2016 Election Guide on Mental Health

In the first 2016 presidential debate between Donald Trump and Hillary Clinton, there wasn’t any discussion about mental health. The only time the issue came up was when Clinton mentioned the challenges faced by law enforcement officers, and said: “Mental health is one of the biggest concerns, because now police are having to handle a lot of really difficult mental health problems on the street.”

Two national mental health organizations have put together helpful guides to mental health issues in the 2016 U.S. election. Check them out below, and scroll down to the bottom and read Hillary Clinton’s Comprehensive Agenda on Mental Health.

 

Mental Health America (MHA)

MHA produced “Vote for America’s Mental Health in 2016: A Guide to Rights and Issues.”

MHA Guide’s excerpts from the Republican Party Platform

Preserving Medicare and Medicaid. “Block granting Medicaid is particularly needed to address mental health care. Mental illness affects people from all walks of life, but there has been very little success in developing effective system-wide medical models for addressing mental health. For a variety of unique reasons, government is often the first frontier for people experiencing mental health problems—from first responders who deal with crises to publicly funded mental health facilities to prisons where large numbers of inmates suffer from mental illnesses.”

Choice in Education. “We opposed school-based clinics that provide referral or counseling for abortion and contraception and believe that federal funds should not be used in mandatory or universal mental health, psychiatric, or socio-emotional screening programs.”

Ensuring Safe Neighborhoods: Criminal Justice and Prison Reform. “Along with diversion of first-time nonviolent offenders to community sentencing, accountability courts, drug courts, veterans treatment courts, and guidance by faith-based institutions with proven track records of rehabilitation, our platform emphasized restorative justice to make the victim whole and put the offender on the right path. As variants of these reforms are undertaken in many states, we urge the Congress to learn from what works. In the past, judicial discretion about sentences led to serious mistakes concerning dangerous criminals. Mandatory minimum sentencing became an important tool for keeping them off the streets. Modifications to it should be targeted toward particular categories, especially nonviolent offenders and persons with drug, alcohol, or mental health issues, and should require disclosure by the courts of any judicial departure from the state’s sentencing requirements.”

Combating Drug Abuse. “Heroin and opioid abuse touches our communities, our homes, and our families in ways that have grave effects on Americans in every community. With a quadrupling of both their sales and their overdose deaths, the opioid crisis is ravaging communities all over the country, often hitting rural areas harder than urban. Because of over-prescription of drugs is such a large part of the problem, Republican legislation now allows Medicare Part D and Medicare Advantage plans to limit patients to a single pharmacy. Congressional Republicans have also called upon the Centers for Medicare and Medicaid Services to ensure that no physician will be penalized for limiting opioid prescriptions.”

Honoring and Supporting Our Veterans: A Sacred Obligation. “Like the rest of American medicine, the VA faces a critical shortage of primary care and mental health physicians. That’s why there are long waiting times to see a doctor and why doctors are often frustrated by the limited time they have with their patients. This is especially the care with mental health care, which often amounts to prescribing drugs because there are not enough psychologists and psychiatrists to do anything else. Inadequate treatment of PTSD drives other problems like suicide, homelessness, and unemployment. This situation may not be quickly reversed, but a Republican administration will begin, on day one, to undertake the job.”

MHA Guide’s excerpts from the Democratic Party Platform:

Honoring Indigenous Tribal Nations. “We will work to fully fund the Indian Health Service, Tribal, and Urban Indian health care to ensure that all American Indians have adequate, safe, and affordable access to primary care providers, including oral health, mental health practitioners, and substance abuse treatment options.”

Supporting Community Health Centers. “We must renew our commitment to Community Health Centers, as well as community mental health centers and family planning centers. These health centers provide critically important, community-based prevention and treatment in underserved communities, prevent unnecessary and expensive trips to emergency rooms, and are essential to the successful implementation of the ACA.”

Combating Drug and Alcohol Addiction. “We must confront the epidemic of drug and alcohol addiction, specifically the opioid crisis and other drugs plaguing our communities, by vastly expanding access to prevention and treatment, supporting recovery, helping community organizations, and promoting better practices by prescribers.”

