A personal and deeply moving article appeared in The Atlantic on June 8 titled How to Fix A Broken Mental-Health System. The author shares the personal account of his son’s battle with severe mental illness and points to the shortcomings of today’s mental health system, which centers public-policy changes needed to improve mental health. He highlights that for many persons suffering severe mental illness, the freedom of choice can mean homelessness, jail, or worse. Certainly not the best choices. We can do better.
The article goes back in time to highlight the transformative (at the time) Community Mental Health Act of 1963 and mentions the positive aspects and its shortcomings, much of which set the direction for where we are today regarding the design, delivery, and financing of mental health services.
Decades of decreased funding levels at the federal level and state level has contributed to the negative impact of our currently frayed system of care. Community based services capacity stretched beyond limits, low reimbursement rates, and lack of a qualified workforce remain significant challenges to improving the mental health system.
But a renewed interest, for the first time in a long time, in public-policy and political circles, in counties, states, and even in Washington, DC, has brought attention to mental health as essential to overall health.
And we do know more today with advances in psychopharmacology, evidenced-based models of care, trauma informed care, integrated health care, peer support, mental health courts, crisis intervention training, and the list goes on.
Senate and House bills are in play at the moment with positive (and some questionable) provisions embedded to address mental health system improvements. But this is an election year, with many congressional leaders on the fence on key provisions that remain up for debate.
The author concludes that he does not want to see other families go through the turmoil and heartache his family faced, through no fault of their own, with an illness that devastates lives and brings unimaginable stigma and pain, and unnecessary suffering.
We often get caught up in looking for new innovations, costs, data, etc. We know more about the economic costs of mental/behavioral health. However, this is about human lives. A 2006 seminal publication reported that persons with serious mental illness live on the average twenty-five years less than the general population and that 60% of premature deaths in persons with schizophrenia are due to medical conditions (largely preventable) such as cardiovascular, pulmonary and other infectious diseases.
The time to act is now. Inaction will result in continued loss of life. That means more than numbers and cost data.