Talking about Mental Health…And America

Greetings and Salutations;

As I have touched on a number of times on this blog, mental health issues are a serious problem that Americans deal with about as well as they deal with nudity and death..Not well at all. I think that this is a situation that must change if we are to avoid falling into the pitfalls of society, such as the cesspool of madness we are trying to swim out of now. Just a warning…this is a complicated issue, so this is a fairly lengthy essay!

It seems to me that mental health is one of those subjects that is the Elephant in the living room, that no one wants to talk about. This has been true throughout most of my life, and, when I look back into American History, I see more avoidance, and misunderstanding about the topic, that almost always turns out poorly for the person with the issues. Look, for example, at how, for most of America’s history, the attitudes towards mental health issues punished those having challenges. My parents grew up in the early part of the 1900s, so, their life was a challenge… In no particular order, they had to deal with the Great Depression of the 1920s and 1930s, which must have made them believe the entire world was crashing down, and there was no saving it. They had to deal with the Civil Rights Movement where the people of color really started actively pushing to gain the equality they started getting in the 1800s. Part of this Civil Rights movement was the growth of women being acknowledged as equal humans too, perhaps best marked by the 19th Amendment to the Constitution, passed in 1919 and ratified in 1920, that enshrined the woman’s right to vote. They had to deal with the technological changes of the world…going from Steam engines for trains, and horse-drawn buggies, to Atomic Energy, Computers, internal combustion engines, and the automobiles that used them. They were on the slide of American society going from a mainly agrarian society, to a more industrialized model that persists today. Their world was turned upside down by two World Wars that not only caused a huge jump in technological progress, but, brought more fear and uncertainty and a direct connection with death to every family in the country.

How did Americans, in general, react to this? They suppressed the fears, anxieties, nervousness and uncertainty that these radical changes brought, and pretended that everything was “OK!” I was born in 1955, and the lessons I was taught as an infant, were “big boys don’t cry”, “Suck it up and be a man”, “Never reveal your emotions. Emotions are a weakness, and weakness will be used against you”, “Buckle down and do what you need to do”, “Do NOT expect help from anyone else. Do it yourself!”. These, and similar rules for living were deeply ingrained in my mind, as they were very early programming. Even today, 65 years later, I have not fully managed to get away from them controlling my reactions to reality. That having been said, I am also moved to point out that these are not necessarily the worst rules to live by. Self-sufficiency is a good thing, for example. Being able to set aside an emotion reaction and deal with a bad situation is a good thing. After all, doctors and nurses do it EVERY day as they care for us when we are having the worst day of our lives. The problem I see, though, is that these rules must be applied in moderation, not taken as the absolute ONLY way to deal with reality. In my case, the self-sufficiency rule was continually repeated and emphasized to me by my father. This ended up with me being a tad extreme in my dealings with other folks. For years, I was never able to ask for help, and often would refuse it if offered. Yet, I would also go out of my way to help other folks with tasks they were having difficulties with. Today, I have improved, I think, at least a little. I still go out of my way to help others, but, I recognize, to some level, that I cannot do it all alone, and am less reluctant to ask for help. I also have gotten it through my head that other people derive the sort of pleasure I do when I can help ease another persons life by helping them deal with issues.

Well…now…back to the original topic…

Through out my life, I have been dismayed by the way that Americans in general put a stigma on “mental health”. Anyone with “mental health issues”, no matter what they are, is looked upon as a broken person, who should be viewed with suspicion and not trusted. Because of this, people fear to seek out help when they are having issues. This avoidance reaction ranges from a firmly held belief that they do not need therapy, because they are not “crazy”, to fear that someone will find out, and it will weaken them at work or in their community, to fear that if they seek out mental health help, the doctors will have them picked up at their office, and they will be swept away to an asylum somewhere, or put in a locked ward…a virtual prisoner. Even in those cases where (reluctantly) a person is convinced to seek out help, they will do things like travel to a nearby city, that is off the beaten track for them, so they will not run a chance of meeting someone they know on the street, and have to explain why they are coming out of a therapist’s office.

We have 200+ years of America ignoring the elephant in the living room, and stigmatizing folks for seeking mental health help, in spite of the reality that this course of action does NO good for anyone. Ignoring a problem is like leaving a package of chicken breasts out on the counter for a few weeks, and pretending one does not smell rotting meat. The only way to deal with the problem and help folks get their mojo back is to accept their reality, in a non-judgmental fashion, and, do what one can, when asked, to help them deal with it.

