Our Health Policy Matters

At least thirty-six states increased funding for mental health services during 2013, according to a recent report by the National Alliance on Mental Illness .  And last week, Vice President Biden announced that the federal government was adding $100 million in new funding for mental health services. So have we turned the corner on our nation’s mental health funding crisis, as many of the accompanying news headlines seemed to imply?  Or are these initiatives more a token gesture aimed at mollifying the mental health advocacy community in the aftermath of the Sandy Hook massacre, as others have suggested ?  I think that – with a couple of notable exceptions in Connecticut and Texas – the initiatives tend more toward tokenism than real change. Consider the national initiative.  On the face of it, $100 million sounds like a lot of money.  But it still represents only around 3 percent of the Substance Abuse and Mental Health Services Administration (S...

At least thirty-six states increased funding for mental health services during 2013, according to a recent report by the National Alliance on Mental Illness .  And last week, Vice President Biden announced that the federal government was adding $100 million in new funding for mental health services. So have we turned the corner on our nation’s mental health funding crisis, as many of the accompanying news headlines seemed to imply?  Or are these initiatives more a token gesture aimed at mollifying the mental health advocacy community in the aftermath of the Sandy Hook massacre, as others have suggested ?  I think that – with a couple of notable exceptions in Connecticut and Texas – the initiatives tend more toward tokenism than real change. Consider the national initiative.  On the face of it, $100 million sounds like a lot of money.  But it still represents only around 3 percent of the Substance Abuse and Mental Health Services Administration (S...

Exactly a half century ago, in October, 1963, President John F. Kennedy signed the Community Mental Health Centers Act into law.  It affected two very different classes of people - people with mental illness and people with developmental disabilities. In many ways, it was a civil rights act, promising to replace large, segregated institutions with integrated, community-based services. It made a huge difference for people with developmental disabilities.  But for people with mental illnesses, its promise is unfulfilled and the dream sometimes feels like it is dying. When President Kennedy signed the Mental Retardation Facilities and Community Mental Health Centers Construction Act on October 31st, he did so with optimism. The law specified that the new community mental health centers would offer four services – prevention, diagnosis, treatment, and rehabilitation or recovery – to people with mental illness.  And the result would be that all people, no ...

Exactly a half century ago, in October, 1963, President John F. Kennedy signed the Community Mental Health Centers Act into law.  It affected two very different classes of people - people with mental illness and people with developmental disabilities. In many ways, it was a civil rights act, promising to replace large, segregated institutions with integrated, community-based services. It made a huge difference for people with developmental disabilities.  But for people with mental illnesses, its promise is unfulfilled and the dream sometimes feels like it is dying. When President Kennedy signed the Mental Retardation Facilities and Community Mental Health Centers Construction Act on October 31st, he did so with optimism. The law specified that the new community mental health centers would offer four services – prevention, diagnosis, treatment, and rehabilitation or recovery – to people with mental illness.  And the result would be that all people, no ...

In 2009, there were 36,891 suicides in the United States, according to the CDC .  This translates to a rate of 11.9 for every 100,000 people. And rates among certain groups were even higher.  For example, the suicide rate among veterans, according to the Veterans Administration, was three times higher – or 35.9 per 100,000 veterans. Suicide is a problem that ought to command our attention. And it does.  For many years we have used suicide data as surrogates for documenting the consequences of serious mental illness.  We all know that the “danger to self” standard we use for determining when people with mental illness qualify for emergency care is, in effect, a “suicide may be imminent” standard. As a result, for many years community mental health organizations have also been asked to track suicides as a measure of the effectiveness of their programming.  But there are reasons why focusing on suicide rates too closely leads to inadequa...

In 2009, there were 36,891 suicides in the United States, according to the CDC .  This translates to a rate of 11.9 for every 100,000 people. And rates among certain groups were even higher.  For example, the suicide rate among veterans, according to the Veterans Administration, was three times higher – or 35.9 per 100,000 veterans. Suicide is a problem that ought to command our attention. And it does.  For many years we have used suicide data as surrogates for documenting the consequences of serious mental illness.  We all know that the “danger to self” standard we use for determining when people with mental illness qualify for emergency care is, in effect, a “suicide may be imminent” standard. As a result, for many years community mental health organizations have also been asked to track suicides as a measure of the effectiveness of their programming.  But there are reasons why focusing on suicide rates too closely leads to inadequa...

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...

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...

In November, 2012, a fourteen-year-old Utah boy named David Q. Phan committed suicide by shooting himself on a pedestrian bridge near his junior high school.  It was reported that he had been the victim of bullying. In June, 2013, the New York Times published a story about three students who committed suicide at East Hampton High School during the past three years.  All three students were Hispanic. Sam Harris, who is half-Native American and half-African American, has written a first-person account of his own experience with mental illness that has been published on SAMHSA’s “Promote Acceptance” web site.   In his account, he reports that he lived for years with symptoms of mental illness without seeking help in part because he believed that he would be stigmatized by “going to the white man” for help. And in a case which has attracted recent national attention in the aftermath of the Zimmerman verdict, 32-year-old Marissa Alexander – an African Ameri...

In November, 2012, a fourteen-year-old Utah boy named David Q. Phan committed suicide by shooting himself on a pedestrian bridge near his junior high school.  It was reported that he had been the victim of bullying. In June, 2013, the New York Times published a story about three students who committed suicide at East Hampton High School during the past three years.  All three students were Hispanic. Sam Harris, who is half-Native American and half-African American, has written a first-person account of his own experience with mental illness that has been published on SAMHSA’s “Promote Acceptance” web site.   In his account, he reports that he lived for years with symptoms of mental illness without seeking help in part because he believed that he would be stigmatized by “going to the white man” for help. And in a case which has attracted recent national attention in the aftermath of the Zimmerman verdict, 32-year-old Marissa Alexander – an African Ameri...

Should all school children be screened for mental health? The evidence suggests that if we do not screen them, then we will be continuing a persistent and historical pattern of neglecting the mental health needs of our children.  But why let evidence get in the way of fear? Over the past several months, legislators in a number of states have considering mandating – or at least offering – mental health screening for all children, either in the schools or in pediatricians’ offices.  But when the Connecticut Legislature had a public hearing on a mental health screening bill recently, opponents came out in force .  One parent called mandatory screening an “unnecessary invasion.”  The Connecticut Civil Liberties Union argued that mental health screenings should be optional.  A treatment provider asserted that the problem wasn’t with a lack of assessment, but the lack of treatment options. And in recent days, a Palm Beach Post writer in Flor...

Should all school children be screened for mental health? The evidence suggests that if we do not screen them, then we will be continuing a persistent and historical pattern of neglecting the mental health needs of our children.  But why let evidence get in the way of fear? Over the past several months, legislators in a number of states have considering mandating – or at least offering – mental health screening for all children, either in the schools or in pediatricians’ offices.  But when the Connecticut Legislature had a public hearing on a mental health screening bill recently, opponents came out in force .  One parent called mandatory screening an “unnecessary invasion.”  The Connecticut Civil Liberties Union argued that mental health screenings should be optional.  A treatment provider asserted that the problem wasn’t with a lack of assessment, but the lack of treatment options. And in recent days, a Palm Beach Post writer in Flor...