Those who struggle with mental illnesses are perhaps the most misunderstood and the most stigmatized people in America.
We treat people who have a heart attack with compassion, and we put casts on broken limbs. Our televisions are flooded with commercials about newly-created medications for diabetes, high cholesterol, erectile dysfunction and migraines. But eyes quickly fall when people begin to discuss mental illnesses because mental illnesses often cause people who are afflicted with them to behave in unusual ways.
I remember reading an article, several months ago, about a young man whose modeling career was destroyed when he walked, naked, into a public square and began to dance in front of a startled crowd. I remember a woman walking past me while I was leading a worship service at a psychiatric hospital and lighting a cigarette using a flickering candle that had been placed on the altar. I’ve come face-to-face with the loneliness that mental illnesses create while speaking with countless people who had been abandoned by their families because of their unusual behavior. I worked at a State-run psychiatric hospital during the time when the government decided to reduce its involvement in caring for the mentally ill; and, while I was serving as a chaplain, I watched the government reduce the census at a psychiatric hospital from 2,300 residents to 435 residents – and, as that was happening, homelessness in the surrounding community quadrupled.
According to the National Institute of Health (2015):
- 17.9% of the adults in America struggle with a mental illness;
- 13% of the children between 8 and 15 are afflicted with a mental illness;
- 1-in-42 boys and 1-in-189 girls struggle with autism;
- 8.6 million Americans contemplate suicide each day;
- 1-in-30 people in America struggle with PTSD;
- 64.2% of Americans incarcerated in local jails are mentally ill;
- 56.2% of Americans incarcerated in state prisons are mentally ill;
- 44.8% of Americans incarcerated in federal prisons are mentally ill.
American Healthcare is failing the mentally ill.
State governments decided to reduce the census in state-operated psychiatric hospitals several decades ago, and people who lived in those institutions were released into the general population. People strongly rejected attempts to house people who struggle with mental illness in their neighborhoods; and, people who depended upon daily, established routines (that included medication management) became homeless. According to the National Institute of Health, nearly 25% of the homeless people in the United States suffer from a severe mental illness. The lack of taxpayer-supported psychiatric hospitals, transitional housing, adequate resources to provide out-patient care and counseling, and the reluctance of people in America to support people who struggle with a mental illness so that they can become productive members of our society has left stigmatized people both disaffected and disenfranchised.
But the American Healthcare system is failing the mentally ill in still other ways.
Many insurance companies combined the medical and mental health benefits for policy holders in the closing years of the 20th Century. People who struggle with a mental illness were once able to continue their out-patient counseling without being burdened by rising, up-front deductibles that begin at “ground-zero” at the beginning of each calendar year because medical and mental health benefits were categorized separately. Some policies supported the cost of out-patient counseling for policy holders by maintaining a zero-deductible benefit for mental health services, while others simply required policy holders to pay a small co-pay. But now, insurance companies have merged medical and mental health benefits; and, those who need out-patient counseling often need to pay the full cost of therapy until their policy deductibles have been met. This change can cost people who struggle with mental illnesses thousands of dollars that they simply don’t have. And, when people who struggle with mental illnesses can’t afford to see their psychiatrist and counselor, they don’t receive support and the medications that they need. When people who struggle with mental illnesses don’t receive support and the medications they need, they find that their lives are harder to manage. Some people begin to self-medicate with drugs and alcohol. Some people turn to opioids. When people who are struggling with a mental illness are properly medicated and supported, they are more able to cope with the daily stresses of life in appropriate ways. But, when medications and counseling are abandoned, people lose their jobs and sources of income. People lose their homes and sources of shelter. Families break-down and crumble in the face of challenges. And the very society that unraveled a system that once supported people who are struggling with mental illnesses begins to suffer. Homelessness rises. Drug and alcohol abuse rise. Crime and incarceration rise. And people begin to stigmatize those who struggle with mental illnesses even more when they hear about someone who suffers from a mental illness committing a violence crime – dancing, naked, in a public square – planning and executing a unpredictable massacre – or jumping from a bridge during rush hour.
American Healthcare is failing the mentally ill.
The United States Senate has been desperately trying to “repeal or replace” Obamacare in the last few months while ignoring a Congressional Budget Office report that indicates that as many as 32,000,000 Americans will lose their health insurance if the Senate’s new healthcare plan is enacted. If, for the sake of argument, we use statistics that have been furnished by the National Institute of Health, we can determine that the plan that’s being proposed by the United States Senate will take health insurance away from 4,654,000 people with diagnosable mental illness and from 910,000 people who are battling PTSD. The Senate will, additionally, take health insurance benefits away from people who are contemplating suicide, children who are suffering from autism and many people who are addicted to opioids. And that devastating effect can be seen when we simply reflect upon the effects that our government’s efforts to “repeal and replace” Obamacare will have upon people who struggle with mental illnesses. It’s easy for United States Senators to sit around their tables and “talk numbers” without putting faces onto statistics. It’s easy to dismantle vital services from a safe distance. But the unraveling of out-patient mental health services and counseling creates other costs. Once again referring to the report of the National Institute of Health: 64.2% of those who are incarcerated in local jails, 56.2% of those who are incarcerated in state penitentiaries, and 44.8% of those who are now incarcerated in federal prisons suffer from a diagnosable form of mental illness.
