Without a lot of fanfare, a remarkable thing happened in the world of mental health and substance use care this past December. It had little notice but when you consider that behavioral health problems have often been a forgotten aspect of the U.S. health care system, it’s not surprising. Add to that the pervasive stigma that is also too often tacked on to these conditions by a poorly informed or prejudicial citizenry, the absence of headlines and news stories could have been predicted.
The strong message came in an unassuming document merely 17 pages long, a simple read in comparison to the complex ideas it conveyed. If ever we are to have a U.S. health care system we can be proud of, one that every American deserves, then leaders, providers, payers, politicians and the public will do well to take the words to heart.
They called it “A Unified Vision for Transforming Mental Health and Substance Use Care,” and what’s noteworthy is that it comes from 13 disparate organizations, including Mental Health America, the oldest advocacy group in the nation and the only one, as far as I know, dating back to 1909. The other equally heavyweight names behind the document are all undeniably respected, credible and laudatory, which makes the fact that they could all agree on the values, goals and action steps something powerful. Their overarching goal in doing so is a straightforward, no-jargon and achievable hope: Improving lives.
They’re after a lofty aspiration. While it might sound out-of-reach for many states still grappling with the pandemic and worried about the economic toll COVID-19 is taking on us now and in the foreseeable future, big dreams are part of our DNA in America and the world already knows we can accomplish great things when we come together to get something done.
Their call is eloquent: “We must fundamentally shift our perceptions around mental health, substance use and well-being; embrace the concept of population health, which includes prevention, promotion, and recovery; address vital conditions such as housing, transportation, and employment; transform the systems that impact whole-person health; integrate care; and dedicate adequate resources to ensure people receive the services and support they need, when and where they need them.”
The document spells out seven critical elements that could be the strong foundation for such a future. One in particular seems both vital and timely as we mark the dawn of a new leadership and in the wake of celebrating the legacy of Martin Luther King Jr. and other civil rights leaders. Its sad absence in our country should make everyone take new actions. It is the problem of equity.
We must “address social and political constructs and historical systemic injustices, such as racism and discriminatory structures and policies, that disproportionately impact the mental health of people of color.” No transformed health care system, behavioral health or otherwise, is possible unless disparities and inequities are addressed.
This means that people of color and other marginalized communities must have improved access to care, because they bear a heavier adverse impact of things that threaten health. We need a new and sober realization that veterans, the LGBTQ community, Black Americans, and indigenous people most often get poorer health care and have worse outcomes. Such injustice must end in our state and beyond.
Alongside these critical goals, the authors of this vision map out specific “pathways for success.” It will take policy changes on the federal, state and local level to achieve this transformation, to be sure, but perhaps it all starts with a question for each of us: Do we want a better future for people who face mental health and substance use challenges?
Those individuals might be you, your daughter, son or sibling; your friend or neighbor, the men and women who served our country in peace and war; your doctor or health care provider; the pilot on the next plane you board; your plumber or grocery clerk; your imam, minister, priest or rabbi.
With the new year still young and the growing light at the end of the coronavirus tunnel we’re all in, let’s hope that we unite behind the noble vision expressed by these pathfinding organizations and bring about improved lives for everyone.