Several of Hillary Clinton’s campaign workers were held hostage yesterday at her headquarters in Rochester, New Hampshire, and Ronald Reagan bears at least part of the blame. Richard Kim explains at The Nation – Reagan started to dismantle state-funded mental health care without creating an alternate system, and subsequent administrations have only made the problem worse.
State-funded mental health care wasn’t all that great in many respects, and advocates for the mentally ill supported reform of the large state-run psychiatric hospitals. Reform meant that inpatient institutions, many of which had become abusive warehouses for people the state saw as defective, would be replaced by community-based mental health centers who could provide appropriate, personalized care for those suffering from mental illness while the patients lived at home, with the support of their families. The advent of effective anti-psychotic drugs made that possible – but that’s not what happened.
What happened is that funding for mental health at every level, public and private, has been consistently reduced over the last 25 years. No insurance, public or private, covers psychiatric meds or talk therapy at the same level that it covers physical illness. I’m not saying meds are the solution to everything – far from it – but people with insurance can access medications far more easily than they can talk therapy. For most emotional illnesses (save schizophrenia), talk therapy is just as effective as meds, but it’s far more expensive and insurances just don’t pay for it.
In my area, psychiatrists don’t do therapy any more unless the patient is paying privately. Privately insured patients can see a therapist (one on their insurance’s panel who is taking new patients) for a limited number of visits with a much higher copay than the one charged for a visit with me. They can more easily access medications, but it can take three or four months to get an appointment with a psychiatrist (one on their insurance’s panel who is taking new patients). And all this is assuming they can acknowledge that psychiatric care and/or therapy might be helpful to them. People with no insurance, or with public insurance like Medicaid, have far fewer choices. And if you have public insurance and don’t speak English? The next available appointment with a Spanish-speaking therapist in my community is usually six months away. If you speak Arabic, or Farsi, or Portuguese, or French? Forget it.
I can’t imagine what yesterday afternoon must have been like for the people in the building, their families, the family of the Leeland Eisenberg, or the police who had to manage the situation. I imagine that they might have nightmares, anxiety, flashbacks and other symptoms. I hope they have better access to mental health care than Mr. Eisenberg did, but thanks to Ronald Reagan I bet they don’t.
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