Matters Of The Mind: The Politics of Mental Health
BOSTON (CBS) — Providing adequate treatment for the one-in-five American adults living with mental illness, and preventing future generations from suffering the same fate, comes down to prioritizing initiatives that work.
"This is so obvious and yet we as a nation have not embraced it as fundamental to overall success in our society," former Rhode Island Congressman Patrick Kennedy told WBZ-TV.
Read: More Matters Of The Mind
Kennedy left Congress in 2011 and has spent the years since touring the country to advocate for mental health causes. This week he hosted The Kennedy Forum in Boston, a national conference to bring together advocates and policy makers in an effort to lay out a strategy for improving mental health in America.
"By the time we treat most mental illness and addiction in this country, it's progressed to stage four cancer. We wouldn't imagine in this country waiting until cancer got to be stage four before we treated it," Kennedy said.
WBZ-TV political analyst Jon Keller points out that the mentally ill are not particularly well organized when it comes to lobbying state lawmakers.
"We are no different than other states. The squeaky wheel gets the grease," Keller said. "When it comes to mental health issues, the squeaky wheel is not the mentally ill and their advocates. It's the pharmaceutical industry. It's the health care industry. They are big players in this state."
Keller believes it will take someone with enough clout and a dynamic presentation in order to generate enough noise that policy makers sit up and listen. Kennedy himself is a recovering addict with a history of mental health and addiction disorders, so when he speaks about the topic, his passion is clear.
When state and federal budgets took a hit after the recession, funding for treatment access and research shrank dramatically. The National Alliance on Mental Illness estimates states cut $5 billion from their public mental health budgets between 2008 to 2013. During the sequestration of 2013, the same group reports mental health funding was cut by 8.4 percent, rather than increasing with the pace of medical research inflation. Programs like President Obama's BRAIN Initiative have provided some lifeblood for the research community, but early intervention and treatment remain a lower priority than other public policy concerns.
It's the early intervention and prevention that Kennedy and many other advocacy groups feel government and private sector leaders need to focus their attention. Yet to date, most resources are aimed at treating only acute cases of mental illness when they've already progressed to a crisis.
Kennedy sees opportunities for employers, not just politicians, to be proactive about mental health by rewarding mental fitness, much like they did tobacco cessation, through their health plans and employee assistance plans.
"This isn't just an issue about our jails and emergency rooms. This is about the workplace because people in the workplace have addictions and mental illnesses," Kennedy said. "Employers are not as productive when they can't concentrate because they have depression and anxiety. We've got to have corporate leaders really put out what should be the gold standard."
Kennedy served for 16 years on Capitol Hill and his hallmark achievement was helping to pass the 2008 Mental Health Parity and Addiction Equality Act. The law, fully implemented last year, requires insurance companies to treat mental health the same way they treat physical health. Prior to the passage of mental health parity, insurance companies could demand higher copays for mental health treatment and often imposed lifetime limits on the services a person could receive.
Several different strategies for mental health are championed by advocacy groups. The World Health Organization pushes for mental health screenings by primary care physicians and mental health promotional activities at schools. The National Council for Behavioral Health promotes Mental Health First Aid as a means of training the public to recognize concerns and find help. Crisis Intervention Teams seek to train police officers for safer, more productive, interactions with mentally ill people.
"It's always follow the money," said Kennedy. "In other words we can all argue about this program or that program, but the key to all of this is where we prioritize our funding so as to incentivize the things that work."
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