America’s mental health care system has been in decline ever since the era of deinstitutionalization. Deinstitutionalization is when patients were released from mental institutions after World War II and the discovery of antipsychotic drugs. Because of the abuse within the institutional systems before World War II, it was seen as a positive that the mentally ill could now function outside of a hospital and lead a semi normal life. This lead to cutting state funds for mental health care, decreasing the number of hospital beds, and letting go of psychologists and psychiatrists because these things were no longer needed, or so it was thought. What happens when these individuals do not think it is necessary to take their medicine, or do not like the side effects of it? Today, the seriously mentally ill are in a vicious cycle of incarnation, homelessness, and frequent short stays in the hospital because there are not the proper legislations, number of hospital beds, state funding, and mental health care providers to ensure their safety and well being with proper treatment. Mentally ill individuals and or their family members desperately want treatment but are not able to get it because more often than not their insurance does not cover it. Both sides of American politics have taken note of this issue and are working to fix it, but favor different approaches. I will review these contrasting approaches in my detailment of a few articles on this issue from various media outlets that uphold opposing views from one another.
- The Christian Science Monitor: Conservative
In Rare Bipartisan Success, Congress Passes Major Mental Health Bill
Amanda Paulson, Dec 7, 2016
Image: Senator Chris Murphy (D) speaks at Sandy Hook Inaugural Promise Gala.
The 21st Century Care Act, a recent legislation concerning health care, is praised by this right leaning article as being a great start to putting America’s broken mental health care system on the right track. It is considered the first reform to have taken place in twenty plus years, winning by a 94 to 5 vote in Senate. Although it does not include much additional funding for the mental health portion of the bill, it lays a great foundation for eventual receiving of future funding. The bill calls for the new position of Assistant Secretary for Mental Health and Substance Abuse, more programs for early intervention, additional mental health care providers and psychiatric beds, an increase in health insurance coverage, and fresh research on mental illness and the criminal justice system. Congressman Tim Murphy (R) of Pennsylvania, the main force behind the bill, and a practicing psychologist, saw the Sandy Hook Massacre of 2012 as the breaking point of a failed system. Mental illness affects 1 in 5 Americans, but today’s treatment is only accessible in a crisis or a tragedy, which results in expensive hospitalization and or the harm of oneself or of others. Those seriously mentally ill and not in treatment are often in between prison and homelessness. Even with the new advancements in legislation, Murphy claims that “we didn’t get everything we needed but we needed everything we got.” Although the bill won by a bipartisan vote, the democratic party fears that the new law will “reduce pharmaceutical regulations.” Jennifer Mathis, director of policy and legal advocacy for the Bazelon Center for Mental Health Law, felt that the original final bill emphasized too heavily on involuntary treatment and institutionalization while also reducing the mentally ill’s legal rights. This article struck me as taking a more conservative standpoint because it accredited the bill’s success to Republican efforts while mentioning the democratic party of being in disapproval of select bullet points of the original proposal and the further blockage of improvement in mental health care. In contrast with the liberal point of view, conservatives like Murphy believe that the seriously mentally ill should be involuntarily institutionalized under certain situations in order to prevent catastrophe. This was not implemented in the bill, but continues to be pushed by Republicans.
- The Huffington Post: Liberal
Repealing the ACA Could be a Nightmare for Mental Health Care
Lindsey Holmes, Jan 16, 2017
This article featured by the Huffington post reviews the potential negative effects if the Affordable Care Act were to be abolished. Holmes, the author, claims that the disappearance of ACA would “strip health insurance from 20 million Americans, including coverage for services that help some of the 1 in 5 people with mental health conditions.” The president and CEO of American Psychiatric Association took it upon themselves to write congress a letter about how Obamacare has led to greater health care coverage of those with mental health issues while reducing the stigma surrounding mental illness. Statistics show that between 2012 and 2015, uninsured individuals with a serious mental illness went from 23.1% to 19.5% with the instatement of the ACA. Although Obamacare is not considered to be perfect, and recent legislations like the 21st Century Care Act may be helpful with funding for adding more psychologists and psychiatrists, it is crucial that congress does not revert the original advances that were made in mental health care, only positive reformations should be made. Like The Christian Science Monitor, this article blames the opposing political party, in this case the Republicans, for the potential damage to mental health care. The reader can know that this is coming from a liberal point of view because the writer is in favor of the continuation of Obamacare and foretells of the negative implications on mental health care if it is repealed. Holmes approves of new legislations, like the 21st Century Care Act that was reviewed in The Christian Science Monitor, believing that it has some benefits, but despises the fact that ACA could be repealed because it would do away with pre existing positive assets. The other side of the political spectrum does not see the good that ACA does for mental health and considers it to be a determent.
