Primary declaration season is finally upon us, and I know this is an unpopular take, but I’m ravenous. Receiving news of political tumult (at best) and terror (at worst) day in and day out is exhausting. I can’t even begin to imagine what it’s like for folks (minorities, furloughed workers, the lowest economic classes, etc) who are more personally affected by the state of our union than I. That doesn’t mean I want to swear off political ingestion, however. I just want something to believe in, to vote for.
It’s been said by many that candidates’ stances on climate change and gun violence are the two major issues that folks, or at least youth, need to vote based upon. I absolutely believe this to be true; our planet is in desperate need of our protection and so are our girlfriends, wives, schoolchildren, etc. I’d add a third dealbreaker to the list, personally; I will be most inclined to vote for a candidate who prioritizes mental health awareness and reform.
With that in mind, let’s examine the public opinions of a few of the major 2020 Democratic frontrunners when it comes to mental health. I’ll be taking a look at Kamala Harris, Bernie Sanders, Joe Biden, Elizabeth Warren, and Kirsten Gillibrand, though neither Biden nor Sanders (as of this writing) have technically declared their candidacy, I’m leaving out Trump for the sake of my own mental health and for another day, and I don’t want to think about Tulsi Gabbard or that Starbucks guy for one minute longer than my news feed makes me.
Kamala Harris: “Our country is facing a mental health crisis, yet far too many Americans don’t receive the treatment they need due to lack of access or stigma.”
Take a look at Senator Harris’ history with mental health and you’ll find a legislator who both articulates and delivers. In a tweet on January 9th of this year, Harris declared that “our country is facing a mental health crisis, yet far too many Americans don’t receive the treatment they need due to lack of access or stigma. With ~123M Americans living in an area with a shortage of mental health professionals, it’s vital we expand access to these services.”
I’m sometimes skeptical of the online statements of political figures, as they can just as easily be drawn up by some intern as the candidate, and with no intention of any follow-through. However, in December of 2018, Harris introduced the Mental Health Telemedicine Expansion Act and the Mental Health Professionals Workforce Shortage Loan Repayment Act, both accompaniments to similar acts proposed in the House.
The former enhances the accessibility of Telemedicine, a program that allows for digital treatment and prescription. With ailments (such as mental illness) and life circumstances (such as living in rural areas, working multiple jobs, disability, etc) that make in-person evaluation more difficult, the introduction of Telemedicine can, and has been, revolutionary. The latter bill creates a loan repayment program for mental health professionals who are willing to work in places that are in greater need of clinicians, including specific educational debt repayment.
Harris also endorses Senator Sanders’ famous Medicare for All bill, which is legislation that includes “no major medical bills for any mental health care services, including services to support as independent a life-style as possible,” and “no arbitrary limits placed on the number of visits to medical professionals.”
With public declaration of anti-stigma and pro-enhanced care, legislative follow through, and general healthcare endorsement, Harris is hard to criticize when it comes to mental health. She’s doing a lot of good for the mentally ill community and their health practitioners.
Bernie Sanders: “We have a mental health crisis in this country and many mentally ill people are ending up in jail because there is no place else for them to go.”
Senator Sanders is the originator of the previously mentioned Medicare for All legislation, which would provide coverage for no shortage of mental healthcare, so he gets plenty of points for that. He’s also been talking about the need for increased mental healthcare awareness and coverage for some time. Here is a video of him, in 2013 and in Congress, discussing the need for increased mental healthcare coverage and its relationship with economic disparities. He interweaves an endorsement of Medicare for All, as is proper. All of this illustrates that Sanders would be, indeed, likely to take tangible legislative steps towards bettering the state of mental healthcare in this country.
However, stigma is the alternate side of the coin, and I’m afraid Sanders doesn’t do very well on this front. Plenty of political figures have said things that they regret and that are to be condemned but not taken too seriously. Actionable, measurable steps taken are usually a better indicator of a candidate’s efficacy. Mental health is a bit different, and during his 2016 presidential race, Sanders very publicly and negatively stigmatized mental health.
It was a packed and nationally televised house in Flint, Michigan in early March, 2016. Just Sanders and Clinton occupied the stage and, though Sanders wasn’t expected to win at this point, his words reached nearly 6 million people upon airing, and many more once he was unflatteringly quoted. “We are… going to invest a lot of money into mental health,” Sanders said, “and when you watch these Republican debates, you know why we need to invest in that.” Whoa.
NAMI issued a better callout than I ever could, but I hope that it goes without saying, although it seemingly doesn’t, that the traits that Sanders was referring to in his perhaps valid criticism of Republican candidates- apathy, cruelty, internal bickering, mockery and general nastiness- are NOT symptoms of mental illness. Those are symptoms of being a person of poor moral integrity. Such a persona is a choice; mental illness is not. The only mental illnesses that I can think of that even approach those qualities are sociopathy and psychopathy, and those are much more complex than simply being obsessed with money and power and indifferent to the needs of the masses. It really takes necessary, intentional credit away from conservative ideals when they are attributed to mental illness.
By drawing a correlation between mental health and the characteristics Sanders was decrying, he did the mentally ill community a real disservice in the PR department. I’m not huge on censoring “comedy,” as this was clearly an attempt to create, but when it comes to mental health in particular, stigma (perpetuated by jokes such as these) really kills.
Joe Biden: “We have to make it clear to all people that there is no stigma in seeking help for a mental health issue.”
