Sunday, February 24, 2013

The Economy and Mental Health

Sunday, February 24, 2013

Mental Health and the Economic Downturn

 

The connection between austerity and mental illness

 


                Experiencing mental health and how it is handled, I have reached some conclusions. 
The first being that we definitely need better funded public health care as it pertains to mental wellness.  We have a system where health care workers are over taxed.  The rush to get those afflicted service are rushed through a system that is simply not equipped to handle the needs of a society that desperately needs more comprehensive mental health care, that is for everyone.

                As more and more employers turn the U.S. into palace of part-time employment, the reality of health care insurance is that many simply do not have access to it via their employers.  There are options to obtain insurance other ways, but all are invariably outside the income level of many.  Even full time employment that offers insurance, it is far from comprehensive.   Between co-pays for visits and often monthly costs, to simply to have the coverage is not enough. Out pocket costs are not practical, and quickly add up even with best of plans.

                Just employers cut down expansion, banks are reluctant to low, the belt tightening inside the Beltway is all about cuts to vital services.   In more and more cities, vital services are cut or eliminated that benefit the working class, the middle class, the disadvantaged, and ironically enough the very people suggesting we to to austerity programs that are not effective

                Look no further than Europe and the disaster of cut backs and leaner anorexic government has translated into low wages, frustration on the part of the public and in some cases a complete retirement of government all together.

                The notion that you stimulate an economy but cutting cutting and cutting just adds fuel to the fire.  This is the kind of fire that just keeps burning.

                It is no secret to anyone there is waste in government.  There are programs that are long past their prime, or just excuses to keep people employed who are doing next to nothing at all.

                On the flip side, government provides services, stimulates the creation of jobs and actually has a beneficial impact.  The problem has never been big government versus small government, the real issue is effective government as a opposed to bloated government that caters to special interests and lobbyists advancing an agenda works against the interests of the greater good.

                Persuasively, Republicans have put forth the notion of fiscal responsibility and cutting government. But his was the same party, accompanied by corporate Democrats and those blowing with the political winds, decided that a massive war while cutting taxes was a wise move.

                After 911, that same group rode a tidal wave.  Once in office, it became clear that the very people that voted them into office would be left hanging when government was made smaller.

                The Tea Party attitude of populism was little more than a good sales campaign for a party that knew full and well if their real agenda were known, not one of them could be elected dog catcher.
                The agenda was simple. Attack school teachers as over paid, make fireman over paid and make the public pay for services previously covered by taxes.

                It this was not bad enough, Unions and collective bargaining became public enemy number one.  Demonizing unions as obstacles to employment, unrealistic demands and union dues demanded of everyone, suddenly unions and government employees became scape goats.

                The argument that unions were universally bad, corrupt and full of bloat seems to ignore the simple fact that working conditions and pay have become worse.  As time as gone by, few and fewer full time posts exist as we go towards a part time economy.
 
                From my own experiences, I had full time employment with a company that offered private insurance through a large company.  This was offered at for a cost.  If you wanted what amounts to real coverage, you had to pay much more than the basic plan offered.  In short, you had an affordable plan that everyone could utilize, but offered  high copays, or a higher priced plan that provided what most people wanted with a smaller co-pay.  Why  Americans have not protested co-pays has always been a mystery to me, but then again, protests have happened, but they simply did not effect change.

                As well intended as the Occupy Movement has been, and I fully support their objectives, the lack of central organization, the lack of defined leaders and the lack of a clear to understand message, the movement lost momentum.   It was effective in pulling people out of their chairs and into streets. That it did do.  But, when it came to harnessing and utilizing the strength of individuals, local business owners and a cross section the population of America, Democratic, Republican, Independent and assorted political persuasions in between, everyone was gathered wondering what to do next.  Aside from walking around a bank protesting economic inequity, Occupy has yet to provided electable candidates that can actually effect real change.

                Note, I am not underestimating “grass roots” movements.  People and numbers are powerful.  Even under repressive regimes, when people organize around one idea and are motivated, tyrants will toppled. Look no further than now, look further back to France, Russia and China, to name a few, all became oligarchy free.

                We in the U.S.  have been directed to see protest as ineffective.  However, it is not the fault of the people as much as it is a society that places a premium on consumption and minimum on quality of life that impacts the community.  Rather than look at the common good and the resources we all share, the philosophy that guides some of us can be summed up as “I got mine, and now you get yours.” 

                Old cliché, “Pull yourself by your own bootstraps,” is still part of the political dialog.  However,  what if you have no straps with which to pull yourself upward?  This is not about personal responsibly. There is that to contend with, but in a culture where things have reached this point, shared responsibility is not part of the equation.

