Monday, September 30, 2013

Decisions have consequences....

We all know that. What we do in our personal lives can influence how we live the rest of our lives. Truly.  This is also true for public policy decisions.  Because mental illness and the problems connected to it have had such a huge impact on the public consciousness in recent years, I consider it of some importance to examine that.  Obviously, it is clear that mental illness has impacted our lives in recent years.  If you look around you, the topic has had influence on every national story that we are examining today.  That includes homelessness, crime, the costs of incarceration, and violence. It also winds its way through the healthcare debate.  The outcome of the Affordable Healthcare Act debate will heavily influence access to services for the mentally ill. The numbers of the mentally ill have been documented.  And the problem is a large one.  If we can honestly say that one in four in this country struggle with some level of mental illness, it is something that impacts all of us in one way or the other.

What is my point?  I have been doing some reading in recent days.  And many people believe that the severity of the recent problems with mental illness lie in the policies of  President Ronald Reagan.  It appears that in his zeal to cut costs and decrease the size of government, one of the key areas that he cut was in mental health services and support systems.  I will leave it to you to read the specifics of how that was done.  The articles were very interesting and provide a clear window into the results of policies pursued by President Reagan.  You may find this discussion partisan.  I don't.  The consequences of policies play out many years after the President leaves office.  And discussing the consequences of President Reagan's policies is as legitimate an exercise as any other policy discussion would be.  Here is one of the articles:  http://bit.ly/WCv1qO.  Here is another: http://bit.ly/18BgjYw

If you look at these articles, there are clear lessons to be learned.  The first is that we have to have a clear understanding of the issues involved in policy decisions.  That includes an understanding of mental illness and the consequences if we don't come up with a cohesive and informed policy.  If we don't, we will be dealing with the fallout.  The second one is that it appears to me if we don't spend money in one area, we end up spending money in another area.  In addition, we are faced with other consequences that we might not expect, including the large population of the mentally ill currently housed in our prisons. The other might be the connection between homelessness and mental illness.  President Reagan didn't solve problems with his cuts to the system to deal with mental illness.  He created increasingly serious problems that have influenced everything from services available to the mentally ill to the incidences of violence committed by the untreated mentally ill.

Now, of course, the problems won't be solved by simply throwing money at them.  But in order to deal with these issues, we have to start asking the hard questions.  For example, why did the shooter at Navy Yard go to a VA facility without being identified and treated as mentally ill?  Why did he have a security clearance that allowed him access to Navy Yard in spite of considerable evidence that he had a violent history?  Why don't we have a cohesive system that responds to mental health problems before they become the deaths of  12 human beings at the Navy Yard?  Or 26 children and adults at Newtown?  The questions are important.  They heavily influence what occurs today.  And they will impact our future.  Will it be one in which we humanely deal with the issues surrounding mental illness?  Or will it be a situation in which we act like there is no problem to be solved and ignore the fallout? What do you think?

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