Our Health Policy Matters

From time to time, I take a look at this blog - a collection of nearly 200 essays now aging in place - because I want to remind myself about how I thought about health policy broadly and the health and mental health policy issues that were hotly debated around the time the Affordable Care Act was being crafted and implemented. I think about how my own narrative and the narratives of my family members were affected by policy decisions made by others. There are plenty of commentators and scholars who know a whole lot more about this stuff than I ever did. So, most of my blogs have no historical significance at all - although one may someday.  It includes my first written expression of the "Before Stage 4" concept that became a hashtag (#B4Stage4) and the messaging frame for the work of Mental Health America beginning in 2014, a frame that was widely embraced by the mental health advocacy world. I posted only a handful of new blogs here while I was the position as President and ...

From time to time, I take a look at this blog - a collection of nearly 200 essays now aging in place - because I want to remind myself about how I thought about health policy broadly and the health and mental health policy issues that were hotly debated around the time the Affordable Care Act was being crafted and implemented. I think about how my own narrative and the narratives of my family members were affected by policy decisions made by others. There are plenty of commentators and scholars who know a whole lot more about this stuff than I ever did. So, most of my blogs have no historical significance at all - although one may someday.  It includes my first written expression of the "Before Stage 4" concept that became a hashtag (#B4Stage4) and the messaging frame for the work of Mental Health America beginning in 2014, a frame that was widely embraced by the mental health advocacy world. I posted only a handful of new blogs here while I was the position as President and ...

This might just be the year for mental health reform in Congress. A few months ago, practically no one would have said that. But on Wednesday of this week, the House Energy and Commerce Committee voted 53-0 to send H.R. 2646 - a significant mental health reform bill - on its way, most likely to the House floor for a July vote.  And in recent weeks, a Senate bill has gathered steam, too, and that chamber could also now take up this legislation this summer. So what happened to make mental health reform a real possibility? First, members of Congress sincerely wanted to do something.  The House proposal, sponsored by Rep. Tim Murphy of Pennsylvania and Rep. Eddie Bernice Johnson of Texas, has 199 co-sponsors as of today.  Our mental health system has been in disarray since - well, since as long as anyone can remember. Second, members have finally decoupled mental health reform from gun control.  Mental illnesses and violence have never been stron...

This might just be the year for mental health reform in Congress. A few months ago, practically no one would have said that. But on Wednesday of this week, the House Energy and Commerce Committee voted 53-0 to send H.R. 2646 - a significant mental health reform bill - on its way, most likely to the House floor for a July vote.  And in recent weeks, a Senate bill has gathered steam, too, and that chamber could also now take up this legislation this summer. So what happened to make mental health reform a real possibility? First, members of Congress sincerely wanted to do something.  The House proposal, sponsored by Rep. Tim Murphy of Pennsylvania and Rep. Eddie Bernice Johnson of Texas, has 199 co-sponsors as of today.  Our mental health system has been in disarray since - well, since as long as anyone can remember. Second, members have finally decoupled mental health reform from gun control.  Mental illnesses and violence have never been stron...

For the past several months, I've been traveling around the country for Mental Health America. I have been delivering two messages.  The first is that it was a mistake to use a "danger to self or others" standard as a trigger to treatment for people with serious mental illnesses.  Because this has made mental illnesses the only chronic diseases we wait until Stage 4 to treat, and then often only through incarceration. The second is that if we are to treat people with mental illnesses the same way we treat people with other chronic conditions, we have to act before Stage 4.  We have to start with prevention and then invest in early identification and intervention.  We have to integrate health, behavioral health, and other services.  And we have to give people an opportunity to recover at all stages in the disease process. May is  Mental Health Month . Since 1949, it has been a signature program of Mental Health America, formerly known as the Nat...

For the past several months, I've been traveling around the country for Mental Health America. I have been delivering two messages.  The first is that it was a mistake to use a "danger to self or others" standard as a trigger to treatment for people with serious mental illnesses.  Because this has made mental illnesses the only chronic diseases we wait until Stage 4 to treat, and then often only through incarceration. The second is that if we are to treat people with mental illnesses the same way we treat people with other chronic conditions, we have to act before Stage 4.  We have to start with prevention and then invest in early identification and intervention.  We have to integrate health, behavioral health, and other services.  And we have to give people an opportunity to recover at all stages in the disease process. May is  Mental Health Month . Since 1949, it has been a signature program of Mental Health America, formerly known as the Nat...

