From the Oregonian, June 3, 3013
When Sen. Elizabeth Steiner Hayward walked into a committee meeting, she didn’t plan to reveal to the world that she has suffered from major depression for 15 years.
“If I go two days without taking my medication, I can’t walk in the door of this building,” Steiner Hayward, D-Beaverton, told colleagues. “I can’t get up in the morning. I can’t take a shower. I can’t function as a normal human being.”
She went home that April day and had to tell her husband what she’d said.
Steiner Hayward is coming forward as a public voice for mental health at a time when Oregon lawmakers are considering Senate Bill 823, which would significantly expand mental health care in Oregon. The bipartisan proposal plots a six-year effort to ramp up funding for community mental health programs, with an emphasis on early intervention and treatment of children and young adults.
Leading the effort is Senate President Peter Courtney, D-Salem, who in February called for a “game-changing” investment in mental health care. His call came as lawmakers across the country discussed ways to reduce gun violence in the wake of shootings at Clackamas Town Center and Sandy Hook Elementary in Newtown, Conn.
Steiner Hayward works as a family physician at OHSU and has long been open about having multiple sclerosis. Now she’s also open about her mental health.
“I wanted to be clear that it’s a more complicated debate and a lot of people live with mental health issues but are highly functional if it’s well-controlled,” Steiner Hayward said in an interview. “I have an opportunity — because I’m a legislator and because I’m a physician — to make the story they’re telling with (Senate Bill) 823 very real, to be one of the public faces of people who need this.”
READ – Senate Bill 823 Outlines Courtney’s Vision for Mental Health, The Lund Report
READ – Senate Bill 823, 2013
The bill would expand existing programs, such as the Early Assessment and Support Alliance, which provides intervention and treatment for young adults when they first suffer psychosis. The highly lauded program exists in 15 of the state’s 36 counties. Advocates hope to expand the program statewide.
The proposal also aims to create new programs, such as “young adult community hubs” to connect youth to mental health services, new collaboration efforts with schools, and training for health care providers to screen for trauma, such as childhood abuse, neglect or bullying.
Gov. John Kitzhaber proposed $637.5 million in funding for community mental health programs in his 2013-15 budget, a 43 percent increase from the current biennium’s $445 million.
The governor’s proposed budget also includes separate funding to open the Oregon State Hospital’s Junction City campus. The Blue Mountain Recovery Center in Pendleton and a leased mental health facility in Portland are scheduled to close.
Legislative budget writers are hoping to get close to the governor’s proposed figure for community mental health when they release that portion of the budget in the next couple of weeks. “Discussions are still going on as far as what’s possible,” said Rep. Peter Buckley, D-Ashland, co-chair of the Joint Ways and Means Committee.
Other lawmakers hope to find another $50 million to add to the governor’s proposed amount, said Sen. Brian Boquist, R-Dallas. Boquist is a co-sponsor of Senate Bill 823 along with Courtney and Sen. Tim Knopp, R-Bend.
About $20 million could be raised by eliminating an off-shore tax loophole for some businesses, a proposal that already cleared the House and is in the Senate. Another $30 million could be raised by a 10-cent cigarette tax dedicated to mental health funding.
More than half of that $50 million would go to programs for children and young adults, Boquist said. “If you wait until later and by the time it gets to adult (stage), then it’s much more costly to identify, treat and mediate those issues.”
Mental health advocates are excited about getting more money for a system they believe has been chronically underfunded.
“This is a unique window for mental health,” said Andy Smith, legislative liaison for the Salem-based Association of Oregon Community Mental Health Programs. “It’s easy to talk about wanting to do something about mental health. In this cycle, we’re close to being able to do something bigger.”
Even so, mental health advocates face plenty of competition for additional dollars. Lawmakers consider education funding the top priority and have, at least so far, failed to agree on further tax measures.
About 5-to-6 percent of the U.S. population suffers from serious mental illnesses, such as schizophrenia, bipolar, severe anxiety and major depression, Smith said. Counting milder forms of depression and other less serious mental illnesses, that figure jumps to about 20 percent — roughly one in five Americans.
Like many states, Oregon’s mental health system often treats people when they cost the most: through the criminal justice system or the Oregon State Hospital. The six-year proposal on the table now would help fund a strategic shift to emphasize early intervention and a more holistic system.
“If you’re looking at the spectrum of what we’re proposing — from education and working with family and peer supports to managing acute systems of mental illness and the stigma associated with them — you really have to think about this as taking a new approach to how we’re addressing mental health,” said Linda Hammond, interim director of the Addictions and Mental Health Division of the Oregon Health Authority.
Steiner Hayward is ready to tackle the stigma associated with mental illness that contributed to her reluctance to disclose her depression.
She says she last suffered a major episode in 2001, when she lost 10 pounds in two weeks, didn’t talk much and had suicidal thoughts.
After revealing her struggles with depression this spring, she said she received handwritten notes and was stopped by strangers who thanked her for speaking out and showing publicly that people with mental illness can be highly functional. “To know that in some small role, in telling my personal story, that I have the potential to change that conversation, it’s a gift.”