                How does this factor in to public mental health?  It does in a direct way. Over time, seem to have “historical amnesia” on how we arrived at this point and the policies of the Bush administration and those immediately before him, including the some the policies endorsed by the Clintons, included N.A.F.T.A. and the wars in the middle east, we the public ended up with lower wages, the middle class, even the affluent, having to bear the cost of these wars and tax breaks that were completely unnecessary. 

                At no point in time have lowering the taxes during a time of war makes sense. But no one had a problem sending your brave men and women to combat and not being concerned about their physical and mental health when they returned.  The “We are Number One,” chant was great when we saw massive weapons and troops in valiant uniforms.  When the men and woman came back, mutilated, physically and mentally damaged and in need of long term care, those, many of whom were not middle class, but working class, found themselves literally on their own.  We loved them when they left, ignored them when they came home.  Is it any wonder that those who fight these wars and do not receive proper mental healthcare become violent, antisocial and eventually mass murders with the weapons and the knowledge to wreak havoc and death.

                The old school of thought said that world war one and those vets did not need psychiatrists and the like. Those brave men and women were tougher.  

                Reality paints a different story.  People came back scared. It maybe the numbers may have been smaller. 
                One point no one can ignore is that our heroic men and women in combat have been in it much longer that four or five years.  The mental and physical demands of constant long term tours of duty has to translate into mental health issues greater than those of their predecessors.

                We greeted the heroic of world war two with parades.  Vietnam vets and the Middle Easter war vets were invisible.  The recent wars were fought by the economically challenged who had few options except to serve the country.  Whatever motivated them, they risked their lives to protect this country.

                The condescending line “That’s for your service” sounds condescending. They certainly deserve more than superficial gratitude from politicians. At the very very minum, they desrerve life time mental health care and some place to live in safely.  I do not think that is too much to ask. Had we done this, there would be fewer violent victims of PTSD. 

                In the discussion of gun control, mental health has been mentioned, but it is not brought to the forefront as much as one might think.  Limiting the kinds of arms available to the general public makes sense. (Please note: I “DID NOT SAY ELIMINATE PRIVATE GUN OWNERSHIP!  I have no problem with responsible SANE Men and Women with Guns.)  

                However, all of the gun control in the world will help curtail the problem, but it is one part of a larger picture.  If we have a public attune to the signs of mental health problems and a culture that promotes healthier lifestyles, perhaps, just maybe, we will have fewer mass murders.
                There is no one pat answer to guns and violence. A combo maybe in order to alleviate this issue.

                With all of this said, how does the economy impact mental health?  That is relatively easy to see.  As more people lose their jobs as high paying ones become scare, housing, petroleum, food and everything else goes up, along with transportation, taxes, tuition and heath care costs, the pressures on individuals, families and communities takes a toll. The pressure is unrelenting and with no nets or safety nets, people are falling between the cracks.

                If one believes we have enough government funding services, like health care, think seriously again.  More projects aimed the economically disadvantaged or being stressed to the breaking point.  Long stop call, service is limited.  Of the many that seeking mental health care that needs serious, 80 percent are turned down.  Even if those deemed “seriously ill” still are at risk, the number becomes scary in terms of who has access to comprehensive mental, and medical health care.

                There is so much to say about the connection between income, mental health care, and social systems breaking down.

                What makes all of this truly difficult is that many are simply not aware of mental illness, or fail to even know the signs.

                As some mental disorders make the headlines, the reality of being diagnosed means dealing with those who not only fail to understand mental illness, they fail to see the need for medications, therapies and long term vigilance. 

                For some, mental health care may require a few visits to a psychiatrist, a therapist and group and they may move along. For others, group therapy, cognitive therapy, meetings with therapists and long term prescription medication are lifelong.

                At one point, I was one of those who believed that long term visits to a therapist or group would be counterproductive.  I thought that at some point you need to move forward.

                That very thinking is simply not an accurate view when it comes to mental health wellness.  For those struggling with depression, anxiety, depression and anxiety, unipolar disorder, PTSD, schizophrenia, Bipolar and assorted other life threatening disorders.  

                Some disorders do not interfere with normal life, if managed and contained by support systems.  Others maybe treated over time.  

                Some consider mental disorders a lack of character. It is not so much a lack of character, but biology.     
                The connection between genetics, environment and life experiences all play are role.  The fundamental concept that brain chemistry and inherited characteristics makes a good case for chemical imbalances as a source for mental disorders.

                The evidence is not completely in, but those with a history of family mental illness are more prone to suffer them. This is particularly true for those closely related.

                Until more is known, mental illness remains an enigmatic mystery.  It is hoped that science, research and a society focused on the public good may see the need for more insight into this subject and less focus on guilt, blame and shame.