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Is transparency the best public policy for behavioral healthcare?

May 26, 2010
by Terry L. Stawar, Ed.D.
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Shortly after taking office President Obama sent a memorandum to all governmental department heads in which he said: “My administration is committed to creating an unprecedented level of openness in Government. We will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration. Openness will strengthen our democracy and promote efficiency and effectiveness in government.”

I think most people would agree with this lofty goal, but how does it really play out across the country as the political and funding environment becomes harsher and more challenging?

As the recovery slowly grinds forward, more and more states are forced to make difficult and politically unpopular cuts to programs and reductions to service. In recent months I have become more concerned about the issue of transparency in this process. Is the public being informed as to what is transpiring and what the consequences really are? Are governmental entities even being open with each other? Or do they prefer to stay, as I heard one official recently say, “under the radar?” 

It seems to me, that you would only be afraid to have an open airing of issues and prefer to stay “under the radar,” if you had something to hide or if you lacked trust in the public, the press, or other government entities to understand and deal responsibly with the issues. It seems like this is a way to try to disguise questionable actions and is contrary to the doctrine of transparency.

Perhaps policy makers really fear that voters will actually comprehend the issues, but disagree with some of the decisions and actions.

I have always believed that behavioral healthcare does not get the degree of public or governmental support it deserves, because we have not been transparent enough. We do a terrible job of putting a human face on our story and objectively demonstrating the needs that exist and the effectiveness of treatment.

Finally, I don’t believe, as a field, we are interested in any special privileges or considerations, if they have to be snuck by the public or government monitors. It may be naïve, but I have faith that our field can stand on it own merits.



It's time that mental health be on par with overall health, no matter what! And, working in public health for the Fed. I see that often times, people just don't understand mental health. I suppose after years of siols, there's a lot to learn...from all directions. But, I think that putting the human face to the story is imperative, as is creating innovative ways of making mental healtha part of overall health...PERIOD! I see that concept beginning to take off here in D.C. and throughout the country...although more so within certain circles.

As for being shut outI have learned that there are many reasons why folks are shut out-shut out of processes, meetings, jobs, leadership opportunities, etc. It's not always stigma, but it can certainly be discrimination!

Don't wait for a call! Make sure that your voice is heard!

Teresa Chapa, Ph.D., MPA
Senior Policy Advisor, Mental Health
US DHHS, Office of MInority Health

Much of the mental health establishment still promotes stigma, dispite words condemning it. While the Feds seem to being doing a better job of accepting input from the bottom up than most of the states, more needs to be done. Those of us who have acheived significant recovery often are aware of many things which have helped us, but have typically been shut out of the process. Instead of automatically shutting us out, we need to be invited to speak about how meeting the challenges that our mental health problems created for us, caused us to seek innovative recovery methods. Greater openness and transparency is needed.

Right on!

I believe the stigma associated with mental illness makes mental health providers even more cautious of transparency. This only acerbates the problem of getting adequate funding for these services.

Senator Tim Mathern

Thanks for the comments. I have a lot of concerns about how FMAP stimulus funds are actually being used through out the country.

Terry Stawar

President/CEO (LifeSpring, Inc.)

Terry Stawar


Terry L. Stawar, EdD, is President and CEO of LifeSpring Health Systems, a community behavioral...

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