Treating Mental Health. “We must treat mental health issues with the same care and seriousness that we treat issues of physical health, support a robust mental health workforce, and promote better integration of the behavioral and general health care systems. Recognizing that maintaining good mental health is critical to all people, including young people’s health and development, we will work with health professionals to ensure that all children have access to mental health care. We must also expand community-based treatment for substance abuse disorders and mental health conditions and fully enforce our parity law. And we should create a national initiative around suicide prevention across the lifespan—to move toward to HHS-promoted Zero Suicide commitment.”

Preventing Gun Violence. “We will fight back against attempts to make it harder for the Bureau of Alcohol, Tobacco, Firearms, and Explosives to revoke federal licenses from law breaking gun dealers, and ensure guns do not fall into the hands of terrorists, intimate partner abusers, other violent criminals, and those with severe mental health issues.”

Veterans and Service Members. “We must also look for more ways to make certain the [Department of Veterans Affairs] provides veteran-centric care, such as providing women with full and equal treatment, including productive services; expanding mental health programs; continuing efforts to identify and treat invisible, latent, and toxic wounds of war; treating post-traumatic stress; and expanding the post-9/11 veteran’s caregiver program to include all veterans. We reject attempts by Republicans to sell out the needs of veterans by privatizing the VA. We believe that the VA must be fully resourced so that every veteran gets the care that he or she has earned and deserves, including those suffering from sexual assault, mental illness, and other injuries or ailments.”

 

National Alliance on Mental Illness (NAMI)

NAMI provides links to the two parties’ platforms, with some excerpts of their own:

Republican Platform

In [the Affordable Care Act’s] place we must combine what worked best in the past with changes needed for the future. We must recover the traditional patient-physician relationship based on mutual trust, informed consent, and confidentiality. To simplify the system for both patients and providers, we will reduce mandates and enable insurers and providers of care to increase healthcare options and contain costs. Our goal is to ensure that all Americans have improved access to affordable, high-quality healthcare, including those who struggle with mental illness.

Democratic Platform

 We must treat mental health issues with the same care and seriousness that we treat issues of physical health, support a robust mental health workforce, and promote better integration of the behavioral and general health care systems. Recognizing that maintaining good mental health is critical to all people, including young people’s health and development, we will work with health professionals to ensure that all children have access to mental health care. We must also expand community-based treatment for substance abuse disorders and mental health conditions and fully enforce our parity law. And we should create a national initiative around suicide prevention across the lifespan—to move toward the HHS-promoted Zero Suicide commitment.

 

Hillary Clinton’s Comprehensive Agenda on Mental Health

It’s worth noting that the Democratic campaign released a proposal on August 29, 2016 called Hillary Clinton’s Comprehensive Agenda on Mental Health (Trump has yet to issue a policy document on the topic). Excerpts from the agenda:

Today, Hillary Clinton announced her comprehensive plan to support Americans living with mental health problems and illnesses—by integrating our healthcare systems and finally putting the treatment of mental health on par with that of physical health. Nearly a fifth of all adults in the United States, more than 40 million people, are coping with a mental health problem. Close to 14 million people live with a serious mental illness such as schizophrenia or bipolar disorder. Moreover, many of these individuals have additional complicating life circumstances, such as drug or alcohol addiction, homelessness, or involvement with the criminal justice system. Veterans are in acute need of mental health care, with close to 20% of those returning from the Iraq and Afghanistan wars experiencing post-traumatic stress or depression. And the problem is not limited to adults: an estimated 17 million children in the United States experience mental health problems, as do one in four college students.

Americans with mental health conditions and their families need our support. The economic impact of mental illness is enormous –at nearly $200 billion per year nationwide in lost earnings—and the human cost is worse. Too many Americans are being left to face mental health problems on their own, and too many individuals are dying prematurely from associated health conditions. We must do better. To date in this campaign, Hillary set out policies that will direct support to individuals with mental health problems and their families—including a detailed agenda to support military service members and veterans, an initiative to end America’s epidemic of drug and alcohol addiction, and a robust caregivers’ agenda. Today, she is building on those proposals with a comprehensive agenda on mental health. Hillary’s plan will:

—Promote early diagnosis and intervention, including launching a national initiative for suicide prevention.

