The House and Senate adjourned last week as members returned to their states and districts to campaign for re-election. Before leaving Washington, Congress passed a bill to fund the federal government at current levels through December 3. Lawmakers will return on November 15 for a lame duck session, which may address as many as 20 pieces of major legislation.
With the campaign season in full swing, this is an important time to find out where the candidates stand on critical issues affecting mental health. The new parity law and the enactment health care reform recognize how integral mental health is to overall health. But continued steps are needed to ensure their implementation and effectiveness. Budget shortfalls in the states are causing cuts in mental health services at the same time that demand for these supports are increasing. Every day, we read the tragic news about suicide rates in the military. Stigma and lack of effective services continue to prevent servicemen and women and veterans from receiving the help they need.
Use the questions we have provided below at town hall meetings, for call-in radio shows and other candidate appearances.
General:
Our state is facing incredible budget pressures due to the downturn in the economy. What will you do to protect services for individuals with mental illnesses?
The key federal health agency dedicated to behavioral health issues, SAMHSA, funds critical services, such as the mental health and substance use block grants, supports, prevention and promotion efforts. How can these resources be used more effectively in our state? What will you do to protect these essential resources?
Mental health is integral to overall health and wellness. The Centers for Disease Control and Prevention (CDC) have pointed to the influence of mental health conditions on the onset, progression, and outcome of other illnesses such as diabetes, heart disease, and cancer. How will you implement policies that overcome the barriers to fully integrating mental and general health care?
Untreated mental illness costs our economy more than $100 billion annually. More than 34,000 American lives are lost to suicide each year—more deaths than are attributed to traffic fatalities. People with serious mental illnesses are dying, on average, 25 years earlier than other Americans, from a range of manageable health problems like diabetes. At least two-thirds of youth in juvenile detention facilities have a mental health condition. What would you do to address these unacceptable realities?
Health Reform:
The Affordable Care Act will increase access for 32 million individuals, many of whom have mental health conditions, and prohibit harmful insurance company practices like discriminating based on pre-existing conditions and placing yearly and lifetime limits on treatment. In what ways will you work to implement health reform to increase access to insurance coverage and improve quality?
The health reform bill recognizes the importance of community-based prevention and wellness services. Many of the most effective behavioral health prevention programs are community based, including working with schools to engage them in practices that strengthen social and emotional development while fostering a positive learning environment and mental health literacy. What would you do promote prevention and wellness programs—in schools and the community?
Veterans:
Post-Traumatic Stress Disorder (PTSD) is a real illness and is especially prevalent among our soldiers returning from Iraq and Afghanistan. But it has been estimated that only about a quarter of veterans currently receive VA services. What would you do to help returning service members receive mental health services?
Last year, more service members died by suicide than in combat. And veterans make up about 20 percent of the more than 34,000 suicides each year. Yet, a recent report found that suicide prevention efforts aren’t effective because of mistrust among soldier of military mental health services. What steps have you taken—or will you take—to change that?
Parity:
The federal Mental Health Parity and Addiction Equity Act, which took effect in January of this year, bans employers and insurers from imposing stricter limits on coverage for mental health and substance use conditions than those set for other health problems. What would you say to a business that says it has to drop mental health from its policy because equalizing coverage is too costly?
Suicide:
There are nearly twice as many suicides (34,000) as there are homicides (18,000) in the US. What would you do to address this public health crisis? Would you support community and schools partnering to address this issue?
