Long overdue, mental health’s time in the spotlight has finally come | Fletcher McClellan

Mental health depends on healthy lifestyles, vigorous politics, and responsive policies

October 16, 2022 6:30 am
Direct service providers rally for more money in the 2022-23 state budget at the Pennsylvania state Capitol on May 24, 2022 in Harrisburg, Pa (Photo by Amanda Berg, for the Capital-Star).

Direct service providers rally for more money in the 2022-23 state budget at the Pennsylvania State Capitol on Tuesday, May 24, 2022 (Photo by Amanda Berg, for the Capital-Star).

Inflation, abortion, Ukraine, and the midterm elections are on top of many citizens’ minds these days, but another issue – mental health – is finally receiving the serious attention it has long deserved. 

Heightened interest in mental health and illness can be attributed to a confluence of events. The COVID-19 pandemic dramatically changed peoples’ lives, leading to increased psychological stress. Especially affected were women, the young, those with low incomes, essential workers, and communities of color.

Deaths due to suicides, alcohol, and drugs rose markedly during the pandemic. As related by her daughter, the actress Ashley Judd, the country recording artist Naomi Judd took her own life last spring, “believ[ing] that her mental illness would only get worse, never better.”

In addition, prominent celebrities and athletes, including Demi Lovato, Michael Phelps, Leonardo DiCaprio, and Naomi Osaka, reported various kinds of mental ailments.

Even prior to the arrival of COVID, one in three high school students and half of female students reported persistent feelings of sadness or hopelessness, an overall increase of 40% from 2009, according an advisory on youth mental health issued last December by U.S. Surgeon General Dr. Vivek Murphy.

Not to be ignored is a laundry list of contributing factors to mental distress. Social media, which has had damaging effects on teenage girls. The outrage industry, especially right-wing media, MAGA Republicans, and hate groups, which keeps people in a constant state of fear. Donald Trump, needless to say, and red-state policies

Responding to what 90 percent of Americans say is a mental health crisis, President Biden announced a new mental health initiative in the 2022 State of the Union Address. Not since Jimmy Carter has a president given the issue such high-level attention.

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According to the National Institute of Mental Health (NIMH), one in five U.S. adults in 2020, or 52.9 million people, lived with a “mental, behavioral, or emotional disorder” of any kind or impact. Nearly 15 million Americans suffered from a severe mental illness, defined as “a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities.”

Almost one-half of adults with any mental illness and 65 percent of those with severe mental illness received treatment, counseling, or prescription medication in 2020. More women than men with mental illnesses received mental health services, the NIMH reported. Unfortunately, a lower percentage of young adults obtained mental health services than did older age groups.

Government efforts to address mental health have a long and tragic history. Prior to 1955, people with severe mental illnesses were committed to state hospitals, reformatories, and prisons for treatment. Official reports and horror stories, depicted in such works as One Flew Over the Cuckoo’s Nest, condemned the kind of care patients received.

The emerging deinstitutionalization movement achieved official recognition from President John F. Kennedy, whose sister Rosemary was diagnosed with a mental disorder, lobotomized, and committed to a private hospital for the rest of her life (a secret the family kept for decades). 

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On October 31, 1963, JFK affirmed the Community Mental Health Act (CMHA), the last bill he signed into law. The CMHA provided funds to states for the construction of community mental health centers. Conceived as an alternative to institutionalization, community-based care allows patients to work and receive treatment at local centers while living at home. 

However, governments underfunded the community mental health center program for decades. Fewer than half the 1,500 centers Kennedy projected 60 years ago were built. In the meantime, most state long-term or psychiatric institutions closed.

Consequently, hundreds of thousands of mentally ill persons, either released from facilities or integrated with communities, became homeless or re-institutionalized into prisons

Estimates are  that more than 40 percent of the U.S. prison population have a diagnosed mental illness, and 15-20% of inmates have serious mental illnesses. Only a small percentage of diagnosed prisoners receive professional treatment, while force by prison officers is disproportionately applied.

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In the midst of these challenges, mental health policy progressed. In Olmstead v. L.C. (1999), the U.S. Supreme Court ruled that unjustified segregation of mentally disabled persons constituted unlawful discrimination under the Americans with Disabilities Act. 

The Obama administration launched a demonstration project to revive the CMHC, paying mental health clinics the full costs of providing care under Medicaid. The results were promising, and state participation in the project has expanded

In Pennsylvania, the 2022-23 budget increased funding for county mental health programs by $43 million or 5 percent, the first such boost in 10 years. The General Assembly set aside an additional $100 million from American Rescue Plan funds to bolster the mental health infrastructure, but a specific spending bill has yet to pass, the Capital-Star noted last week.

The recent focus on mental health comes not a moment too soon. This begs a larger question: How can we live less stressful lives? 

Self-care is certainly one answer. But more should be done. 

Writing for the New York Times, Danielle Carr of UCLA argues that society must address structural inequities causing stress, including “housing, food security, education, child care, job security, the right to organize for more humane workplaces, and substantive action on the imminent climate apocalypse.”

In other words, mental health depends on healthy lifestyles, vigorous politics, and responsive policies.

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Fletcher McClellan
Fletcher McClellan

Opinion contributor Fletcher McClellan is a political science professor at Elizabethtown College in Elizabethtown, Pa. His work appears biweekly on the Capital-Star’s Commentary Page. Readers may email him at [email protected], and follow him on Twitter at @mcclelef.