—Integrate our nation’s mental and physical health care systems so that health care delivery focuses on the “whole person,” and significantly enhance community-based treatment.

—Improve criminal justice outcomes by training law enforcement officers in crisis intervention, and prioritizing treatment over jail for non-violent, low-level offenders.

—Enforce mental health parity to the full extent of the law.

—Improve access to housing and job opportunities.

—Invest in brain and behavioral research and developing safe and effective treatments.

As a down-payment on this agenda, Hillary will convene a White House Conference on Mental Health during her first year as President. Her goal is that within her time in office, Americans will no longer separate mental health from physical health when it comes to access to care or quality of treatment. The next generation must grow up knowing that mental health is a key component of overall health and there is no shame, stigma, or barriers to seeking out care…

Hillary Clinton’s agenda includes the following focus on suicide prevention:

Suicides, which are usually fueled by mental illness, are rising among numerous population groups, from adolescents and college students to veterans and older adults. The overall rate of suicide increased by 24 percent between 1999 and 2014, and is now at its highest level in 30 years. Over 40,000 Americans die of suicide every year, making it the tenth-leading cause of death nationally. As the former director of NIMH, Dr. Tom Insel, often notes, suicides have 11 victims: the person who dies, and at least 10 people close to them who will never be the same. Hillary believes that suicide is a critical issue that she will prioritize as president. She will:

—Create a national initiative around suicide prevention across the lifespan that is headed by the Surgeon General: As president, Hillary will move toward the goal of “Zero Suicide” that has been promoted by the Department of Health and Human Services. She will direct all relevant federal agencies, including HHS, the VA, and the Department of Education, to research and develop plans for suicide prevention in their respective settings, and create a cross-government initiative headed by the Surgeon General to coordinate these efforts. She will also launch a citizen input and feedback mechanism, to enable outside groups to comment on agency recommendations, and explore how we can harness technology to reach out to people who need support.

—Encourage evidence-based suicide prevention and mental health programs in high schools. In 2013, a survey of high school students revealed that 17 percent considered attempting suicide in the last year, with 8 percent actually attempting it. The suicide rate among American Indian/Alaska Native adolescents is even higher, at 1.5 times the national average. There are effective ways to respond. It is critical that school districts emphasize evidence-based mental health education, so that students, teachers, and school nurses are aware of the warning signs and risk factors of mental illness and how to address them. The Model School District Policy on Suicide Prevention, released by four leading mental health organizations, includes concrete recommendations that school districts can follow. Hillary will direct the Department of Education to emphasize mental health literacy in middle and high schools and will work with regional and national PTA, school counselor associations, and associations of secondary school principals to encourage school districts to adopt this model policy.

—Provide federal support for suicide prevention on college campuses. Hillary believes that every college campus should have a comprehensive strategy to prevent suicide, including counseling, training for personnel, and policies that enable students to take leave for mental health. Such multi-layered approaches have a proven track record of decreasing suicides. For instance, the Air Force launched an initiative in 1996 that brought together multiple intervention programs and reduced the suicide rate among Air Force personnel by nearly a third in under a decade. Groups such as the Jed Foundation, American Foundation for Suicide Prevention, the Suicide Prevention Resource Center, and Active Minds have created frameworks around suicide prevention tailored for colleges and universities. Hillary will dramatically increase funding for campus suicide prevention, investing up to $50 million per year to provide a pathway for the country’s nearly 5,000 colleges – whether private or public, two-year or four-year – to implement these frameworks on behalf of students.

—Partner with colleges and researchers to ensure that students of color and LGBT students are receiving adequate mental health coverage. Evidence suggests that the psychological needs of students of color are disproportionately unmet, impeding their ability to adapt to college life. LGBT students face added burdens as well, with gay youth being four times more likely than their straight peers to attempt suicide. Hillary will direct the Departments of Education and Health and Human Services to work with universities, researchers and community programs to determine how best to meet and respond to the challenges these students face and to provide specialized counseling.