At last night's MSPP ( Massachusetts School for Professional Psychology) sponsored Gubernatorial Forum on Mental Health there was much talk among all of the candidates about how devoting resources to mental health care is a wise investment. But there was virtually not one mention of prevention in the form of children's mental health care. This was striking, as Nobel prize winning economist James Heckman has offered extensive evidence of how devoting resources to prevention in early childhood leads to decreased long-term costs of physical and mental health care.
Investing in early childhood also leads to decreased spending on prisons, a topic all of the candidates addressed in terms of decreasing the number of people in prison for non-violent crimes and first time drug offenses. They all correctly identified the high rate of mental illness in prison and the need to offer treatment, particularly substance abuse treatment.
The whole night I was thinking, "what about the children?" This might have been due to the format, and the fact that moderator Tom Ashbrook did not ask a single question about children.
I was struck by the contrast between this discussion and last week's American Academy of Pediatrics sponsored symposium on Child Health, Resilience and Toxic Stress.
All the best science of our time, in the form of research at the interface of neuroscience, genetics and developmental psychology, tells us that to invest in prevention means to invest in parents and children.
I was disappointed by Martha Coakley in a sense towing the NIMH party line, whose great shortcomings I describe in a previous post, by saying that mental illness is like any physical illness, such as diabetes. I am one hundred percent in favor of parity for mental health care, and decreasing the stigma of mental illness. But the only way to achieve this parity is to recognize that mental illness is not like diabetes.
Resilience and emotional wellbeing develop in the context of relationships. To both prevent and treat mental illness the focus of intervention needs to be on relationships. What makes us human is our historical and relational context. We need to value space and time to listen to each other.
The most important point of the evening, that was made in some form by all three democratic candidates, is that reimbursement for mental health care needs to increase significantly. When we place value, both cultural and monetary, on taking the time to listen, whether to parents of young children, teens struggling with substance abuse, or adults with a range of diagnostic labels, then we will be making meaningful steps not only towards mental health care parity, but also towards promotion of health and resilience.