I do, of course, realize that “mental health issues” is such a broad collection of issues that there is no “one size fits all” answer. The solution that a person who is suffering from mild depression due to the immediate stresses of life is different from that needed by a person who has struggled with clinical depression their entire life which is different from the solution needed for a person with schizophrenia, and so on. As I touched on before, though, the stigma Americans place on these issues is almost the same…

Back in Reagan’s day, there was a real push by the Republicans to close mental health care facilities, and, he did a lot to defund and force the closings of these institutions. The attitude was pretty much the reactionary attitudes I have spoken of earlier, to “it is not the Government’s job to take care of these people…it is the church’s/private corporations that should be doing it”. This was, to put it mildly, misguided. Part of the design of our society by the Founding Fathers was that the government should be responsible for “the common good”. I, and many others, interpret this to mean that part of the government’s job is to take the responsibility of providing care and help for the least fortunate in our society. America was not set up to be an Oligarchy, or an Aristocracy. Its design goal was to be an egalitarian society, where all people have equal respect, and there IS no “Royal Class”. Hence, the idea of the government being responsible for helping the downtrodden and challenged. It is certainly an admirable goal to have churches shouldering that burden, as that IS sort of the message of Christ. However, from a realistic point of view, it is a pipe dream. The mega churches who might be able to do serious good there are so far away from being the good citizens that Christ calls them to be, it is like getting AT&T to drop money into the bucket. They have turned into “for profit” enterprises that benefit the leaders…and there is little taste to change that. The smaller churches sometimes can do a bit, but they are economically limited, so rarely can help more than one family at a time. Some of the mid-range churches can help more people, but, they too, have limits on funding, and the larger they get, the more focused on buildings and making more money come in they seem to get.

I have spent quite a few words pointing out the failures in the system today…so let me move on to discuss some changes I think would improve the situation a lot.

  1. We must change our focus back to providing adequate funding for mental health care in America. I would like to see a massive increase in support from the Government (from Federal all the way down to local), providing both high quality facilities for providing whatever level of care is needed, AND increasing the number of professionals, well educated in the field, to meet the demand.
  2. As part of this funding change, we must make access to quality mental health care affordable and accessible. The former can be a problem today, because many insurance programs still do not cover the cost of mental health care. Few of us can afford the $75 and up per hour that a good therapist charges..so, there is a huge roadblock there. Far too often, the insurance that covers such aid is limited to the number of visits allowed, which can be a serious problem. As for the accessible part…over and above the cost issue, there is the simple fact that it can be a challenge to find a qualified, mental health care professional that one can build a relationship with. There are far too few out there, and so they tend to be a little overwhelmed by the demand.
  3. The most difficult step I see is removing the stigma of admitting to mental health issues. One of the very good aspects of the radical social changes of the 1960s and 1970s is that people are far more open to admitting when they are having challenges, over the past 20-30 years I have seen a disappointing backsliding in the area. The old programming of swallowing our emotions, anger, etc, and not admitting to them is coming back. I believe that this is one of the factors that is twisting society into the extremist, intolerant and prone to violence state it is in now. We tend to forget that changes like this – involving some of the most basic and oldest programming we are given – are not a sprint. They are a marathon. It can take a lifetime of work to change one person’s view of reality, so, by extension, it will take lifetimes of work to change enough of society that a new “normal” takes charge. However, while the journey is long, and challenging, we must all work to complete it…single step by single step.
  4. I hope that in the near time-frame, parents will understand the need for removing the stigma, and even if they are uncomfortable with it, will work to teach their children to not add that to their prejudices.

I know that there are objections to these changes, some of which are valid, and some of which, in my opinion, are not. For example let us look at funding, both for trained personnel and affordable access. I have heard people say “this will cost $Billions! We cannot afford it!”. I have a couple of things to point out here. The current administration gave the richest members of society a tax cut a few years ago that was a $TRILLION windfall for them…that, is $1000 BILLION. Were these folks on the verge of bankruptcy and nearly destitute? Far from it! The tax cut was supposed to be used to allow these “job makers” to increase benefits and salary for their workers. What happened in real life? Damn little for the workers. All but a pittance of the money was used to invest in the stock market, in order to make them richer. This leads to the obvious conclusion that rescinding that tax cut would provide much funding needed by the government to take care of all citizens, and would not materially hurt the ultra-rich that benefited from it. At least in my world, either not being able to buy a second yacht, or, having to buy one that is only 150 feet long, instead of 200 feet, is not exactly “hurt”.

