Sequestration Update: Feeling the Pain

Care for Your Mind Update


capitol3Two months ago, we shifted from discussing the importance of access and barriers to access to examining how a specific governmental policy, sequestration, was impacting the delivery of mental health services across the country. Even then, we could already point to examples of sequestration’s impact: the closing of a residential treatment center in Alaska, the reduced availability of civilian mental health professionals to military personnel, and the increased wait to receive residential treatment in Utah—not to mention the potentially devastating long-term impact of spending cuts on research, both in terms of treating people during clinical studies and finding effective treatments to mental health conditions.

It is unsettling, though perhaps not surprising, that the most-reported impacts of sequestration have been airport travel delays and the cancellation of air shows at Military bases for the July 4 celebrations. Because these cause discomfort for the general population, they are easy topics for media coverage. However, this does not appropriately reflect the level of real suffering happening as a result of sequestration across the country. This under representation of suffering is probably due to the fact that the populations arguably suffering the most severe consequences from sequestration are in fact underrepresented in general—the poor, people in the military, and minorities (an ironic realization as we reach the end of National Minority Mental Health Awareness Month, which draws attention to the need for mental health awareness, better utilization of services, and the development of culturally competent care for the nation’s racial and ethnic minorities).

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To Market, to Market: The Health Insurance Marketplace and You

As of the date of this post, there are 75 days until open enrollment begins on the Health Insurance Marketplace.

With the implementation of the ACA, the Health Insurance Marketplace will be your destination for figuring out how to get the best health care coverage you can within your budget.

Under the Affordable Care Act (ACA), Americans are assured access to health coverage, whether through insurance provided by your (or your spouse’s) employer, a government-administered program, or an exchange (the marketplace).

A Personalized Shopping Cart

The Health Insurance Marketplace provides personalized information about your options for health coverage and provides the mechanism to enroll. You’ll learn whether you can reduce the costs of your monthly premiums from your current coverage through private insurance plans and if you can lower your out-of-pocket costs.

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What’s standing in the way of mental health recovery?

Paolo del Vecchio, M.S.W.
Director, Center for Mental Health Services
Substance Abuse and Mental Health Services Administration (SAMHSA)

Yesterday, Paolo del Vecchio told his personal recovery story and shared a set of elements that help define recovery. Today, he puts recovery into perspective with health reform.

Opportunities for Recovery under the ACAdelvecchio

To recover, individuals need access to quality, affordable health care and mental health services. The Affordable Care Act (ACA) expands mental health and substance use disorder benefits and parity protections to an estimated 62 million Americans and heralds a new era of hope for people with mental illnesses.

Beginning January 1, 2014, millions of uninsured Americans with mental health and substance use conditions will have access to health insurance coverage, many for the first time. In addition, thanks to the new health care law, beginning in 2014, insurers will no longer be able to deny anyone coverage because of a pre-existing mental health condition. Individuals will be able to sign up and enroll for insurance beginning in October of this year. People should go to www.healthcare.gov to find info on how to enroll.

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Defining Recovery: From Mental Health Consumer to Policymaker

Paolo del Vecchio, M.S.W.
Director, Center for Mental Health Services
Substance Abuse and Mental Health Services Administration (SAMHSA)

delvecchioWe recover in community. In community, we share stories and spread hope. And in community, we raise our voices so all may have the opportunity for recovery.

For more than 40 years, I have been involved in behavioral health as a consumer, family member, provider, advocate, and now policymaker.

The thread throughout my journey has been opportunity and hope. Over the years, I’ve learned that it is community that provides opportunity, and it is in community that we find hope.

I am pleased to participate in this forum to share stories of recovery and spread the message that recovery is not only possible, it is the expected outcome of services, supports, and treatment. Together, through our shared experiences and with our collective voice, we can change the conversation on mental health and increase awareness of the possibility of recovery.

My Recovery Story

My own story is deeply rooted in the healing power of community. I experienced mental illness early in my childhood.

As a child, I experienced trauma by witnessing domestic violence and alcoholism in the family. As a result, I became withdrawn, depressed and anxious. And, I was alone.

