I love politics—so much so that I used to call myself a “political junkie” (a label I've avoided since learning more about substance abuse disorders). As of this writing, plenty of Americans are ready for the primary season (and the incessant news coverage) to end, but not me. I hope the Democratic and Republican presidential contests continue into March so that my state (Ohio) will have a “say” in the nominating process.
Yet much to my disappointment, I haven't heard the presidential candidates say much about issues near and dear to those in the behavioral healthcare field. There has been some talk about Medicaid and Medicare reform but nothing substantive (at least to this observer). Ideas about universal healthcare and mandating healthcare coverage have been floated, but lately we haven't heard much about those plans either. This election cycle we haven't even heard the usual get-tough-on-drug-offenders stump speeches typical of campaigns past. In fact, we haven't heard much about anything except the candidates’ commitment to change (a mantra behavioral healthcare executives are all too familiar with).
I suppose I shouldn't have expected behavioral healthcare to be front and center in the race for the White House. After all, presidential campaigns focus on the big issues: national defense, the economy, race relations, and so on. But when you think about it, mental health and substance use are big issues.
To be fair, some of the presidential candidates have responded to questions from the National Alliance on Mental Illness (go to http://www.nami.org to read their responses). But as Super Tuesday neared, none of the Republican candidates had responded specifically to NAMI's questions. And these issues deserve more attention than written responses from campaign staffers that few ordinary Americans read. They deserve to be articulated in speeches picked up by the national media outlets. (Our current President did recently talk about his past problems with alcohol, but John Schwarzlose, president of the Betty Ford Center, told the Associated Press that it's probably too late in Bush's term for the President to aggressively tackle substance abuse issues.)
We can expect the presidential candidates to focus on mental health issues at least on April 16, the one-year anniversary of the Virginia Tech shootings. Perhaps stalled federal parity legislation will get 30 seconds on the nightly news broadcasts that day. Yet I'm increasingly skeptical that parity will become a reality this year, as Congress tends to accomplish little in an election year and differences in the House and Senate versions of parity legislation have not been resolved.
It's said that all politics are local, and when it comes to behavioral healthcare that couldn't be truer, with funding levels relying heavily on the decisions of local and state politicians. Let me know what's going on in your community—are your local races focusing on behavioral healthcare issues? Send me a note at firstname.lastname@example.org. We probably won't hear much about behavioral healthcare in the national campaigns, but in communities all across America mental health and substance abuse issues are important concerns—whether the candidates talk about them or not.