Will Oregon have the political guts to tackle mental illness?

From the Salem Statesman Journal, Dick Hughes’ Blog, January 17, 2013

I think state Senate President Peter Courtney is right.

But I challenge Oregonians to prove him wrong.

Courtney contends the Oregon Legislature lacks the political will to confront the overriding factor behind many of the mass shootings that have struck our state and nation: mental illness.

“You have to make a commitment to mental health that we have never, ever made in this country at any level,” the Salem Democrat said.

This comes from a politician who has done more to foster improved mental health care than any other leader in recent state history. Courtney was the driving force behind the rebuilding and reforming of the Oregon State Hospital to bring its facilities and programs into the 21st century, emerging from its legacy as the filming site for “One Flew Over the Cuckoo’s Nest.” He continues to push for building a second, smaller state psychiatric hospital in Junction City. That hospital is included in the proposed 2013-15 budget that Gov. John Kitzhaber sent to the Legislature, as are increases in mental health spending.

But Oregon’s mental health system needs a complete overhaul, and those steps are mere tinkering. Which is why Courtney said the current legislative session is ill-prepared to grapple with such a monumental issue.

“You see all these politicians talking mental health? They don’t know what they’re talking about,” he said. “You’ve got to say, ‘This session, before anything else, it’s mental health.’ And everybody else says, ‘All right.’”

One irony: This issue has widespread support among Republicans and Democrats, regardless of whether they represent rural or urban constituencies. “There is no doubt Oregon has failed on this,” said Sen. Larry George of Sherwood, the state Senate’s deputy Republican leader.

The impediments: money and power.

If the state finds the courage to invest more in mental health care, that will mean less money for other programs. And changes in providing that care will mean winners and losers within the current system.

As an example, the coordinated care organizations (CCOs) required under Oregon’s health-care reforms should — over time — improve the integration of mental and physical health care. But independent physicians, Salem Health and other health-care providers in the Mid-Valley can’t even agree on how to establish their regional CCO. How then can we get people statewide to rise above their self-interests and agree to make mental health care the priority for this Legislature?

Again, our failure to act is ironic: Mental health care works.

It can benefit every segment of society and improve the livability for all Oregonians. Almost all of us know someone who suffers from mental illness, just as we know someone who suffers from cancer or heart disease.

These days mental illness is in the news because of the recent mass shootings. (Of course, I would argue that almost any murder is an irrational act and anyone who commits murder is insane; but the law doesn’t see it that way.)

There are great challenges in getting mentally ill, potentially dangerous individuals to receive treatment and to follow their treatment protocols on a daily basis. Medication can be expensive and can carry unpleasant side effects. A person with certain mental illnesses may prefer the unmedicated, albeit irrational, euphoric high … until the crash comes. And in a society that values freedom, few patients can — or should — be forcibly treated.

But huge obstacles are no justification for shirking our even bigger responsibilities.

Medication works in many instances, although not always. Counseling, communication- and family-training programs, anxiety-relieving meditation and exercise, and other approaches also are important.

Consider how each of us would benefit if the state made a massive commitment to improving mental health: Families would be stronger; employees would be more effective. Fewer police officers would face the trauma of “suicide-by-cop” calls. Workplaces, malls and schools would be safer. In addition, teachers would be better prepared to deal with unruly kids — and would have fewer of them.

Simply, countless lives would be improved, and many would be saved.

To some, the above will sound like a mindlessly irrational and unrealistic nirvana.

But what’s irrational is our failure to remove the stigma of mental-health treatment.

What’s unrealistic is to expect that we can ever end mass violence, as well as many lesser societal problems, without addressing mental health.

And Nirvana is a band ripped apart by suicide.

Dick Hughes — who takes medication for anxiety, participates in Tuesday and Friday prayer sessions, and wants to learn meditation — is editorial page editor of the Statesman Journal. Contact him at dhughes@StatesmanJournal.com; P.O. Box 13009, Salem, OR 97309; or (503) 399-6727. Read his blog at StatesmanJournal.com/DickHughes or follow him on Facebook or at twitter.com/DickHughes.