How might we address the issue of mental illness in a fiscally responsible way?
- I suggest that we need to begin addressing the needs of people in America who struggle with mental illnesses by focusing upon the fact that God creates us to be “whole” and that God intentionally creates human community; so that, the “least of these” are both protected and supported by others (Matthew 25:35-40). Can we, as people of faith, begin to see the “face of Christ” in people that we’ve stigmatized, and begin to grow past the deep-seated prejudices that surround mental illnesses? We need to begin by confessing our own harsh attitudes, our own biases, our own deeply-seated prejudices, and our own tendency to stigmatize people who suffer from mental illness (1 John 1:8). We, as men and women of faith, can help people in America who struggle with mental illnesses by recognizing the God-given dignity of their personhood and by confronting those who perpetuate misconceptions.
- People of faith can be more vocal advocates of those who are mentally ill, and can help elected leaders in America to recognize the injustice that the government and insurance companies have inflicted upon some of the most vulnerable people in our country (Deuteronomy 16:20, Psalm 41;1, Proverbs 31:8-9, 2 Corinthians 8:13-15). We, presently, have the highest rate of incarceration in the “free world,” and the National Institute of Health reports that more than half of the people who are incarcerated in America are struggling with a mental illness. We, as people of faith, need to remind our elected leaders that incarceration is not free. The Federal Register, a daily journal of the United States Government, reports that taxpayers pay $31,977.65 ($87.61 per day) to incarcerate a federal inmate each year (2015). The Prison Policy Initiative reports that we currently have 2.4 million prisoners in American correction-facilities. Don’t let your elected leaders tell you that we don’t have money to address the challenges of mental illness in America! The money that we save by failing to provide necessary mental health services is quickly and permanently absorbed by our bloated prison system.
- We, as people of faith, need to be strong advocates who continue to stand against Attorney General Sessions’ attempt to expand the “War on Drugs.” America’s “War on Drugs” has led to the mass-incarceration of people in the Black community and of people who struggle with mental illnesses. People who struggle with a mental illness often use drugs and alcohol to self-medicate when they’re not able to obtain the kind of support that they need. And when people who self-medicate with drugs and alcohol are arrested, incarceration is a predictable outcome. Jesus came into the world to “proclaim liberty to captives and to the oppressed” (Luke 4:18). Once again, when we look at statistics provided by the National Institute of Health, we can see that 64.2% of those incarcerated in local jails, 56.2% of those incarcerated in state prisons, and 44.8% of those incarcerated in federal prisons are suffering from some form of mental illness. People of faith need to continue to lift these very sobering statistics before our leaders’ eyes. When we fail to invest in people who are mentally ill by providing necessary services, we encourage people to gravitate toward alcohol and the types of drugs that don’t offer therapeutic results. When people who are already struggling with mental illnesses gravitate toward alcohol and the types of drugs that don’t offer therapeutic results, they’re often arrested and incarcerated. This is a classic example of choosing the best route forward in America. Do we want to continue to remove people who struggle with a mental illness from the rolls of the insured, cut mental health services that they need, and then arrest and incarcerate them – or do we want to invest that money in prisoners who are suffering from mental illnesses and in providing high-quality mental health support and services to people before they are incarcerated in the first place? How can we, as people of faith, “proclaim liberty to captives and to the oppressed” (Luke 4:18) by promoting the types of policies that support those who are struggling with mental illnesses instead of quietly allowing the Attorney General to expand the “War on Drugs” and incarcerate even larger groups of people?
- Lastly, as people of faith, I believe that we need to stand against any Senatorial efforts to “repeal and replace” Obamacare that will remove people who struggle with a mental illness from the rolls of the insured. The Bible clearly states: “For the whole Law is fulfilled in one word, in the statement: ‘You shall love your neighbor as yourself.” (Galatians 5:14) People who suffer from mental illnesses suffer when they can’t obtain the support and medications that they need. Removing even more people who suffer from mental illness from the rolls of the insured guarantees that even more people, who require medical treatment and support, will live lives where those needs aren’t met. God blesses doctors, nurses, psychiatrists and counselors with gifts of healing (1 Corinthians 12:4) God clearly tells us: “I will restore you to health and I will heal you from your wounds.” (Jeremiah 30:17) We, as people of faith, must continue to proclaim God’s desire to create health and wholeness in the lives of the people that He’s created. We, as people of faith, must continue to push for the expansion of comprehensive health insurance coverage and oppose efforts to remove people (especially the mentally ill) from the rolls of the insured. We, as people of faith, need to realize that those who struggle with mental illnesses will carry those illnesses with them throughout their lives and they will surely struggle to obtain health insurance every time they change jobs in a society where pre-existing conditions allow insurance carriers to deny coverage. We, as people of faith, can only support Congressional efforts to “repeal and replace” Obamacare that expand the rolls of the insured and that guarantee that people who struggle with mental illnesses can obtain the care that they need, at an affordable cost, as they continue to face the challenges of their illness.
The American Court Jester