Oh, Joe. What a joy. Researching Fmr. VP Biden’s history with mental health actually took me a little while, for it’s so extensive, sobering and delightful that I hardly know what to include. I’ll initially summarize by saying this; Joe Biden is an ally of the highest esteem.
He comes at his ally-ship from a few angles. His Biden Foundation, co-operated with his wife, Jill Biden, largely deals with mental illness and wellness among the veteran community. Father of a veteran, Biden and his foundation seek to prioritize early intervention and de-stigmatization. According to its website, the Foundation supports Give an Hour, an organization that promotes free mental healthcare to veterans, and the Campaign to Change Direction, which amplifies awareness of the “Five Signs of Emotional Suffering.”
Biden has also delivered several notable speeches at national and international mental health events. In 2013, at a commemoration of JFK’s Community Mental Health Act, he spoke of the “astounding discoveries” that the scientific community has made on behalf of mental health (particularly PTSD), and the positive impact that the Affordable Care Act was having on mental health coverage. He made similar remarks at an APA conference in May 2014.
In October of 2018, he delivered the opening speech for the Global Summit on Mental Health Culture Change in London. In what I see as a perfect summary of his stance on, and work for, mental health related issues, he conveyed that “… we need to make sure that people know that there is help available. We need to ensure they have access to healthcare providers in rural areas or [in places with] few medical facilities, and we need to ensure that insurance policies include mental health. We have to make it clear to all people that there is no stigma in seeking help for a mental health issue.”
Biden is also generally concerned with matters of the brain. He’s had two cranial aneurysms and was given a low chance of survival, or survival with no serious cognitive complications. On the topic, he commented that “the only totally un-chartered portion of the universe is the brain.”
Fmr. VP Biden has put endless time, energy, and funding into matters to do with mental health. I think he deserves immense credit for it, and his fellow primary candidates should take heed.
Elizabeth Warren: “Americans have a right to equal health care coverage for physical and mental illness.”
Senator Warren’s approach to mental health is similar to Harris’ in that it is composed of two elements: her own history and her endorsement of Medicare for All. She absolutely passes the walk-and-talk test.
In December of 2017, Warren called for the doubling of the funding (1 billion dollars) for the Substance Abuse and Mental Health Services Administration (SAMHSA). Urging the government to “do more,” she brought attention to the disparity between the cost of the national opioid crisis- 500 billion annually- and the money that was being spent to combat it. “We are investing only one fifth of one percent of that amount… [for the] mental health piece of this problem.”
In January of 2018, she and Senator Kennedy co-sponsored a bill called the Behavioral Health Coverage Transparency Act, one that would provide accountability for insurers when it comes to equitable mental health coverage. Parity, or equal quality coverage, had previously been federal law, but enforcement was “weak and inconsistent.” The Act increased the frequency and necessitation of insurers’ reports to federal overseers, among other measures.
In April 2018, she authored an op-ed in her local Southcoast Today paper about the need for increased funding for the Mental Health Block Grant, which she describes as “the federal government’s largest source of grant funding for mental health services.” She poignantly began her piece with the statistic that “annually… 10 million Americans experience a serious mental illness that substantially impacts their major life activities.” Thank you, Senator Warren.
As with most of her fellow 2020 competitors, she has endorsed Medicare for All. I’d be proud to vote for Elizabeth Warren and her history with mental health advocacy and legislation.
Kirsten Gillibrand: “I will continue doing everything in my power to make sure our state has all the resources it needs.”
Senator Gillibrand’s approach to general mental health has been neither extensive nor proactive, but she conveys every indication that she would make the right decision should the opportunity for legislative change present itself. She has, however, intently zeroed in on the opioid epidemic and combating PTSD in veterans, as well as improving general healthcare.
In February 2018, she and fellow NY Senator Schumer successfully lobbied for a grant of 500,000 dollars of federal funding for the New York State Office of Mental Health. In August 2018, she individually and also successfully pushed for an additional 3.7 billion dollars to be designated for the opioid crisis and appropriate mental healthcare for it in the Fiscal Year 2019 (FY19) Labor, Health and Human Services, Education, and Related Agencies bill. She is a fervent supporter of the Opioid Addiction Prevention Act, which was “modeled after New York state law.”
Gillibrand has, on her Senate website, particularly focused on a three pronged agenda for combating mental health crises in veterans. She seeks to…
- “Improve coordination between Defense Department and the VA”
She has requested that Secretaries Gates and Shinseki develop “a coordinated approach” in treating traumatic brain injury.
- “Embed mental health providers with National Guard and Reserve units”
She has “co-sponsored legislation [to embed a] mental health professional with every Guard and Reserve unit to build the trust of troops and their families and help identify the onset of mental injuries.”
- “Establish long-term screening and care”
She sent Assistant HA Secretary Rice an urging to improve mental health related transition services between armed and civilian life for veterans.
In May 2014, after speaking to a veteran constituent with PTSD, she pushed for, and got passed, legislation that ensures that at least one mental health professional is present on every military discharge review board. Said Gillibrand, “Too many of our service members have been discharged as a result of an undiagnosed or improperly diagnosed mental health condition… our service members receive a correct diagnosis and treatment for mental health injuries like PTSD, TBI and MST.”
She, like most of her Democratic field, supports Medicare for All.
I hope this little rundown gave you at least a peek into my rationale for my 2020 Democratic primary vote, and at most a good framework for your potential vote. Mental health on the national, legislative level is paramount, for that’s where it all starts. That, and combating stigma, which is the job of you and I. Please educate yourselves further on all of the 2020 candidates and, above all, VOTE!