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…)
Worse Before It Gets Better December 17, 2010
Posted by alana in Depression, Economy, Marxism.2 comments
Over the last decade that I’ve been an activist, I’ve often heard repeated variations on the adage, “Things have to get worse before they get better.” The worse things get, the more frustrated I am whenever I hear this cynical and backward projection. Here’s my explanation for why I think that it’s wrong.
The most common expressions of the logic that “it has to get worse before it gets better” that I’ve heard are related to war and the economy. In the absence of an antiwar movement, people form the opinion that nobody is motivated to challenge the U.S.’s imperialist ventures because they aren’t personally affected, and there will be no resistance until there’s a draft. In the absence of fighting labor unions that actually represent the interests of workers rather than acting as mediators on behalf of management, people get the impression that working people are still too “comfortable” in their relative prosperity compared to the rest of the world and that greater economic hardship will be necessary to push them into action. In general, it is progressive liberals who hold this notion that most people are too complacent to agitate for real change – mainly because they buy into the mainstream ideology that “we are all middle class,” even if it’s on an unconscious level and they outwardly acknowledge that the middle class is disappearing. I think radicals can sometimes be subject to these same mistaken impressions, especially in academic environments where post-colonial theorists emphasize the ways in which all Americans benefit from exploitation of poorer nations. I would never seek to minimize or dismiss the plight of the so-called “Third World,” but comparing relative miseries and calling one of them a position of privilege because it is comparatively less miserable only allows the truly privileged ruling economic class off the hook and divides those of us who are exploited by them in different ways, but who share a common interest in ending exploitation. 
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The Season To Be Jolly? December 10, 2010
Posted by alana in Anxiety, Coping Strategies, Depression, Economy.4 comments
This is not a rant about how Christmas has become a commercialized orgy of spending that directly contradicts the spirit of peace and giving that is supposed to imbue the holiday season. Whether they frame it in socioeconomic terms, or as a tension between the secular and religious, most people are at least somewhat aware of these clashing ideologies. I expect readers of this blog have an even more acute political awareness of the class dynamics involved, recognizing that pressure on the working class to “fully enjoy” one of their few significant breaks from daily drudgery means spending as much as they can afford (and more) on decorations, gifts, and feasting, thereby increasing the profits of the elite minority who flaunt their wealth, accept tax cuts, and cut thousands of jobs. It’s nothing new this year, but given the unemployment rate and austerity measures making life even more disproportionately difficult for workers in the worst economy since the Great Depression, the notion of a “season of giving” is severely strained. The immediate economic and social pressures of holiday celebration are stressful enough, but for radicals who are conscious of the broader implications, additional layers of alienation and disillusionment can weigh heavily on us.
Instead of running down statistics on how bad things really are right now, or going through a cultural and historical critique of winter holidays from their pagan roots to today, I’m going to try something a little different. I want to discuss some concrete ways of coping emotionally with these holiday pressures and contradictions. This is something a bit more personal, drawing from my experiences with therapy, but is still very much informed by my politics. I’ve been getting feedback and suggestions from readers, which I deeply appreciate and I do take to heart (even if it does take me a while to process what you’re saying and find a way to address it), and this is an attempt to respond. Please don’t hesitate to let me know if this kind of post is helpful and whether you want to see more like it sometimes; or whether you would rather have seen a more explicitly political, economic, social, or historical analysis along the lines of previous posts. You have my sincere thanks!
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It is widely acknowledged in the mainstream that the holiday season induces extreme anxiety and depression in many people, and a quick search online will bring up plenty of ‘tips’ on how to deal with holiday stress – but they have always rung rather hollow to me. Leaving aside those that want to sell you stress-reducing products and focusing on those that are more earnest, even these lists can leave you feeling pretty hopeless.
Commercials at this time of year are always reminding you how little time there is left to do your shopping, as though all you have to be concerned about spending is your TIME. Many of these coping tips have to do with time management – for example, saying ‘no’ to some of those party invitations to leave more time for yourself. If you’re unemployed or underemployed, these commercials are laughable because you have more “free” time than you’d like, but you certainly won’t be spending it on shopping with no money to spend. Even if you’re working 40-60+ hours per week, there’s no guarantee that you have money for gifts when so many people are supporting families on low-wage jobs and are burdened with medical bills that aren’t covered by insurance, the fallout from the mortgage crisis, or astronomical student loan payments. Tips on coping with financial difficulty are stated simply: “Don’t spend more than you can afford to.” Meanwhile, the vast resources of capitalist culture are bombarding you with exactly the opposite message, and if you fail to join in the gift-giving and merry-making, you’ll be seen as someone who is stingy and isolating yourself as a killjoy scrooge. (more…)
Great Recession Depression November 19, 2010
Posted by alana in Depression, Economy, Mental Illness, Racism, Suicide.5 comments
Yesterday the Substance Abuse and Mental Health Services Administration (SAMHSA) released the results of a study showing that 19.9 percent of American adults — 45.1 million people — suffered from mental illness last year. 11 million of them had a diagnosable mental disorder that substantially interfered with their daily life, 8.4 million had thoughts of suicide, 2.2 million made suicide plans, and 1 million attempted suicide.
These appalling numbers clearly correlate to a miserable economy, which is no surprise given the peak number of suicides during the Great Depression of the 1930s. But if our image is one of old white fat cats jumping from their office buildings following the stock market crash of 1929, it is only because those deaths were the most publicized. A New York Magazine article last year, Are Wall Street Suicide Epidemics Real?, stated that “Bankers don’t appear to be any more prone to preexisting psychiatric problems than other groups… The rise and fall of the Dow isn’t the key factor here; the health of the overall economy is.” While it is true that most recorded suicides from The Depression era were of older white males, the picture today is very different, although still tied to the economy. With Wall Street getting bailed out by the Federal Government, it is the unemployed poor of this country who make up the overwhelming number of casualties in the current class war.
As the SAMHSA press release states:
“The survey provides other insights into the nature and scope of mental illness, including information on those segments of the population who may be at greater risk of experiencing mental illness. For example, the survey shows that mental illness is more likely among adults who were unemployed than among adults who were employed full time (27.7 percent versus 17.1 percent).
There is a marked difference in the percentages with mental illness between men and women as well, with 23.8 percent of women experiencing some form of mental illness, as opposed to 15.6 percent of men. In terms of age, young adults (ages 18 to 25) had the highest level of mental illness (30 percent), while those aged 50 and older had the lowest (13.7 percent).”
The press release doesn’t mention race, but the statistics given in the report show that among adults over 18, 15.5 percent of Asians, 16.7 percent of Native Hawaiian/Pacific Islanders, 17.8 percent of Hispanics, 17.9 percent of African Americans, 20.7 percent of whites, 21.6 percent of American Indian or Alaska Natives, and 32.7 percent of those reporting two or more races suffered from any kind of mental illness last year. This might lead one to assume that depression is still a “white” problem, but these percentages include a variety of mental disturbances, not just depression. The numbers reported for serious thoughts of suicide show the rate as being almost the same between Hispanics, (3.3 percent), African Americans (3.5 percent), and whites (3.9 percent). (more…)