I would like to see the Federal Government actually move to a single payer healthcare system. People object to this, because they say “my taxes will go up!” However, they ignore the reality that the taxes that go up will end up being much smaller than the healthcare premiums they are paying now (for a net gain in money in their pocket). This change would also eliminate or cut drastically, other expenses, such as co-pays, prescription costs and the like. The Republicans (mainly) scream bloody murder over this for a variety of reasons ranging from their delusions that they are fiscal conservatives, to wanting to cut the overreach of government, to their false belief that lower taxes are a huge benefit for all. I often ask people who are standing against this idea “Why, if it is so difficult to have a successful single payer healthcare system, have only 33 of the 34 heavily industrialized countries in the world managed to make a great success of it??” I NEVER get a civil answer to this.

In the long run, I would like to see serious reform of the tax codes in America. Right now, they are massively swayed to support the very rich. There are thousands if not millions, of loopholes that are inaccessible to most citizens, but ensure that the very rich pay NO taxes. For example, there is a provision in the tax code that allows Real Estate developers to use business losses to offset personal income. This allowed Real Estate Developers, such as #3, to avoid personal income taxes for decades while they raked in the cash. It allows landlords, making millions off rental properties, to use any rental losses to offset income… I am not a tax expert by any means, but, it seems to me that claiming the protections of a corporation, which these folks do, and then being able to deduct corporate losses from personal income is, to put it mildly, a bit sketchy.

I am not in any way, shape or form an advocate of a flat tax, or a VAT, specifically because such a scheme hurts the less well off far more than the very rich. I would like to see a progressive tax system that ensures that the very rich pay a fair share of the dues to be American. I sometimes get blow-back about those words “Fair share” I am reminded that the upper 10% or so pay 90% of the taxes collected (or some number like that). I argue that the persons making this claim are looking at the wrong numbers. I advocate that we ignore the amount paid, and focus on the percentage of income only. As I have said elsewhere, a 70% tax on a person making $5 million a year has far less impact than a 70% tax on a person making $40,000 a year.

I will not get into corporate taxes or hiding income over seas just now, but, that is part of the reforms that have to happen. Before Reagan, the maximum tax rate was 70%. In a couple of rounds, he cut the throat of America’s budget by reducing that maximum to 28%. The income tax was implemented in 1861, and over the years, gradually grew as the Federal Government, and the tasks it took on grew. Here is a good history of the path. During the 1920s, when the income tax really grew, the wealth disparity between the richest and poorest in America was fairly huge. Over the years, it did drop to a far more reasonable level, but, in the past few decades has started a precipitous rise again. Here is an excellent analysis of how the wealth disparity has changed since 1900, and where it is going. At one time, it was around 50 to 1. Now it is upwards of 500 to 1. Now, if the tax rates were returned to pre-Reagan levels, and some blatant loopholes removed, it would make a huge difference in the American economy. not only would it address the issue of the overwhelming deficit, but, it would provide funding for many projects that would restore the strength of the middle class. This, by the by, is important, because in the 1940s and 1950s, when the Middle Class was strongest, America saw the most growth and progressive steps taken in its history.

Another step that we, as a society must take is to elect representatives that promote these views, and will work to implement them. This eliminates the Republican party these days, and for some unknown time into the future. The Democratic party platform does push these ideals…but, as a part of this change, we, citizens, must be proactive. We have GOT to not only vote in every election, from local on up to Federal, but, keep an eye on what the people we elect are doing. We should take time to give them feedback, both positive or negative, depending on their actions. If we do not do this, they will trot along their merry way, doing whatever they want, with the unquestioned assumption that everyone agrees with them. There are many tools out there to find how to contact elected officials. I tend to use the “Contact Me” page that every member of Congress has. A Google search for “contact congressman <state name>” will pop up the link immediately. Use Email, write post cards, call them…just be polite, calm, deal with one issue at a time, and move on.

I also call, once again, for the money that lobbyists can pour into the pockets of Representatives to be either limited, or publicly visible and audited. There is way too much bribery going on in the Federal, State and Local governments to ensure that a majority of citizens, instead of the privileged few, will benefit.

I am sure there are folks out there who are far more qualified than I to discuss why it is that Americans deal so poorly with mental health issues. If any of y’all run across this essay and care to comment on it, I welcome your input!

Stay safe.

God Help Us ALL

Bee Man Dave

This entry was posted in Advances in Healthcare, Ethics, Heath, Humanity, Nuttiness, Observations, Politics, Questionable decisions, Ruminations and tagged , , , , . Bookmark the permalink.

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