As we savor the warmth, cheer, and camaraderie of our family and friends during the winter holidays, we also must spend some time reflecting on the fast approaching new year and what awaits us just around the corner. For each of us, 2016 likely will be a year for making very difficult decisions and a year for taking necessary but very difficult actions.
In the new year, a series of complex issues will converge at a very convoluted crossroads. Because 2016 also coincides with a presidential election, these issues will be framed in extreme and simple terms, greatly accentuated, discussed frequently, and often confused. Because the ISIS threat continues to grow, particularly for unconnected actions by local terrorist cells, these discussions even are likely to take on an apocalyptic tone. However, let us not permit these eventualities to lead us astray.
Below, I have separated several key issues, each of great concern to our field, in order to discuss them. However, it is very important to recognize they interact with each other, and decisions and actions about one will affect each of the others.
Personal Rights for All: In our country, we pride ourselves on our personal rights, some of which are enshrined in the Constitution’s Bill of Rights. Yet, we also must recognize that these rights are neither absolute nor unconditional. Let me state just a few of the antipodes we will confront in 2016: How far should our right to freedom from search and seizure be limited by the need to identify ISIS cells? How far should our right to communication privacy be limited by the need to monitor terrorist use of media? How far should our right to gun ownership be limited by the community’s right to safety from mass shootings? Clearly, many, many more questions of this type could be posed.
Social Justice for Many: How we frame our personal rights, together with the premise that all persons are created equal, will determine how we realize the concept of social justice. In its essence, social justice seeks to promote equity by moving resources from those who are more fortunate to those who are poor or disabled to increase the wellbeing of the latter. Here are just a few of the likely 2016 antipodes: How far should we promote social justice for those who are poor and disabled at the expense of other urgent community needs? How far should we promote social justice for one group at the expense of social justice for another group when resources are limited? How far should we promote equity in health status at the expense of cost containment for health?
Life Chances for a Few: The life chances of persons with mental illness or substance use conditions already are limited by our concepts of personal rights for all and social justice for many. They are limited further by negative stereotypes and stigma that persist to this day. How far should we support self-determination for care for some at the expense of others with behavioral health or intellectual/developmental disability conditions receiving no care at all? How far should we support better life chances for persons with mental illness at the expense of the life chances of other groups with disabilities? How far should we support better personal rights for persons with behavioral health or intellectual/developmental disability conditions at the expense of community rights?