Where our nation's mental health is concerned, disparity, not parity, rules. Mental Health America released a new report today.  It's entitled Parity or Disparity: The State of Mental Health in America, 2015 .  The report offers the first cumulative ranking of mental health status and access to services for all fifty states and the District of Columbia. Source:  Data from www.mhascreening.org The report includes measures of mental health status and access for adults and children, drawn from national databases that are regularly updated.  Altogether, they paint a very interesting picture of how states measure up to one another in protecting the mental health of their people. The best states for your mental health?  Massachusetts leads the list, followed by Vermont, Maine, North Dakota, and Delaware.  Rounding out the top ten are Minnesota, Maryland, New Jersey, South Dakota, and Nebraska. There are traditionally liberal and traditionally conserva...

Where our nation's mental health is concerned, disparity, not parity, rules. Mental Health America released a new report today.  It's entitled Parity or Disparity: The State of Mental Health in America, 2015 .  The report offers the first cumulative ranking of mental health status and access to services for all fifty states and the District of Columbia. Source:  Data from www.mhascreening.org The report includes measures of mental health status and access for adults and children, drawn from national databases that are regularly updated.  Altogether, they paint a very interesting picture of how states measure up to one another in protecting the mental health of their people. The best states for your mental health?  Massachusetts leads the list, followed by Vermont, Maine, North Dakota, and Delaware.  Rounding out the top ten are Minnesota, Maryland, New Jersey, South Dakota, and Nebraska. There are traditionally liberal and traditionally conserva...

I was sitting at my desk at Mental Health America when the news broke on Friday afternoon that a fifteen year old student at Marysville-Pilchuck High School in Washington had opened fire in the school cafeteria, killing at least one other student before taking his own life as well. Another fourteen year old who was shot died over the weekend, bringing the death toll to three – all young teenagers. It is hard to know what to make of these kinds of tragedies, because we don’t really understand them.    The shooter, Jaylen Fryberg, was said to be popular and well-liked.  The victims – two of whom remain in critical condition – were his family and friends.  Some form of bullying may have been involved, but no one had any reason to believe that when he walked into school on Friday he intended anyone harm. In recent years, shootings – whether or not they are related to a mental illness in the shooter (and most frequently they are not) – have shone a bri...

I was sitting at my desk at Mental Health America when the news broke on Friday afternoon that a fifteen year old student at Marysville-Pilchuck High School in Washington had opened fire in the school cafeteria, killing at least one other student before taking his own life as well. Another fourteen year old who was shot died over the weekend, bringing the death toll to three – all young teenagers. It is hard to know what to make of these kinds of tragedies, because we don’t really understand them.    The shooter, Jaylen Fryberg, was said to be popular and well-liked.  The victims – two of whom remain in critical condition – were his family and friends.  Some form of bullying may have been involved, but no one had any reason to believe that when he walked into school on Friday he intended anyone harm. In recent years, shootings – whether or not they are related to a mental illness in the shooter (and most frequently they are not) – have shone a bri...

By now, everyone has heard the news from Ferguson, Missouri.  An unarmed 18 year old named Michael Brown was shot and killed by a police officer.  Michael Brown was black. Some of the events surrounding the shooting are in dispute.  But what isn’t in dispute is that for the past two weeks, a community has been torn apart by race – a community that until recently was best known for its proximity to St. Louis and its designation as a Playful City, USA . Picture credit: Health Affairs Media reports since the August 9 th shooting have focused almost entirely on one angle – race relations.  We’ve heard about unrest in the city, the National Guard, police in riot gear, and danger in the streets.  We’ve heard about the District Attorney’s ties to law enforcement, and concerns that a too-white Grand Jury may be racially motivated not to indict the police officer involved in the deadly shooting. But the media have been strangely silent about a dif...

By now, everyone has heard the news from Ferguson, Missouri.  An unarmed 18 year old named Michael Brown was shot and killed by a police officer.  Michael Brown was black. Some of the events surrounding the shooting are in dispute.  But what isn’t in dispute is that for the past two weeks, a community has been torn apart by race – a community that until recently was best known for its proximity to St. Louis and its designation as a Playful City, USA . Picture credit: Health Affairs Media reports since the August 9 th shooting have focused almost entirely on one angle – race relations.  We’ve heard about unrest in the city, the National Guard, police in riot gear, and danger in the streets.  We’ve heard about the District Attorney’s ties to law enforcement, and concerns that a too-white Grand Jury may be racially motivated not to indict the police officer involved in the deadly shooting. But the media have been strangely silent about a dif...