MHA’s 100th Anniversary Conference

Five hundred people attended Mental Health America’s 100th Anniversary Conference in Washington, D.C. June 10th through June 13, 2009. It was a great success, according to MHA staff. It was the largest conference ever for MHA, and it was a wonderful conference, but this important event concerning one of the biggest health issues in America should have been attended by 5,000 people, maybe 50,000 people, or even 500,000 people: that’s how big an issue mental health is in America. To have only 500 committed advocates at this conference is pathetic number. I am ashamed for our country.

How big is the mental health issue? The statistics iterated at the conference tell the tale. In the workplace, the number three issue affecting workers after allergies and back pain are mental disorders, particularly depression. Depression alone is more damaging to everyday life than are many chronic physical conditions such as diabetes, angina, and asthma. One would have to be very unaware not to see how much depression medication is pushed on national television for the treatment of this epidemic. Depression intensifies the severity of other conditions such as heart disease, for which there is far more funding. Someone at the conference jocularly remarked that funding for heart disease research was far in excess of what was available to depression research because so many members of Congress were of an age at which heart attacks are a common occurrence. We all who heard this remark laughed cautiously. Washington has sensitive ears.

The statistics are astounding. Mental illness is the leading cause of disability and premature death in the United States. Persons with serious mental illness die, on average, 25 years earlier than the general population. More than 67% of adults and 80% of youth do not receive needed mental health services. An amazing 80% of children entering the juvenile justice system have mental disorders. Of the more than 30,000 suicides in America every year, 90% are associated with mental illness. 130,000 people are hospitalized each year after a failed suicide attempt. Statistically, the under-populated state of Wyoming leads the country in suicides per capita. The western states generally lead the country in suicides per capita. What is it about the wide out spaces of our glorious west that makes people want to die? And what is it about American culture that makes us lead the world in mental illness? It was cited that Mexico has a rate of mental illness comparable to the rest of the world, but when Mexicans have lived in the USA for twelve years their rate to mental illness leaps 30% to American levels. There must be great stress living in the world’s greatest superpower.

The day the conference began, a Jew- and black-hating white supremacist shot his way into the Holocaust Museum in Washington, killing a black security guard. The news reports all focused on his racist beliefs, but his actions were really those of a mad man. The politically correct viewpoint would not allow us to humanize this poor demented fellow and call his actions what they really were: the acts of a mentally ill person. When this event was brought up in an opening session for newcomers at the conference, it was quickly glossed over. The subject is too explosive to handle, yet it is fundamental to the whole issue of the treatment of the mentally ill. The stigma of mental illness is still enormous, and if the tent is made too large to encompass all who have the disease, both the maniacal violent criminal and even racist ill together with depressed passive broken and suicidal ill, the risk of losing support from a skittish public is apparently too great for even the mental health community to contemplate. Better to exclude some portion of the sick than to lose the possibility of help for the many who would benefit. Therein lie a conundrum and fault line too great to cross.

2009 is seen as the year of health care reform. Parity for mental illness with other medical illness was finally passed by act of congress; now the issue is to see that this parity is incorporated into the new health care reform bill being proposed before Congress. The trouble, as usual, is money. When push comes to shove, certain things get funded and others don’t. Mental health programs have always been the ones to get short shrift. Mental Health America is working hard to lobby that mental health and substance abuse treatment are core components of any health care benefits package and have parity in coverage with medical and surgical benefits. The sell is a hard one, especially if there is a hint of socialized medicine in the mix, or if there is emphasis on the criminally or socially unacceptable mentally ill. Better to focus on an issue on which both conservatives and liberals could be guaranteed to support: mental health care for veterans.

The conference placed special emphasis on addressing the mental health needs of America’s veterans, with three of its sessions dedicated to this particular issue. Not that this is an issue without merit; it is. Male veterans are twice as likely to commit suicide as non-veterans. 20% of veterans returning from deployment report both symptoms of post traumatic stress or depression. 19% of veterans returning from deployment have experienced possible traumatic brain injury. 25% of veterans seen by the VA have a mental health diagnosis. Recent health reporting shows reservists with 60% mental health claims and retired military with an enormous 76% mental health claims. 25% of single homeless persons have served in the armed forces. Last, the families of service men and women suffer from the stress of long and repeated deployments, resulting in marital discord and domestic violence. The “mentally wounded warrior” issue is epidemic.

To place special attention on this issue, MHA is making a strategic political move. It is trying to enlarge the tent of the mentally ill by drawing in the conservative right with an apple pie and American flag issue. War veterans with mental illness can easily be identified as a group deserving of help since they are serving our country. If funding for their programs is tied into programs of funding for other programs helping low income families cope with marital discord and domestic violence, and depressed and suicidal men and women find help mental health programs in general will be well served.

As was pointed out again and again at this conference, gaining a reasonable system of national health insurance in the United States will be a difficult task. Having adequate mental health coverage in this national health insurance will be an even more difficult task. But now is the time to fight for both. The stakes have never been greater and the possibility of passage never more promising. The mental health community, the providers and the consumers, especially the consumers, must make their voices heard. No longer can we who have the diseases of mental illness stand passively by and let the professionals, or the drug companies, or the few advocates, who speak on our behalf, carry the burden. We must rise and demand that our voices be heard. We maybe wounded, but we are not inarticulate. WE KNOW WHAT WE NEED. We need a health care system in which we can get treatment. Too many of our number are going without treatment, either because we cannot afford to pay, or none is available. When we can pay, we need a system that we can pay for that meets our needs, that does not stupefy us with drugs, incarcerate us against our wills, stigmatize us, and talk down to us. I want a health care system that is affordable, and treats us with respect in the name of Clifford Beers, founder of MHA.