So many people think of Ronald Reagan as one of our greatest Presidents.  He is attributed to “winning the cold war,” and reducing the size of government.  I’m not going to debate those issues, but I do know that during that time thousands of people were discharged from mental health facilities where they were being warehoused and sent out to find their own housing and services.  They were supposed to be supported by out-patient community services.  Instead, people with serious mental illnesses started falling through the cracks and not receiving proper medical treatment, if any treatment at all.  Today many people with serious mental illnesses are living on the streets, in prisons or in sub-standard, unlicensed boarding homes.  Some families with mentally ill family members are bearing the expense and emotional roller coasters of living with someone who can be challenging at times because they aren’t diagnosed correctly or the stigma surrounding psychiatric disorders keep them from seeking professional  care -  even though  proper medical treatment works and mental health recovery is a reality.  While our Governor Brewer is a fan of slashing the state’s budget for mental health treatment thinking that will help to solve the state’s financial woes, she like President Reagan,  does not always have our best interests at heart.

So, even if President Reagan was a great man, it was during his presidency that treatment for our nations most vulnerable went from bad to worse.  The following article is a reprint because I found it expresses my concerns adequately and one month after the horrible shootings in Tucson, people seem to be more receptive to learning about this issue.

Ronald Reagan, Mental Health, and Spin . . .

Man Behind the Myth

By Phyllis Vine

For the next twelve months, the Ronald Reagan image machine will be turning out countless vignettes of the nation’s 40th president, the man neighbors called “Dutch.” He will be described as no-nonsense yet kindly, remote but avuncular, a movies-star-turned-politician, and remembered as a local lifeguard rescuing people in troubled waters. With dashing good looks, a sonorous tone that became the voice of General Electric, and an affable smile, even those who disagreed with his policies will say he was genuinely kind-hearted.

So what did this mean practically for policies about mental health? Here we need to  ask how the image departs from the reality.

Contrary to the spin about trimming government, which he called “the problem,” we all know he oversaw increases in federal spending that exploded the national debt, and grew the size of the government he impugned. Another part of the reality, rarely the image, is how he attempted to savage the  entitlement system and roll back supports for people with a mental illness.

When Ronald Reagan arrived in Washington, he inherited the Mental Health Systems Act of 1980. One of the last achievements of Pres. Jimmy Carter, this was passed by the House 277 to 15, in the Senate, 93 to 3. With as many critics as there were special interests, it was far from perfect. Yet it expanded the federal government’s commitment to services, to research, to training professionals, and to patient rights. It identified stigma as an impediment to seeking and receiving services.  It established parity in Medicaid and Medicare. It recognized the link between physical health and mental health. And it dedicated $800 million over 4 years to redress the gross neglect of the commitment to mental health in earlier administrations.  In short, it moved an agenda that minimized homelessness, the reliance on expensive nursing homes, jails and prisons, and one that to more hopeful choices for those who needed help.

The Mental Health Systems Act was a milestone. It came on the heels of four years of hearings and a presidential task force benefiting from First Lady Rosalynn Carter’s active involvement.  Philosophically it affirmed Pres. John F. Kennedy’s Community Mental Health Centers, an attempt to thwart hospitalizations. It fit into the safety-net values championed by Pres. Lyndon B. Johnson with the passage of Medicaid and Medicare.

Still, by 1980 the nation needed more for those with a chronic illness. Many failures accompanied the attempts to close the miserable hospitals, often little more than warehouses, to help patients succeed in the community. The neglect of government support conspired to form a patchwork system with notable gaping holes. A 1977 GAO report said, “Government needs to do more.”  Congressional hearings in 1979 re-affirmed the need to strengthen impoverished services and the failed policies.

Although not perfect, the Mental Health Systems Act responded to these problems. For the first time since the National Institute of Mental Health became part of NIH in 1949, mental health was front and center in federal policy.

Then came Ronald Reagan. Within a month, the Office of Management Budget announced it would curtail the budget of the National Institute of Mental Health (NIMH), phase out training of clinicians, interrupt research, and eliminate services.  Cutbacks to staff followed; chaos ensued. Experienced people left, others remained in government service but were forced into menial jobs. Trained professionals were reassigned to labs to dissect dead rats; science writers were reassigned to typing pools. The Mental Health Systems Act would disappear. Instead, the Omnibus Budget Reconciliation Act (1982) would merge money for mental health programs into block grants, and with fewer dollars going to the states.  They had the discretion to use them however they saw fit, often to perpetuate programs already deemed problematic. The pretense for all this was the president’s concept of a “new federalism.”

“Many of our dreams were gone,” wrote Rosalynn Carter in Helping Someone with Mental Illness. “It was a bitter loss.”

