Political Analysts Expect Little Investment in Mental Health Care

The chances are that regardless of who wins the presidential election in November, looming fiscal deficits will prevent federal spending to improve mental health services for Americans, political analysts told attendees at the Opening Plenary of the 2004 conference of the National Alliance for the Mentally Ill in Washington, D.C., last month.

“No matter who wins,” said ABC News anchor George Stephanopoulos, “we will be entering a very dire fiscal situation in January of 2005—there will probably be a half-trillion-dollar deficit that will climb over the next four years.”

This deficit, he said, will severely limit the government's ability to fund any type of health care research or services.

Stephanopoulos is anchor for the ABC News show “This Week” and served as senior advisor to President Bill Clinton for policy and strategy. He chronicled his struggle with depression in his 1999 autobiography, All Too Human (Psychiatric News, June 4).

Stephanopoulos appeared with Robert Boorstin, who is senior vice president for national security at the Center for American Progress, an institute dedicated to advancing “progressive” ideas in the United States. In the 1990s Boorstin served as a White House aide under President Clinton and has written and spoken publicly about his experiences with bipolar disorder.

While implementing the recommendations of President George W. Bush's New Freedom Commission on Mental Health would be “difficult for either candidate” due to federal deficits, Stephanopoulos speculated that based on Sen. John Kerry's proposed economic policies, Kerry might be more able to do so than Bush.

He explained that Kerry's plan to roll back the Bush administration's tax cuts for those earning more than $200,000 a year “will save another $600 million, which could theoretically be used to invest in things like driving down the deficit or investing in the mental health commission's recommendations.”

Kerry has said he plans to use the money to provide health care for all children and many adults currently without health insurance.

Although Bush has said he supports mental health parity, he has not demonstrated a commitment to mental health issues, according to Boorstin.

“I think you can get a pretty good idea of the president's commitment to real mental health reform when you examine the commission he appointed and the fact that he told them to come back revenue neutral, which means, `Don't spend any money on mental health,'” he said.

“I also think the Bush administration has great trouble making decisions that run counter to the health insurance industry and the pharmaceutical industry, and those are the types of industries that will get hit if [mental health] parity is achieved,” he continued.

Another barrier to the progress of legislation that would expand access to mental health care in the U.S., Boorstin noted, is a political atmosphere he called “petty and divisive,” which is controlled by “extreme elements in both houses” of Congress.

“Any progress on these types of issues requires people to compromise, and the current poisoned atmosphere won't allow for that,” Boorstin said.

A deep commitment to mental health issues by members of Congress and other politicians—many of whom have had a family member with mental illness—is the genesis of successful mental health legislation, Boorstin noted.

“It's no coincidence that Sen. Pete Domenici [R-N.M.] and former Sen. Paul Wellstone got together on this subject, nor that Rep. Lynn Rivers [D-Mich.] was concerned about mental illness,” said Boorstin.

Domenici's daughter and Wellstone's brother have been diagnosed with serious mental illnesses, and Rivers has been diagnosed with bipolar disorder.▪