The current political climate is not good for people with mental illness. Many receive benefits under the ACA’s parity for mental and physical health clause and Medicaid expansion. For many of those, especially people struggling with substance abuse, the treatment made available has been very successful. I’ve heard scores of stories, and have seen lots of data, illustrating how people for whom care was unattainable have been able to turn their lives around just because of the availability of treatment. That, and their own hard work at getting well. Now, with the attitudes spurred by the failed American Health Care Act, those newly granted benefits are being viewed by some as up for review.
There’s a lot more at stake than who pays, if anyone pays, for treatment for those with mental illness and desperate financial circumstances. A new trend in our culture, or a long deep-seated but unspoken feeling newly emerged, whispers and sometimes exclaims that we’re not worth it. Enough, a large group of Americans has proclaimed. We’re not going to pay for the poor and sick anymore. With a vast class struggling and a voice given to their anger, a sense of community and compassion seems to be set up as a victim of the angry mob that has settled in front of their news or twitter feeds and rages against the injustice of those who take without contributing. Blaming the victim has evolved into blaming the sick, poor outcomes have been blamed on poor choices, and the stigma against those with mental illness has taken a nasty turn. Lumping those of us who ask for help in with all the accused and undefined leeches who dare to perpetuate the need for a welfare state. Like many unfortunates in the world of Making America Great Again, we don’t fit in, don’t pull our weight, and don’t deserve the fruits of this great nation that we are told we have done so little to build. I think a lot of people would be happy if we just went away.
But giving up is costly for the individual and the group. In several states with the Medicaid expansion emergency room visits for opioid overdoses have declined, while these visits have soared in states without the expansion. This simple availability of treatment options has led to a reduction in healthcare costs for the masses who fund the plans. Throwing money at a problem doesn’t always work. But investing in care for mental illness and substance abuse treatment consistently pays off. Yet, in an age of don’t take mine, not any of it, in a land where we kill what we eat and are reluctant to share with those we deem less fortunate, this success will be ignored. The nation seems prepared to write off the hard facts of results for the simplicity of black and white ideology. And boy do the losers really lose when society loses its sense of compassion and charity. A collective anger has lashed out, and those who just can’t make it on their own will suffer.
My own case is illustrative. I was doing just fine, paying my own way as a young man, when increasing bouts of mania and psychosis cut me down. I’ve been on disability. I’ve been on food stamps. Now, I’ve recovered and have needed no assistance for several years. But the key point is that if that assistance had not been available in the first place I never would have had the opportunity to do the work necessary, and get the treatment necessary, to get better. I’m paying my way again, but if you, yes, you reading this, hadn’t funded the programs that supported me I may be a bigger, more expensive problem for you now. So thank you. Whether you like it or not, I’m doing fine because of your paying into the same programs that many want to diminish, dismantle, or de-fund. And now I’m successfully paying back into that same system. You gave, I recovered, and now I give back. We can do this, countless times, for so many.
So what can the mentally ill do in response to the threats to the programs that help them recover? Be an example. Celebrate your successes, contributions, and hard work. Let society know that our pulling together has helped so many so much. And our pulling apart will not only leave many in worse shape than they are now, it will blacken our collective soul and leave every one of us a lesser, more bitter, more selfish, and more isolated person. Community solutions work. It would be disappointing to see this community of care and support – that works – be sacrificed because of the growing hate of some undefined other that threatens the fabric of American society. We should be judged by how we treat the least of us. We work best when we work together, and the sick who could be so inhumanely thrown off the rolls of Medicaid can recover if given the opportunity and the means. Then they’ll pay back with their best efforts as well.