Mental Health Reform 

In the 1970s and 80s a movement aimed at emancipating the mentally ill from asylums swept the nation. This movement formed a coalition of families of the mentally ill and fiscal conservatives.

While emancipating individuals from asylums was certainly a humane reform there was the dark side of the movement. That was fiscal conservatives' complete disregard for creating an alternative system of treatment for those with mental illness—regardless of the severity of their condition.

As someone clinically diagnosed with severe depression and someone who has suffered employment discrimination as a result of my depression, I have experienced the many layers of misinformation and prejudice attached to the issue of mental health.

The following are some ideas about reforming everything from the way we think about mental health to how we can create stronger public policies to ensure those afflicted with mental health issues are both protected by law and have the opportunity to live vibrant lives.  

The term mental health or illness is perhaps the most misunderstood phrase in our society—that's true in both in thought and practice. The following are some ways we can all change how society treats people with mental health disorders by reexamining the many myths and misconceptions about mental illness. 

Mental health disorders are actual medical conditions just like diabetes and heart disease. According to a survey by the National Mental Health Association (NMHA), almost one in three Americans say they believe depression is a “state of mind.” Behaviors resulting from mental illness can’t be controlled at will. “You’d never hear 31 percent of the population deny that diabetes and heart disease are real,” notes Michael Faenza, president and CEO of NMHA. 

MENTAL HEALTH ISsues are rare, they will never affect me. 

In truth, nearly 1 out of every 5 Americans will have a diagnosable mental disorder within their lifetimes, according to the National Institute of Mental Health.

Mental health is a REAL condition, people do NOT fake mental illness. 

Mental health disorders are actual medical conditions juts like diabetes and heart disease. According to a survey by the National Mental Health Association, almost one in three Americans say they believe depression is a “state of mind.” Behaviors resulting from mental illness can’t be controlled at will. “You’d never hear 31 percent of the population deny that diabetes and heart disease are real,” notes Michael Faenza, president and CEO of NMHA. 

MENTAL HEALTH IS a not permanent condition.

Mental health covers a broad variety of disorders from chronic depression to bipolar disorder. While the severity of these disorder varies greatly ALL mental health related issues are can be treated as long as they are properly diagnosed. That means people with mental health issue CAN return to full vibrancy and health. 

people with mental health issues are NOT "crazy" nor prone to violent behavior. 

The vast majority of people with mental health problems are no more likely to be violent than anyone else. Only 3%-5% of violent acts can be attributed to individuals living with a serious mental illness. In fact, people with severe mental illnesses are over 10 times more likely to be victims of violent crime than the general population.

mental illness is an adult problem and young people are simply being persnickety. 

Even very young children may show early warning signs of mental health concerns. These mental health problems are often clinically diagnosable, and can be a product of the interaction of biological, psychological, and social factors.

Half of all mental health disorders show first signs before a person turns 14 years old, and three quarters of mental health disorders begin before age 24.

Unfortunately, less than 20% of children and adolescents with diagnosable mental health problems receive the treatment they need. Early mental health support can help a child before problems interfere with other developmental needs.

Starting with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 and carrying over to the Affordable Care Act (ACA) the Federal government has increased the range of mental health coverage significantly.   

The ACA offers these progressive benefits:

• Health insurers will have to sell and renew policies to all who apply (called “guaranteed issue and renewal”).
• Insurers cannot deny coverage for a pre-existing condition.
• No health plan can have a lifetime or annual limit on certain benefits.
• Insurers cannot charge people with poor health more than others — premiums (the amount a person pays to have insurance) may only vary by a limited amount and only on the basis of a few factors (tobacco use, age, geographic area and family size).
• Health insurers cannot discriminate based on a person’s mental or physical disability.
• Young adults (up to age 26) must be allowed to remain on their parents’ health insurance, if their parents so desire.

All of these reforms are good news for the mental health community. Still, according to the National Alliance for Mental Illness (NAMI) more than 11 million (24 percent) of US adults affected by mental illness have no health coverage. This is a big problem in a key age group because uninsured adults are more than twice as likely to delay or skip medical care, leading to serious health issues and problems on the job. The younger the individual the more likely they are to avoid getting help. This is largely because younger people have fewer basic health problems and therefore less likely to seek help for any ailment and they are often too immature to understand the gravity of their condition. 

In truth, the only way we can assure universal coverage on mental health issues is to push for legislation that assures affordable single payer coverage for health care ailments. This insurance would cover costs for:

• Primary Care Physician or Referring Physician
• Specialists including psychiatrist, psychologist and group therapy
• Income-based drug rehabilitation services   

The union movement in the United States has a lot to learn from the forward looking polices of our union brothers and sisters in Canada. Canadian unions are on the forefront of progressive mental health policies much in the same way as they were pioneers on workplace bullying and sexual harassment for employers as well as union management practices.

The following are a sensible set of guidelines that should be applicable in both law and practice: 

• Consider the mental well-being of employees and identify hazards.
• Assess workplace hazards such as stressors from job demands. 
• Strive for work/life balance.
• Help workers feel they are treated with fairness, respect and rewarded for their contributions.

This is a framework that addresses prevention, promotion and implementation. It can be enforced through yearly audits conducted by a specialist that can be mutually agreed to by management and union officials.