This could have been enough, but it was not. Pres. Reagan attempted to restrict criteria for determining eligibility for SSI, thought to be a safety-net. Nearly 2.6 million people were receiving insurance because their disability prevented them from working. New evaluations for eligibility led to widespread terminations. Of those who were terminated, about half appealed, and in two-thirds of the cases, administrative law judges reversed the decision. The process took nearly a year, during which time they, and their families, were deprived of promised help.

About 340,000 people would lose their insurance before public outcry and courts halted the process. Sen. John Heinz, a liberal Republican from Pennsylvania, told the New York Times the policy was a “meat grinder.” Sen. Carl Levin, Michigan Democrat, said the reviews caused “unconscionable suffering.” In June 1983 HHS Secretary Margaret Heckler announced she would halt suspending about 135,000 people until the government could improve standards for “functional psychotic disorders.”

By then, however, the nation was doubting the president’s kindness. A1982 Louis Harris survey found nearly three-quarters of the respondents said the president was hard-hearted toward the poor.

These are the facts. And they add up to a roll-back of opportunities for people already struggling with a psychiatric illness.  Whatever spin accompanies the birthday celebrations for Ronald Reagan, we should not create yet another mythic figure, larger than life, more pure than Ivory soap, or with qualities he did not have.  He may have portrayed himself as everybody’s lifeguard, but he seemed willing to let people with a psychiatric illness sink.

Originally appeared in MIWatch.org

Talking about mental illness in one’s family has always been difficult.  The issues surrounding mental illness continue to be emotional and sometimes controversial.  Is that why Governor Brewer has abondoned her once passionate advocacy for people with mental illness?

According to recent press releases, Brewer’s involvement in state politics started with her activism pushing better treatment and care for our state’s seriously mentally ill population.  Her son is diagnosed with a serious mental illness and has spent time in-patient at the Arizona State Mental Hospital.  As a Mom with a son who had a serious mental illness, I certainly can understand her motivation to try and make a difference.  Stigma continues to be pervasive and some still believe it’s the Mother’s fault when a mental illness presents itself.  Character flaws, laziness, and violent behavior automatically get labeled as mental illnesses when medical science knows that these illnesses are actual biological brain disorders that are treatable.  With proper medical treatment and support people have and do live in recovery.

Given all the positive news about the potential for recovery, why in the world has Govenor Brewer decided to not only distance herself from the issues, but supported drastic slashes to budgets that assist people with mental illness?  I understand that we need to cut our spending, but why cut spending for our state’s most vulnerable?  In the long run, as Gov. Brewer knows, we will end up spending more for emergency room visits, hospitalizations and incarcerations for ignored people living with a treatable mental illness.  With all the publicity and nation wide visability she has created over the last several months, it seems a shame to me that she hasn’t used the opportunity to advance anti-stigma and the value of  proper treatment to some of our states most vulnerable…….including her son.  Is the illegal immigraton bandwagon the only issue she can focus on now?

Capital Punishment 2007 stats

Lately there have been stories in the news about people that were given the death penalty(capital punishment) and executed only to find out later through  modern DNA testing that the wrong person was killed.  That in and of itself is enough to give pause before taking some one’s life for a crime, but what about when the person is seriously mentally ill and symptomatic when a crime is committed?

 Amnesty International believes that “The death penalty is the ultimate denial of human rights. It is the premeditated and cold-blooded killing of a human being by the state in the name of justice. It violates the right to life…It is the ultimate cruel, inhuman and degrading punishment. There can never be any justification for torture or for cruel treatment.”

At the National Alliance on Mental Illness (NAMI) annual convention in San Francisco last summer  families of murder victims  joined with families of persons with mental illness who have been executed to speak out against the death penalty.

Double Tragedies, a report released at the convention, calls the death penalty “inappropriate and unwarranted” for people with severe mental disorders and “a distraction from problems within the mental health system that contributed or even directly lead to tragic violence.”

The report calls for treatment and prevention, not execution. It is available online at www.nami.org/doubletragedies.

A  joint project of NAMI and Murder Victims’ Families for Human Rights (MVFHR), the report  is based on extensive interviews with 21 family members from 10 states, including  Texas which has the highest rate of capital punishment in the United States.

Most people with mental illness are not violent, many preferring to isolate and have little social contact. When violent tragedies occur it’s usually because the person has fallen through the cracks of a broken mental health care system.  Tragedies are compounded when all the families involved on all sides suffer.

Double Tragedies identifies an “intersection” of family concerns and makes four basic recommendations:

• Ban the death penalty for people with severe mental illnesses.
• Reform the mental health care system to focus on treatment.
• Recognize the needs of families of murder victims through rights to information and participation in criminal or mental health proceedings.
• Families of executed persons also should be recognized as victims and given the assistance due to any victims of traumatic loss.

Since 1976 when the Supreme Court  found capital punishment to be Constitutional, through June 3, 2009, 1,167 people have been executed in the U.S.

Hundreds of people with mental illness have been put to death in the United States and hundreds more are awaiting execution.