- PBS Newshour: Neutral
Why Even Insured Americans Struggle to get Mental Health Care
April Dembosky, Nov 1, 2015
Image: boy receiving in home ABS therapy http://cms.bsu.edu/-/media/www/departmentalcontent/onlineanddistanceed/photos/profilephotos/201411_shappard1.jpg?h=167&w=250&hash=DDFCDFC2BAD70304AF802A5D5D90A330DCF1D89F&la=en
Similar to the article featured by The Christian Science Monitor, PBS Newshour takes a congruent approach in relations to the faults with America’s mental health care system. However, instead placing blame on the government or a particular political party, it criticizes various individual insurance companies. Interviewer April Dembosky uses statistics and testimonials, taking a more neutral standpoint, to show the failures of current mental health care coverage. She opens up by stating that “43 million Americans suffer from mental health issues, but more than half never get help, even people who are insured under Obamacare.” The interviewee, Natalie Dunnege, a struggling single mother with a thirteen-year-old autistic son, is paying $50 an hour for an applied behavioral analysis (ABA) therapist to come to her home for a couple hours every week that her insurance, Blueshield, does not cover. The list of therapists that had to be emailed to her because they were not published on the insurance company’s website along with other doctors, all had a three month waiting list. As an experiment, Dembosky herself called one hundred therapists in San Francisco that claim to accept Blueshield insurance. Half of them said that they do not take that insurance anymore or accept new patients, a fourth of them never even gave a call back, and only eight offered appointments outside of daily work hours. Dembosky called in local psychologist, Dr. Hopman, to get her point of view from the medical side. Hopman was not shocked when she learned of Dunnege’s situation. She said that is not unusual for insurance companies to have a “shortage” of mental health providers, but finds it especially ironic and suspicious that they have this problem. Many colleague of hers have attempted to join various insurance panels, but are time and time again turned down because the company claims that they already have enough providers for the specific area. Hopman has a theory that it is beneficial for insurance companies to make it hard for individuals to receive treatment because more often than not, if it is too difficult, they will stop trying. For eighteen years Hopman has not had an increase in reimbursement rates, but the co-pays and premiums of her clients are continually increasing. These difficulties do not make sense when it is a federal and state law that insurance must cover mental health services in equality with every other provided health care. We can tell that this article is neutral because it does not blame a political party or health care for mental health care system failures unlike Huffington Post and The Christian Science Monitor. Instead of implementing personal opinions on the subject, Dembosky presents facts to make her case that both patients and psychologists are being negatively affected from today’s system of mental health care.
- Breitbart: Conservative
GOP Rep Tim Murphy Touts Mental Health Reform During GOP Address
Ian Hanchett, Dec 24, 2016
Image: Obama signing 21st Century Care Act
Breitbart’s detailment of Congressman Tim Murphy’s (R) take on mental health care reform falls in similar lines with The Christian Monitor’s conservative understanding of the new 21st Century Care Act. The writer, Ian Hanchett, opens up with the statistic that “everyday 959 lives are taken directly or indirectly by mental illness.” Murphy blames the “outdated laws” as the reason why those who desperately need treatment are instead continuously homeless and or incarcerated without any legal assistance of family and doctors. With over 110 federal programs in place, funded by a total of $130 billion, current congressional benefits on mental health care are little to none. This new legislation, signed on December 13, 2016, one day before the four year anniversary of Sandy Hook Elementary, intends to “move away from vague-feel good programs to evidence based care for those at highest risk” with the addition of the new position of Assistant Secretary for Mental Health and Substance abuse, more mental health care givers, and the training of law enforcement on how to identify mental illness. Unlike the article featured in the Huffington Post, Breitbart sees current systems like Obamacare as hurting mental health care. Through its disapproval on Obamacare, we can tell that its bias is conservative. Additionally, it accredits Republican Congressman for the positive changes happening in favor of mental health care. Just like The Christian Science Monitor, this article is in approval of 21st Century Care Act and the further reformation of mental health care.