Capitol Hill Symposium Draws Advocates

I took a day from writing yesterday to attend an all-day symposium in Washington D.C. that was entitled LOST: Dollars, People, Hope.  The keynote was given by Tipper Gore, a long time advocate. The thrust of her speech was that we needed to tie mental health to bigger issues that are important to all Americans if we want to stop Congress from cutting federal mental health funding.  Her first example was war.

Gore said that 18 veterans die each day by their own hands, an alarming statistic and an example of why we need a better mental health care system. If we just complain to politicians about mental health care cuts, she said, we probably will be met with deaf ears.  But if we explain that those cuts are going to penalize veterans who are suffering mental health problems because of their service to our country — then Congress will be more likely to authorize funding. 

 Simply put, politicians might not have much empathy for the homeless man with schizophrenia who is wandering the streets, but if you talk about the number of veterans with mental problems who are homeless then elected leaders will react.

Gore’s keynote was followed by two panels of experts who discussed mental health care problems and the threat of congressional cuts.  All of them said the same thing: that cutting mental health services is short-sighted because treatment is not only the moral thing to do but also the financially smart thing.

Kevin Martone, who helped run New Jersey’s mental health system, said that mental health directors are not even consulted in many states when budget cuts are ordered. They are simply told to reduce their budgets by a certain percentage. He said the first cuts are in administration, next comes hiring freezes and mandatory days off for employees, and then finally critical programs are cut. This results in only a selected few getting help. The others are set adrift and often end up in jails and on the streets. 

Martone said something that I saw first-hand years ago when I was a reporter in Oklahoma and a federal judge took control of the state’s prisons because of the horrific conditions that existed in them. At a press conference, the state official responsible for the prisons expressed outrage at the judge’s actions.  But privately, he confided in me that he was delighted that the judge had intervened. Why the charade? Because the director knew the judge could force the state to do what he couldn’t — begin spending money to improve the prisons.

Martone said many state mental health directors are secretly hoping the U.S. Justice Department will step in and take control of their state mental health programs because that will be the only way to prevent state legislators from gutting the programs with budget cuts.

Another panelist, Dr. Howard Goldman, a professor of psychiatry at the University of Maryland School of Medicine, and a favorite of mine, said that a recent study showed the 60 percent of persons with serious mental disorders could work at competitive jobs if they received supportive employment help, case management and excellent medications. But he warned that even though they could work, most would not earn enough to support themselves, especially during a recession. Because of this, there would not be significant savings in federal disability payments. The workers would still need benefits to pay for costly medications and other services. He added that many persons with severe mental illnesses are afraid they will lose their benefits if they work, creating a Catch 22, that keeps them from seeking employment.  

One of the best speakers yesterday was my good friend, Judge Steven Leifman from Miami Dade County, who talked about what he described as SMART JUSTICE.  In a stunning power point presentation — if there is such a thing — Leifman showed the impact in his community caused by 97 individuals with severe mental illnesses.

During a five year period, these 97 persons where arrested a total of 2,171 times, spent 26,640 days in jail, caused 710 involuntary commitment hearings, spent  the equvilant of 7,000 days in psychiatric inpatient facilities, 2,600 days in emergency rooms, and 3,200 days in state mental hospitals. The cost to the public was $12.6 million.

What’s sad about these so called “frequent flyers” is that few ever get better.  There are two reasons for this. Much of their time in “treatment” is actually spent getting them “competent” to stand trial, not helping them manage their symptoms. The second reason for failure after they are discharged is that few of them receive any follow up services, such as supportive housing or case management.

The most dramatic speakers of the day were actress Glenn Close and her sister, Jessie Close, who suffers from bipolar disorder and has an adult son with schizo-affective disorder. It is difficult to outshine a dynamic acress, especially one as articulate as Glenn Close, who several years ago founded BringChange2Mind and has since lend her name and voice to fighting stigma.

However, when Jessie Close began describing her struggles –that included three suicide attempts and countless ruined relationships, including five marriages — the crowd became entranced. At one point, Jessie described how Fall is especially difficult for her because she suffers from seasonal depression. No matter what she does in life, she is “stalked by depression.”

She told her story well and brought the crowd to its feet by touching hearts and reminding everyone that recovery is possible and  no one who is sick should be cast aside in our society.

In a press release, the National Alliance on Mental Illness, Mental Health America, and other groups, such as the National Council for Community Behavioral Healthcare were given credit for organizing the event. While NAMI’s Mike Fitzpatrick, MHA’s David Shern, and NCCBH’s Director Linda Rosenberg attended the symposium, I was told that the impetus for the day long event was Otsuka America Pharmaceutical Company.  If that name doesn’t sound familiar, it might be because Otsuka is a Japanese based company. It actually developed the anti-psychotic  Abilify and then teamed with Bristol Myers Squibb to distribute it in the U.S.

I was told that Otsuka contacted Patton Boggs LLP and said it wanted to help bring various mental health groups together on Capitol Hill to discuss ways to prevent budget cuts. The law firm hired a public relations company — Hyde Park Communications — to help. It was these two Washington savvy firms — Patton Boggs and Hyde Park — that came up with the idea of hosting a one day symposium aimed at protecting mental health services. Otsuka then footed the bill.

Cokie Roberts, who was the day’s moderator, suggested that the attendees could use the symposium as the first step in forming a coalition that would lobby Congress, but the executive directors of the various groups, whom I spoke with afterwards, said they had little interest in that. They had simply attended to help publicize the need for mental health reforms.