Mental Health Parity January 24, 2011
Posted by alana in Activism, Economy, Health Care.4 comments
I just happened to come across a headline stating “Few Americans Aware of Law Broadening Access to Mental Health Treatment,” and I must confess that I was among the unaware. The article states that, “In a survey recently conducted by the American Psychological Association (APA), 87 percent of Americans said they had not heard of the Mental Health Parity and Addiction Equity Act of 2008, a federal law now in effect for people who have health insurance through a group or employer plan.” The focus is on raising awareness of mental health benefits, which I am all for! But I think what is missing from the “raising consciousness” perspective is an acknowledgment of what parity actually means. It’s not a synonym for equality in the way that we as socialists would use the word equality, meaning “available to everyone.” It is very clear what it actually means from the way it is described by The United States Department of Labor fact sheet for the 1996 Mental Health Parity Act, which preceded the 2008 Parity Law. In fine print at the top of the page, it says,
“The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays, deductibles) and treatment limitations (such as visit limits) applicable to mental health or substance use disorder (MH/SUD) benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical/surgical benefits.”
So, “equal” mental health care means health care that is “no more restrictive” than your regular medical health care. You’ll be forgiven for not bouncing up and down for joy at the thought if, like most Americans, “unrestrictive” or even “adequate” are not words you would use to describe your health coverage.
Right now health care reform is being leveraged as an election campaign issue, and it’s a debate that is framed in very narrow terms that are dictated by conservatives. As Democratic and Republican politicians essentially argue about what is best for the insurance business — requiring people to buy insurance, or keeping “big government” out of it and letting the free market decide who gets health care and for how much — the actual health care needs of ordinary Americans (and their mass support for at least a public option, if not universal health care) are completely marginalized. In this context, the Mental Health Parity Law requiring that mental health care be as accessible as medical health care does not come close to ensuring that people receive the care they need, even if they are aware of the law. (more…)
Toxic Politics vs Mental Health in Arizona January 17, 2011
Posted by alana in Health Care, Mental Illness, Violence.5 comments
A few people have suggested to me that I write about the Arizona shooter who took aim at US Rep Gabrielle Giffords and killed six people on January 8, perhaps as part of a discussion about alienation. The reason I haven’t wanted to do that is because, from a political perspective, I find it so frustrating and hypocritical for the mainstream media to discuss this case as a “mental health issue.”
There is no doubt in my my mind that the shooter, Jared Lee Lougher, is a sick man. And I would be the first to argue that putting more resources into mental health services would reduce crime substantially, both in terms of prevention and rehabilitation. And I wouldn’t argue with the recent spate of articles decrying the stigma against mental illness that prevents the mentally ill from seeking help, and pointing out that adequate mental help is not available to most people in this country anyway. All of those things are true. But in this case, the media rhetoric focusing on the Arizona shooting as an indictment of the mental health system in America serves a hypocritical purpose, and that is to shift the blame away from the unabashed incitements to violence coming from right-wing celebrities like Sarah Palin and Tea Party candidates like Jesse Kelly, who invited his constituents to come and shoot an automatic rifle with him while he was running against Giffords, saying “Help remove Gabrielle Giffords from office. Shoot a fully automatic M16 with Jesse Kelly.” In her insightful article about the politics of hate that created the context for this shooting, Nicole Colson writes: “The shooting in Arizona has demonstrated in the most shocking way how easily the hate-filled rhetoric of supposedly respectable politicians can spill over into violence. Whether it’s the wave of Islamophobia that leads to the stabbing of a New York City cab driver, or a political assault on immigrant rights that turns into actual anti-immigrant violence, or an anti-abortion climate in which doctors can be assassinated as they attend church services, none of these acts occur in a vacuum.” Focusing on Jared Lee Lougher as an individual with specific mental health issues is a way of pretending that this tragedy did happen in a vacuum, allowing the powerful people who build their careers on spreading hate to continue to incite violence without being held accountable. (more…)
The Logic of Suicide January 10, 2011
Posted by alana in Depression, Mental Illness, Suicide.4 comments
“It is no measure of health to be well adjusted to a profoundly sick society.”
- Jiddu Krishnamurti
I was struck with the idea and inspiration to start this blog when one of my closest friends posted this quote on facebook in early October. It encapsulates the deep contradictions inherent in life under capitalism, and it brought to light for me a deep concern that I had never quite consciously articulated to myself before. I realized that there are two ways to interpret that statement, and my great fear is that the radical leftists who want to see a better society – the most important people in the world to me – might experience suffering ill health as a form of protest. I don’t believe that the debilitating pain of depression, mania, anxiety, schizophrenia, or any other mental illness can be considered a form of resistance to adjusting oneself to this sick society. On the contrary, refusing to care for or prioritize one’s mental health is as counterproductive to changing society as refusing medical attention for a gunshot wound is to a soldier returning to battle (or going home alive). Anecdotally, my experience is that the people I know who show the greatest concern for others’ oppression around the world are also the least concerned about their own mental health. People have a right to be proud when they are able to function well enough to live their lives and devote themselves to causes they believe in while suffering significant disability – but I think we have to be careful not to hang on to misery and wear our suffering like a badge of honor or as a sign of refusal to accept all that is sick in the world. We can be healthy without adjusting our radical perspective, and we’ll be better equipped to fight for a better world if we aren’t swinging with one arm tied behind our backs, struggling within ourselves at the same time we struggle against our oppressors.
When I read the suicide note written by programmer Bill Zeller that was published online by his request when he took his life last week, it was his clear, lucid rationalism that broke my heart. Our society encourages and rewards the ability to be logical, detached, analytical, calculating, and unemotional, and Zeller accomplished this so perfectly that he became a PhD candidate at Princeton University, was a very successful programmer, and could isolate himself as a mere variable that should be eliminated for the greater good. In his letter, he points out that this ability to make coldly detached decisions about whether a person should live or die could as easily result in homicide as suicide – and by extension we can say that the same kind of emotional detachment is a requirement for waging war. Culturally, we are led to believe that emotions are chaotic and irrational, that this is bad, and that “bad behavior,” like suicide or murder is therefore irrational or insane. I think Bill Zeller’s well-composed letter explaining his rationalization for his suicide is one of the most poignant examples I’ve seen making the case that suicide is ultra-rational, and that rationality is not the ultimate good. (more…)
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schedule change January 6, 2011
Posted by alana in Uncategorized.add a comment
Happy New Year! And thanks for your patience while I was away for the winter break.
Due to a change in my schedule (work, school, ISO, and volunteering), The Struggle Inside will now be published weekly on Mondays instead of on Fridays. The first “real” post of the New Year will appear on Monday, January 10th.
Folks have not stopped sending me suggestions for topics that they want to see me address on this blog, which is so exciting for me, and I really appreciate it! Here are a few reader-suggested issues that you have to look forward to in the next few weeks:
The Agonizing Last Words of Programmer Bill Zeller
Pressures on teachers to cope with their own and their students’ mental health issues
The issue of “Gender Identity Disorder” being included in the DSM-V
The work of Canadian physician and socialist, Susan Rosenthal
Thank you all again for being engaged with this blog and for sharing your ideas — your participation is vital in making this evolve into a productive conversation instead of simply an archive of articles. I’m really looking forward to continuing with this together!
Alana
