Our Health Policy Matters

This is Mental Illness Awareness Week . But the sad tragedy of Miriam Carey is another reminder of how deeply unaware we are about mental illness in general and its relationship to violent behavior in particular. And how much we rely on myths to fill in the gaps in our knowledge. We all heard the news about Ms. Carey last week.  But we were not exactly informed by it.  Ms. Carey drove her car onto a White House driveway, hit some temporary fencing, backed up, and then pulled away . She was pursued toward the Capitol by law enforcement officers in what became a high-speed chase.  Ms. Carey was eventually cornered near Garfield Circle.  Six officers, with guns pulled, approached her car there.  She apparently panicked, scattering the officers as she drove away.  At least nine shots were fired at her as the chase began again.  She eventually got stuck on a median near a Capitol guard station, where she was shot to death by an officer. ...

This is Mental Illness Awareness Week . But the sad tragedy of Miriam Carey is another reminder of how deeply unaware we are about mental illness in general and its relationship to violent behavior in particular. And how much we rely on myths to fill in the gaps in our knowledge. We all heard the news about Ms. Carey last week.  But we were not exactly informed by it.  Ms. Carey drove her car onto a White House driveway, hit some temporary fencing, backed up, and then pulled away . She was pursued toward the Capitol by law enforcement officers in what became a high-speed chase.  Ms. Carey was eventually cornered near Garfield Circle.  Six officers, with guns pulled, approached her car there.  She apparently panicked, scattering the officers as she drove away.  At least nine shots were fired at her as the chase began again.  She eventually got stuck on a median near a Capitol guard station, where she was shot to death by an officer. ...

The shock of sudden violence is so severe it takes your breath away. When it happens in a time and place where it is unexpected, it does more than just remind us that no one is immune to it.  It also reminds us how pervasive it is, how much it affects us all, and how important it is that we do something about it.  In the summer of 1989, I imagined that sudden, random violence was something far removed from my hometown.  But I was about to learn differently. An  article in The Atlantic has just detailed the event, dredging up some quarter century old memories of a day that changed my community’s life. I was running for Mayor of Middletown, Connecticut, at the time, and had reserved a booth at the city’s annual Sidewalk Sale in late July.  I was handing out yardsticks, asking for a vote “for government that measures up to your expectations.” Suddenly, there was a commotion about a block north of where I was standing.  I noticed people...

The shock of sudden violence is so severe it takes your breath away. When it happens in a time and place where it is unexpected, it does more than just remind us that no one is immune to it.  It also reminds us how pervasive it is, how much it affects us all, and how important it is that we do something about it.  In the summer of 1989, I imagined that sudden, random violence was something far removed from my hometown.  But I was about to learn differently. An  article in The Atlantic has just detailed the event, dredging up some quarter century old memories of a day that changed my community’s life. I was running for Mayor of Middletown, Connecticut, at the time, and had reserved a booth at the city’s annual Sidewalk Sale in late July.  I was handing out yardsticks, asking for a vote “for government that measures up to your expectations.” Suddenly, there was a commotion about a block north of where I was standing.  I noticed people...

More than 11 million American adults with mental illnesses – 4.5 million of them with serious mental illnesses – are not receiving care today.  So it may not be unreasonable to conclude that the history of public mental health services over the last century can be summed up in a single brief sentence.  We replaced the chains of institutions with a chain of neglect. I have argued that this chain of neglect typically begins when children with mental health needs are still young, and continues throughout their lives.  And that it often has tragic consequences. Why is it so important that we talk about breaking it now, the month after Sandy Hook and almost exactly two years since the mass shooting in Tucson? It is because tragedies like those in Sandy Hook and Tucson remind us that it is wrong to balance budgets on the backs of children and young adults with mental illness and expect that there will be no consequences. This is a sensitive, and even com...

More than 11 million American adults with mental illnesses – 4.5 million of them with serious mental illnesses – are not receiving care today.  So it may not be unreasonable to conclude that the history of public mental health services over the last century can be summed up in a single brief sentence.  We replaced the chains of institutions with a chain of neglect. I have argued that this chain of neglect typically begins when children with mental health needs are still young, and continues throughout their lives.  And that it often has tragic consequences. Why is it so important that we talk about breaking it now, the month after Sandy Hook and almost exactly two years since the mass shooting in Tucson? It is because tragedies like those in Sandy Hook and Tucson remind us that it is wrong to balance budgets on the backs of children and young adults with mental illness and expect that there will be no consequences. This is a sensitive, and even com...