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How Can We Improve Mental Health Coverage in the Media?

Rebecca Palpant Shimkets, M.S.
Assistant Director, The Rosalynn Carter Fellowships for Mental Health Journalism, Mental Health Program at The Carter Center

This is, we anticipate, the first of several occasional contributions from The Carter Center relating to its efforts to improve mental health reporting. The American public and the media influence how decision-makers develop, implement, evaluate, and revise policy. Because of the tremendous impact the media has on public opinion and, ultimately, on policymaking, journalists and other media participants must be comfortable with mental health conditions and the people these conditions affect. We encourage you to share your experiences, thoughts, and opinions to help The Carter Center understand and address the good, the bad, and the ugly in the portrayal of and reporting about mental illness in the media. –CFYM

Though nearly one in four adults in the United States experiences a mental illness each year, mental health issues are often covered in the media through the lens of national tragedies or sensationalist news stories.The Carter Center_D. Hakes

Unbalanced or shock-value news stories only serve to perpetuate harmful stigma and discrimination against so many valuable members of our communities. Whether a next door neighbor, a teammate in a pickup basketball game at the gym, or a fellow church member, all of us know someone who has a mental illness. But too often, the majority of our friends, family members, or co-workers avoid effective treatment out of fear that they will be stigmatized or discriminated against because of their medical conditions.

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Beyond the ACA, Part Two: Change the Culture of Care

Ron Manderscheid, Ph.D.
Executive Director, National Association of County Behavioral Health and Developmental Disabilities Directors

Ron ManderscheidPreviously on Care for Your Mind, I asked: “If you or a family member needed care today for a mental health or substance use condition, would you be able to get it?” We’ve explored obstacles that stand in the way of accessing mental health care, and we explored how the Affordable Care Act improves access and quality for people with conditions like depression and other mood disorders.

In yesterday’s post, we explored three ways to change the structure of community-based mental health care. Today, we look at how we can change the processes and attitudes through which community-based mental health care is delivered.

Changing the Culture of Care

Improving access to behavioral health care isn’t only about making changes in how care is structured. It’s also a matter of the content and quality of the care.

Professionals should be able to identify people who need care early. Consumers should be engaged in their care. And consumers need to know that the care they seek is going to be effective. That’s why we need change—and advocacy—regarding processes of care.

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Beyond the ACA, Part One: Make Mental Health Part of Overall Health

Ron Manderscheid, Ph.D.
Executive Director, National Association of County Behavioral Health and Developmental Disabilities Directors

Without access to care, sustained recovery is not possible.Ron Manderscheid

That’s why each opportunity to break through barriers to access is critically important. When access to care becomes universal, millions of people with mental conditions who don’t get care today will get care. That care will be grounded in evidence-based practices and focused on the whole person, not a diagnosis.

Problems will be caught early; symptoms will be mitigated early in their course. And, ultimately, we can help make recovery not a potential outcome, but rather the expectation.

But change doesn’t happen overnight. Overcoming barriers to behavioral health care access requires persistent action and effort to target and sustain new ways of framing, delivering, and sustaining services and supports.

Behavioral health is part of overall health.

Slowly but surely, policy makers and researchers are reuniting brain and body in their thinking. That reunion has begun to help break down barriers to access, reduce the stigma that still surrounds mental health problems, and promote prevention and early opportunities for intervention. And it’s about time!

But to create an environment in which access is open to all, that policy and research reunion needs to be matched by a comparable reunion in program and practice. A number of structural changes—each an opportunity for our action and advocacy—can become the building blocks for full access to behavioral health care as part of overall health care.

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Happy Fourth of July

As we celebrate the history, government, and traditions of the United States of America this Independence Day, we are grateful for the freedoms and power afforded individuals in the U.S.A.

Among those freedoms and power, we count the ability to voice our thoughts, ideas, and
opinions about policy decisions. We have the power to make policy personal, to share our experiences, and to promote change.

Thank you for joining us at Care for Your Mind to exercise these powers. We encourage you to comment on the blog and continue sharing your thoughts and ideas...

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