Time for a Mental Health New Deal

America's economic health is inextricably intertwined with its citizens' psychological well-being.
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Our host Kathleen's sensational homemade chocolate cake was Topic A at the holiday party of Wright Institute Los Angeles (WILA), a non-profit psychoanalytic institute which provides struggling Angelenos with low-cost, long term psychotherapy. But you can't get a bunch of shrinks together without, well, analyzing everything. (Except the cake, which ascended directly to heaven.)

So it didn't take long before the conversation turned to the economic crisis. The individual horror stories about lost jobs, collapsing home values and vanishing 401Ks are becoming all too familiar; then Nina, a WILA post-graduate fellow, raised a question: what to do about the mental health consequences of this debacle.

America's economic health is inextricably intertwined with its citizens' psychological well-being. The very language we use to describe our financial plight -- insanity, depression, panic, insecurity, trauma -- underscores this connection. Financial excess chronicler extraordinaire Michael "Liar's Poker" Lewis puts it succinctly in the title of his new book, Panic: The Story of Modern Financial Insanity>.

To give short shrift to mental health programs would geometrically compound the insanity; over and above the humanitarian cost, the financial losses in productivity and from increased crime rates are incalculable.

Historically, our national leaders have been virtually invisible in confronting mental health issues. Richard Nixon famously told his legal counsel Leonard Garment he'd do "anything except see a shrink," and Ronald Reagan's budget slashed mental health programs so severely that thousands of mentally ill patients became homeless. Following in the footsteps of his father, Bush Senior, who dismissed the idea of introspection as "psychobabble," W has run the country for the past eight years like a non-benevolent monarchy; and you have to admit he's a pretty good candidate for the title "King of Denial." Even Clinton, for all his storied empathy, has been revealed as a poster boy for unexamined narcissism.

Now every day brings new stories of state and local governments from Sacramento to Albany closing or vastly cutting back detox clinics, suicide prevention facilities, psychiatric hospitals and other essential services. These are euphemistically called cuts in "social services."

To give just one example, mental health services in Illinois have already been slashed by $25 million and another $80 million in cuts are coming down the pike. This would leave more than 62,000 people with mental problems untreated in that state, and that's not counting those who've recently been or will soon be traumatized by economic catastrophe. "This is horrible, because what we know today is that with proper medication and psycho-social services and therapy, people can recover," said Suzanne Andriukaitis, executive director of the National Alliance on Mental Illness.

Small, non-governmental programs are springing up to address these problems. WILA, whose board I chair, will soon offer a range of services to address psychological issues facing the suddenly unemployed. But most non-profits are having trouble raising the funds to keep current programs going, let alone launch new ones. In fact, as many as 100,000 American non-profits will shut their doors over the next two years, according to Paul Light, professor of public service at New York University.

What's the plan?

The Obama administration's recovery package will be necessary but far from sufficient to turn things around. Comprehensive health care, if it allows patients access to therapy that goes beyond a single visit and a prescription for meds, should provide some help, but looms as a huge question mark; in any case it couldn't come online quickly enough to address the challenge.

We've got to organize and lobby hard for a mental health "New Deal," in which the Feds immediately restore funds for decimated state and local treatment programs, and then create a national mental health safety net so no one falls through the cracks.

Let's take a page from Obama's grass roots Presidential campaign. Start or join a group at the local level to lobby the president-elect and incoming HHS Secretary Tom Daschle. Bombard your legislators with emails and phone calls. If you're not an activist, become one. If you can give even a few dollars, donate to a mental health-oriented charity or non-profit.

Yes, these proposals will cost more money and mean more borrowing. But if we don't act now, the tragic fallout will reverberate throughout society for decades. And we might just as well say of those in need, "Let them eat cake."

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