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Linda Rosenberg

Former President and CEO, National Council for Behavioral Health

Torn between two causes?

August 5, 2013 | Uncategorized | Comments
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When I was pregnant with my now adult twin sons, I had a reoccurring nightmare.  I was standing between two cribs each with a crying baby unable to decide which son to go to. I’ve heard similar fears expressed about an association’s ability to advocate for more than one cause, one disease state, one group of people struggling or in recovery.  Most recently such fears were voiced when we announced a strategic alliance of the State Associations for Addiction Services, the Legal Action Center, and the National Council for Mental Wellbeing.

We of course see our new alliance as an opportunity rather than a threat to addiction and mental health advocacy. Many agree that it’s the “right thing to do,” but some are concerned that one or the other will get short shrift.  A few have even voiced the fear that mental health could consume addictions as if substance use disorders are not distinct illnesses requiring specific treatments and supports.

The National Council’s growing membership — 2,000 plus — includes a wide array of standalone addiction service organizations, as well as agencies delivering mental health, addiction, and co-occurring treatments. The passage of parity and the ACA have given all of us what we wanted — full inclusion in healthcare.  But with equality comes entry into the competitive fray of the healthcare industry.

The limitations of historic exclusion from general medicine were many, but we also had protections that we will be in danger of losing. Small and even midsize healthcare organizations of all types with small margins and growing compliance pressures will struggle to survive and the illusion that primary care can and will do it all is, I believe, just that — an illusion. Seeing new alliances as a threat can be a diversion from the work ahead.

Fighting for the rights of people with mental illnesses has not and does not negate the ability of the National Council to strongly advocate for addiction prevention, treatment, and recovery. My colleagues — Becky Vaughn at SAAS and Paul Samuels at the LAC — concur, which is why our three associations have come together with a common agenda.

We’ve defined the priorities of our alliance — jointly advocating on national and state alcohol and drug policies, partnering to improve the business operations of provider organizations as healthcare reform and parity dramatically change the marketplace, and collaborating on robust addictions and mental health-focused offerings at the National Council Conference in May 2014, in Washington D.C.

As Paul Samuels said to Alcoholism and Drug Abuse Weekly recently, “For many years now substance use and mental health have been linked in many healthcare reform initiatives. Combined advocacy has been the most effective approach for both fields on those issues, while at the same time the substance use field continues to conduct advocacy on many other important issues, including preserving and growing the block grant.” Becky Vaughn also noted that the passage of federal parity stands as testament to the success that is possible when addictions and mental health work together.

Our work as advocates continues. We must fight for the universal expansion of Medicaid, seek the best possible mental health and substance use coverage in essential health benefit packages, and ensure that all plans have adequate networks of addictions and mental healthcare providers.

Why would we go it alone when we can be stronger together?

We preach “integration” to our members. We tell them to prepare for the demand for one-stop, healthcare shopping — the ease of convenience and the improved care of coordination. Why then should we not follow suit and integrate the missions of the associations that support them?

As Becky Vaughn said, “The National Council wants to work with the leading addiction organizations and we [SAAS] want to work with the leading mental health organization to ensure that all providers get the best possible representation and the information they need to serve their patients.”

My sons are now successful fathers and accomplished professionals. Like all mothers, I am aware of their unique needs and loved, cared for, and advocated for them both. I know the National Council can and must do the same, making accessible services of the highest quality a reality for all Americans with mental and substance use disorders. We are here — together ― to help.