Wednesday, June 2, 2010

New Freedom Commission on Mental Health (2003)


Aspects of Need Addressed: Educational

One great service rendered by the Bush Administration to the Nation was the establishment of the President's New Freedom Commission on Mental Health by Executive Order in 2002. The New Freedom Commission studied all aspects of the state of mental health services delivery in this country. It published a 130 page report which articulates so many of the challenges--and opportunities--within "The System" today.

It is a good document... not a perfect one, but a very good one. It was a detailed summary of all that my son and I have experienced during his odyssey with mental disabililty. It states many things that need to be done. And, oh, so much needs to be done!...

Here are a few notable excerpts on which I would comment:

“After a year of study, and after reviewing research and testimony, the Commission finds that recovery from mental illness is now a real possibility.” (Cover letter to the President)
The recovery focus, rather than the illness focus, is a welcome adaptation. The future of treatment for the mentally disabled MUST be focused on the individual consumer, empowering him or her to participate in and make all the decisions relating to his or her treatment. But I cannot help but cynically note the presence in this sentence of the word "now". Recovery has always been possible. It has not been achieved because of all the impediments we as a society and as invididuals have placed in its way, notably stigma.

"In 1997, the latest year comparable data are available, the United States spent more than $1 trillion on health care, including almost $71 billion on treating mental illnesses. Mental health expenditures are predominantly publicly funded at 57%, compared to 46% of overall health care expenditures. Between 1987 and 1997, mental health spending did not keep pace with general health care because of declines in private health spending under managed care and cutbacks in hospital expenditures..."

Oh, the humanity! The cost of mental illness is high. The funding of mental disability recovery is shrinking. How short-sighted. How tragic.

"Science has shown that having hope plays an integral role in an individual’s recovery."

One of the remarkable conundrums I find in my research on The System is how much reference is paid to "hope" yet how little is made to the role that religion and spirituality can play in recovery. There is, I believe, good evidence to support their helpful effects. At a recent NJ State convention of the National Association of Social Workers, I particularly found this to be the case. We do our loved ones a great disservice if we don't promote certain transcendental concepts. One is that we are all God's children, equal and worthy of innate dignity, even and especially the weakest or afflicted amongst us. Another is that hope in its purest sense comes from God. Man will always fall short and disappoint, corrupted as we mortals are by our avarice, our prejudice and our moral limitations. It was not so long ago in a certain Western country which had smashed traditional religious faith that the mentally disabled were classified as "defectives" and put to death because they were not "useful" to society.
"In partnership with their health care providers, consumers and families will play a larger role..."

It is reassuring to see a government commission state clearly what all desparate families with mentally disabled loved ones have long known themselves from their bitter experiences with The System...

"Of the more than two million adults in the U.S. who have at least one episode of homelessness in a given year, 46% report having had a mental health problem within the previous year."

There seems to be a very high correlation between mentally disabiilty and homelessness.

"A University of Pennsylvania study found that homeless people with mental illnesses who were placed in permanent supportive housing cost the public $16,282 less per person per year compared to their previous costs for mental health, corrections, Medicaid, and public institutions and shelters..."

Doing nothing about it is far more expensive to society.


The whole report takes about an 90 minutes to read. For those of us in the maelstrom, it is worth the time. Download the full report here.