Mental Health on My Mind

Today seems to be a day to talk about Mental Health and mental health parity. Part of what I've written below started out as a comment over at Veterandem's excellent post on The Lane Evan Act. Then, I was reading the Daily Tar Heel and found two stories about mental health, lastly, I've been emailing back and forth with people at NAMI NC about mental health parity and the role of Health Care for All.

The underlying theme is this: mental health still has a stigma attached to it, which hurts each and every one of us in some way.

Nationwide, we find that our soldiers returning home from Iraq are not having their mental health issues addressed, but someone wants to change that.

Over at the Iraq and Afghanistan Veterans of America website there is information on a bill introduced by Olympia Snowe (R-ME) and Barack Obama (D-IL) which will establish manadatory mental health screenings for veterans returning from Iraq/Afghanistan.

Statewide, we find that the solution to mental health problems in our population, is to ignore them.

Limited resources and concerns over quality of care and safety have prompted N.C. mental health officials to place a cap on psychiatric hospital admissions. The cap will prevent facilities from accepting transfers from community hospitals when the short-term wards at the psychiatric hospitals are at more than 110 percent capacity.

While the motive behind the cap is to provide better care by admitting fewer patients, the cap gambles with the fate of those turned away without resources to seek help elsewhere.

Locally, we see that the funding is just A LITTLE bit lower than it needs to be.

In a report filed by the commission's consultant, many problems were highlighted, including a lack of funding. According to the report, the state needs to allocate $2.7 billion to the mental health system in order to meet all needs. This year, more than $7 million will come from state and federal funding. The increase in funding for this fiscal year equates to a little more than $100,000.

From top to bottom, we've let mental health be something we are ashamed of, something we've hidden in the closet or in the basement. Now, that philosophy is coming home to roost, because just as we've come to realize and accept that Alzheimer's is a genetic disease and not just some crazy old coot, just as we've come to accept that autism is caused by genes and the environment, and not by "cold" parenting, we're now coming to realize that Schizophrenia, Depression, Anxiety, and Phobias are caused by genes too. Now, we as a society are much less willing to throw someone out on the streets because they have these problems. We still do, but we don't feel so garsh-darn-superior about it anymore, knowing that "There, but by the grace of good genetics and parenting, go I". Heck, I don't mind you throwing God in there as the "dad" behind genetics either. Whatever. What matters is that we're coming to this realization, now we just have to do something about it.

Unfortunately, not everyone is so understanding. The mental health legislation that will come out this year will NOT include substance abuse treatment. Why? Well, because substance abuse is obviously a sign of evil and weakness. Nevermind that in 2002 over 4 million adults met the criteria for both substance abuse AND serious mental illness, and that many of those people "self-medicate" with illicit drugs.

It's time to fight for mental health parity.

Related to Anglico's idea that we "sanctify" marriage by putting Amendments in the "Family Marriage Act" that you can't get divorced, that adultery is punishable by imprisonment, etc., I would like to suggest that we lay out what mental health parity really means.

Every Congressmen/legislator must have someone in their family who has

  • Major Depressive Disorder
  • Dysthymic Disorder
  • Bipolar Disorder
  • Suicide
  • Schizophrenia
  • Anxiety Disorders
  • Panic Disorder
  • Obsessive-Compulsive Disorder (OCD)
  • Post-Traumatic Stress Disorder (PTSD)
  • Generalized Anxiety Disorder (GAD)
  • Social Phobia
  • Agoraphobia
  • Specific Phobia
  • Eating Disorders
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Autism
  • Alzheimer's Disease

  • The prevalence rates are just too high for them NOT to be personally affected by these disorders. So, I say we make it all or none. A bill in the US and NC Houses which states that these are "mental disorders" as defined by the NIH, and as such will either all be covered by insurance companies the same way a broken bone or a heart attack would be covered, OR, none of them will be covered. At all. Not one red cent.

    Lastly, I'd like to ask each and every one of you that cares about mental health parity to read this diary and send a quick email to the legislature.



    Here's a copy of the resolution (authored by yours truly and a party pro) that will be debated and voted upon in my county Democratic convention in April

    "Whereas North Carolina is 50th in the nation in per capita mental health spending.

    Whereas North Carolina is seeking to further cut funding for mental health services.

    Whereas there are not enough psychiatric hospital beds to meet the need.

    Whereas too many individuals and families lack mental health benefits on their insurance plans.

    Whereas a hired consultant recommended over $2.5 billion dollars in improvements to our state's mental health system over ten years to meet the needs of our citizens.

    Whereas many Local Management Entities are mismanaged and poorly run.

    Whereas large providers have gone bankrupt due to cuts in funding and obstacles to reimbursement.

    Be it therefore resolved: that the Buncombe County Democratic Party support and promote restoring mental health funding and facilities in the state of North Carolina. That the Democratic Party will support Mental Health Parity in Health Insurance. That the Democratic Party will support the restoration of a "safety net" for our citizens in greatest need."

    As a mental health provider, I see the state's "slow-bleed" strategy at work every day. I don't blog on this issue very often, preferring to separate my work life and blogging life, so thanks, Robert, for shining the bright light of your due diligence on the matter.

    Scrutiny Hooligans -

    We know how Liddy will vote

    From the Liddy Dole page at

    Dole consistently votes against needed improvements in Veterans’ Health CareDole voted:

    * “NO” to authorize $21.9 billion for the VA for compensation and pensions; medical care and hospital improvements. (S Roll Call 007, 02/02/2006)
    * “NO” to increase VA funding for the increased demand for VA services due to the Iraq War. (S Roll Call 251, 10/05/2005)

    Dole’s Voting Record Hurts Veterans & their Families 30% of returning veterans diagnosed with mental health problems and/or Post Traumatic Stress Disorder (PTSD):

    * 82% of New Patients need intensive PTSD treatment.
    * 20% of VA PTSD treatment programs are full.
    * 40% of VA PTSD treatment programs are near full capacity.
    * 42% of VA primary care clinics have NO mental health staff.

    VA Advisory Board (Feb. 2006) stated: “VA cannot meet the ongoing needs of veterans of past deployments while also reaching out to new combat veterans (Iraq / Afghanistan) … within current resources.” Increasing Demand for VA Services:

    * Enrollment since 2002- UP 48% due to Iraq War
    * VA patient load since 2002 – UP 28% due to Iraq War

    Obviously, our public mental health services are going to be shouldering the burden of providing for Iraq and Afghan war veterans. Or, they'll be living and dying on the streets like so many Viet Nam Vets.

    Nice to see how we "honor" the brave men and women who fight and die for us. Let's make mental health services (for vets and anyone else) the most predominant "family values" issue.

    “All the world's a stage,
    And all the men and women merely players.”
    So enjoy the drama.