The much-loved festive holidays have departed rapidly. So too will the year’s end of a period filled with exceptional “Sturm und Drang”. Both events signal a need to take stock and to set a clear course for our New Year, 2018.
The festive holidays always emphasize what we all hold dear in our hearts: our families, our friends, an inviting warm hearth, much gaiety, a shared, happy dinner, gift exchanges, and close camaraderie. I am sure that I speak for all of us when I say that these are the same values we do want to emphasize in our behavioral health community. After all, we are very much like a close family.
At the same time, the current annum has confronted us with many unique threats: proposed, but defeated congressional legislation would have decimated state Medicaid programs and adversely impacted state insurance marketplaces for those who are near-poor. Other proposals to eliminate the health insurance mandate, reduce the essential health benefits to a state option, or dramatically cut federal resources will have similar dire consequences. Clearly, we must continue to respond effectively to these ominous threats going forward.
Here, I would like to propose three guideposts for our joint action as we step quickly into 2018:
Preserve Progress: Through our collective efforts during the past half-decade, we have been able to achieve milestones that we only could have dreamed about a decade ago. We have been able to reduce the number of persons with mental illness who do not have health insurance by half, from one-third to about 16%. Similarly, principally through the Medicaid expansion, we have greatly increased the number of persons with substance use conditions who do have any health insurance coverage. As a result, many more people have access to needed care. For example, the percent of persons with substance use conditions who now receive care has grown from 10% to 20% during this period.
To preserve this essential progress, we must remain very vigilant to each new threat as it arises. This year, we learned that joint political action can achieve remarkable results. The entire health community—insurers, states, counties, cities, providers, and peers, joined by all community members concerned about health, acting collectively—was able to defeat very bad federal legislation. We need to continue to work with this coalition in 2018, and we all need to be activated politically to engage every step of any new threat to the inalienable human right to good health.
Protect Person-Centered Care: Undoubtedly, the most remarkable achievement by the behavioral health field has been our willingness to embrace the promise of recovery. Today, we offer the true hope of recovery to millions of person with mental health or substance use conditions. Just a generation ago, that would simply have been unthinkable. Consumers and peers taught us about recovery via their own personal experiences—regaining one’s voice, reconnecting with friends and community, becoming strong. They also taught us about the corrosive role played by trauma, and the need for trauma-informed care throughout the entire behavioral healthcare system. We have listened, and we have learned.