Health and mental health policy stories dominated 2012.  From how the Affordable Care Act framed the health policy debate at the start of the year to how the Sandy Hook tragedy framed the mental health and public health debate at year’s end, 2012 will go down in history as the most significant year in health policy since the 1960s. Here are summaries of a few of the biggest news stories. The Supreme Court Decision on the Affordable Care Act.   Nothing quite compares to the drama of the day in June when the Supreme Court ruled the Affordable Care Act to be constitutional .  Few people guessed right in advance that the decision would come down to finding the “individual mandate” to be constitutional because it is a tax, but mandatory Medicaid expansion unconstitutional because it tied future federal funding for the existing state Medicaid programs to the Medicaid expansion. People on both sides of the debate came away wanting more, and states reluctant to acce...

Health and mental health policy stories dominated 2012.  From how the Affordable Care Act framed the health policy debate at the start of the year to how the Sandy Hook tragedy framed the mental health and public health debate at year’s end, 2012 will go down in history as the most significant year in health policy since the 1960s. Here are summaries of a few of the biggest news stories. The Supreme Court Decision on the Affordable Care Act.   Nothing quite compares to the drama of the day in June when the Supreme Court ruled the Affordable Care Act to be constitutional .  Few people guessed right in advance that the decision would come down to finding the “individual mandate” to be constitutional because it is a tax, but mandatory Medicaid expansion unconstitutional because it tied future federal funding for the existing state Medicaid programs to the Medicaid expansion. People on both sides of the debate came away wanting more, and states reluctant to acce...

The entire world is in mourning over the senseless and horrifying massacre of innocent children and adults in Sandy Hook, Connecticut.  This hit so close to home for me, about forty miles from where I grew up.  So many of my former legislative colleagues are among those trying to help the state through it.  I can’t even pretend to imagine what this must be like for the families of Sandy Hook.  On the first day of the tragedy, too many politicians trotted out their tired old line that “today is not the day to have the debate” about gun control.  Thank God their tone-deaf voices were silenced by the outcry of reasonable people. Connecticut Congressman John Larson (D-1) said that “Congress should be prepared to vote on requiring background checks for all gun sales, closing the terrorist watch list loopholes, and banning assault weapons and high capacity clips. Those measures don’t solve all our problems, but they’re a start.” Senator J...

The entire world is in mourning over the senseless and horrifying massacre of innocent children and adults in Sandy Hook, Connecticut.  This hit so close to home for me, about forty miles from where I grew up.  So many of my former legislative colleagues are among those trying to help the state through it.  I can’t even pretend to imagine what this must be like for the families of Sandy Hook.  On the first day of the tragedy, too many politicians trotted out their tired old line that “today is not the day to have the debate” about gun control.  Thank God their tone-deaf voices were silenced by the outcry of reasonable people. Connecticut Congressman John Larson (D-1) said that “Congress should be prepared to vote on requiring background checks for all gun sales, closing the terrorist watch list loopholes, and banning assault weapons and high capacity clips. Those measures don’t solve all our problems, but they’re a start.” Senator J...

I first heard about James McGillivray, Lloyd “Jim” Middaugh, and Paulus “Dutch” Smit about a month ago, though not by name. A tiny news crawler reported that three men were victims of a serial killer in southern California. James McGillivray’s body was found near a Placentia, CA, shopping mall on December 21 st .  53 year-old McGillivray hung out almost every day at the mall.  Regulars there called him humble, unobtrusive, and a “nice guy.”  A 17 year-old commented “I don’t know why someone would kill him.”  McGillivray was sleeping when he was attacked and stabbed to death. Jim Middaugh’s body was found along a riverbed trail in Anaheim on December 28 th .  He was also stabbed to death as he slept.  After his death, his mother – to whom Middaugh was exceptionally close – described her six foot, four inch son as a “gentle giant.” Dutch Smit was 57 years old when his body was found outside a Yorba Linda public library on December 30 th . ...