What’s The Biggest Threat To Mental Health Care? Ironically, It’s The Opioid Crisis.


(4-3-17) The biggest danger to improving mental health care in America today is not:

*Efforts to repeal and reform the Affordable Care Act or reduce Medicaid.

*Too many persons with mental illnesses being inappropriately incarcerated in jails and prisons.

*A lack of affordable housing, jobs, transportation, or access to crisis care beds and medications.

*A lack of peer support, clubhouses, Crisis Intervention Team trained officers, mental health courts or re-entry programs.

The biggest danger facing mental health care today is the opioid crisis.

Here’s a shocking figure for you to consider:

According to the Centers for Disease Control and Prevention, every day in our country 91 people die because of overdoses. Ninety-one deaths! That is a higher number than Americans who die each day in car accidents and shootings.

Now let me be clear. I am not diminishing this crisis. Let me repeat that. The opioid crisis is a national tragedy and scandal that must be addressed.

So what do opioid deaths have to do with mental health care?

In many states, including Virginia, mental health and substance abuse services are folded into one agency, often along with intellectual disabilities. (Addictions and mental illnesses are seen as a natural fit, because an estimated 40% of persons with serious mental illnesses also have co-occurring addiction issues.) My worry, based on history, is that tax dollars for mental health care are going to be the easiest and most likely to be cut as money is shifted into the opioid crisis.

There are obvious reasons for this. Parents of children with intellectual disabilities have been lobbying and fighting to protect their family members since birth. They are well organized and dogged. They also have a much more empathetic cause than individuals with serious mental illnesses who are homeless and perceived by many as being dangerous and deserving of institutionalization.

Need another reason why future mental health budgets will be in peril?

During the lame duck session of Congress in December, the 21st Century Cures Act was passed and it contained two very important mental health bills. But passing legislation and funding it, are two different things. Having approved two mental health bills, it could be easy for members of Congress to believe that they have solved the problems that plaque our mental health care system.

This is why it is vital that the new Assistant Secretary for Mental Health and Substance Abuse, a position created by Pennsylvania Republican Rep. Tim Murphy’s  Helping Families In Mental Health Crisis Act  be someone familiar enough with mental health to insure that Murphy’s hard-fought reforms are properly funded.

Since the Sandy Hook Elementary School shootings, Rep. Murphy, the only practicing psychologist in Congress, has made mental health reform a top priority. He has been relentless. In the Senate, he was aided by Texas Republican and majority whip, Sen. John Cornyn, and Senators Bill Cassidy (R-La.) and Chris Murphy (D-Conn.)

Obviously, we must do something to end opioid deaths and help those who are addicted. But in doing so, we must not forget the needs of the serious mentally ill who continue to roam our streets, homeless and all too often invisible to us.

Those who do not remember their past are condemned to repeat their mistakes.

From: State Budget Crisis 2011 NAMI : One in 17 people in America lives with a serious mental illnesses such as schizophrenia, major depression, or bipolar disorder. About one in 10 children live with a serious mental disorder. In recent years, the worst recession in the U.S. since the Great Depression has dramatically impacted an already inadequate public mental health system. From 2009 to 2011, massive cuts to non-Medicaid state mental health spending totaled nearly $1.6 billion dollars. And, deeper cuts are projected in 2011 and 2012. States have cut vital services for tens of thousands of youth and adults living with the most serious mental illness. These services include community and hospital based psychiatric care, housing and access to medications.

From an article I published in The American ProspectBecause of the murders at Virginia Polytechnic Institute and State University (Virginia Tech) on April 16, 2007, the state legislature was forced to address our state’s badly fractured and neglected system. The massacre of 32 students by Seung-Hui Cho, who then killed himself, led the governor and legislature to loosen the state’s involuntary commitment language and to approve $42 million in new revenues to be spent over the next two years, mostly to expand jail-diversion programs and hire 146 additional therapists and case workers. Gov. Timothy Kaine acknowledged that $42 million would not pay for a much-needed system overhaul, but he explained it was the best anyone could expect given a recession and corresponding drop in state revenues. At a press conference held to sign the legislation, the governor and major legislators slapped themselves on the back.

What the governor and legislature didn’t mention was that Virginia had cut $50 million from its mental-health services between 2002 and 2004 during a budget crunch, and when former Gov. Mark Warner left office in 2005, he had warned that it would take $460 million to bring Virginia’s anemic system up to par.

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.