court hearing because he was in jail for violating his probation on an earlier offense by being arrested again.  When he finally got to court, no one except the homeless person could keep track of what time he was actually serving for which offense, so he was released. 
People with mental illness don’t belong in jail.  If policy leaders changed the laws that send them there, as a side benefit jail overcrowding would end overnight.
Third, they need to create an emergency mental health response system that looks more like the rest of our emergency response system.  In a health emergency, an ambulance responds.  In a mental health emergency, a law enforcement officer responds.
They should be sainted for taking on this role.  They have diverted many people in crisis away from jails.  But it is no more reasonable to ask law enforcement professionals to evaluate mental illnesses than it would be to ask them to evaluate diabetes, heart disease, or cancer emergencies.
Local and county emergency mental health services systems should be staffed by mental health professionals.  Policy makers should use the new federal insurance parity laws to assure that insurance covers the cost.
Fourth, they need to rebuild our safety net system of care for people with mental illness.  When we emptied our large state institutions beginning in the 1970s, we were supposed to replace them with community mental health centers. But we stopped building these new centers before we were finished. 
It’s time to start building them again, and to pass laws giving them preferred Medicare and Medicaid rates, discounted drug pricing, and access to ongoing federal grants like the ones supporting community health centers.  Then policy leaders should integrate safety net health and mental health care.
These are just four ways policy leaders could start dealing with the epidemic of mental illness.  There are more.  75 million Americans in crisis are waiting patiently.      

Comments

Popular posts from this blog

Trump, DC Homelessness, and the National Guard

Claiming that D.C. crime is out of control, President Trump has brought in the National Guard. Never mind that crime rates are down in the District. The optics are compelling. Trump blames homeless people. As Fox News reported , he is giving them two choices – jail or homeless shelters to treat mental health and substance use disorders. If these choices seem reasonable, they aren’t. Sending someone to jail who hasn’t committed a crime is a bad, even unconstitutional, idea. Like our new South Florida gulag, this notion offends many of us. And many, if not most, of the people who are chronically homeless have seriously undertreated mental health conditions. Jails and shelters don’t have the money or resources to provide that treatment. What this boils down to is comfort. Seeing homeless people congregating makes some people uncomfortable. President Trump is suggesting that the freedom to congregate peacefully is a freedom reserved only to some of us – not everyone. There’s bigotry t...

The Ten Best and Ten Worst States for Your Mental Health

Connecticut spends four times more per capita on state mental health services than Texas.  In Florida, 25 percent fewer people report having mental illnesses than in Washington. Across the nation, there are significant differences in the amounts states spend on mental health services.  Connecticut spends $189 per capita, while Texas spends only $39. But there are also significant differences in the reported prevalence of mental illnesses.  For example, fewer than 18 percent of Floridians report having a mental illness during the past year, but in Washington almost 24 percent do. But what happens when you put spending and prevalence together?  Some new rankings emerge that give you a measure of each state’s real commitment to protecting mental health – and treating mental illness – in their population.  This week, I have ranked all fifty states using both spending and prevalence data.       I have taken per capita m...

For the Health of Our Community, Can We Plan More in Advance?

Mayor Florsheim has proposed a budget with a 2.7 mill increase for the coming fiscal year. This will mean an increase in taxes of approximately $500 per year for a home with a market value (not an assessed value) of $250,000, with larger increases for many homes in our city. While I appreciate the time and effort that went into his budget calculation, like many people I don’t believe that this is a sustainable increase on top of the increases of the past few years. What I appreciate even more is that the Mayor has invited members of the public to work together to offer their own perspective and suggestions to the City Council. In the past few weeks, I have offered several short-term suggestions, including a job freeze, a search for an alternative health insurance provider, and greater advocacy at the state level for fairer PILOT funding for Middletown. As an example, the Mayor’s budget proposes $77,800 for a Grantwriter versus zero from the Finance Department. Maybe we wait on that? ...