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Linda Rosenberg

Former President and CEO, National Council for Behavioral Health

Reclaiming the New Frontier

September 25, 2013 | National Council Magazine | Comments
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As a young college graduate I went to work in a state psychiatric hospital. I saw adults struggling to retain their dignity while they were marched into a communal bathroom to be counted at the change of every shift. I saw men and women restrained because they dared to question staff. And I met families of patients afraid to complain for fear of retribution. I vowed then that I would join the pioneers working to remake treatment for people with serious mental illness.

Today, 50 years after President John F. Kennedy signed the Community Mental Health Act
of 1963, we remember his call for a bold new approach to mental health and developmental disabilities, one in which the “cold mercy of custodial care would be replaced by the open warmth of community.”

In these last 50 years, we’ve seen what open warmth can do to transform the lives of people in the deepest despair. We’ve learned that people with mental illnesses and addictions can recover and live fulfilled lives in their communities. We’ve seen what hope and care can accomplish. We’ve seen it in the lives of thousands like the 50 individuals who chose to share their stories in this special issue of National Council Magazine: 50 years, 50 Stories.

We applaud and appreciate these 50 individuals — for sharing their struggles and accomplishments, for having the courage of their dreams, and for reminding us that people don’t recover in isolation, they recover in a community.

As Oprah Winfrey reminds us, “Every one of us gets through the tough times because somebody is there, standing in the gap to close it for us.” We thank all those who stand in the gap — policy makers, organizational leaders, peers, and staff who go above and beyond to support recovery. Their dedication is evidenced in the stories spanning the pages of, “50 years, 50 Stories.”

The people profiled in the magazine represent the legacy that JFK called for when he said, “The new frontier is here, whether we seek it or not. Beyond that frontier are the uncharted areas of science and space, unconquered pockets of ignorance and prejudice, unanswered questions of poverty and surplus.” JFK believed the times demanded new invention, innovation, imagination, and decision and he asked each of us to pioneer his vision.

In the past 50 years, the pioneers on the new frontier have achieved significant progress in treating mental illnesses and addictions. Science brought us new knowledge — new medications, psychotherapies, peer support, and technologies that expanded our ability to treat and support a range of conditions. Individuals won new rights — to be free from coercive treatment, to live in the least restrictive setting, and to work and play alongside their neighbors.

Yet, as JFK warned us, “The problems are not all solved and the battles are not all won.” We have not yet realized the full potential of community-based care. We continue to struggle with inadequate and misaligned financing arrangements, salaries, clinical training, and systems of accountability.

An analysis of data from the 2010 Global Burden of Disease Study — more people are dying or falling ill as a result of addictions and mental illnesses than from HIV, tuberculosis, and diabetes – makes clear the work ahead. Worldwide, between 1990 and 2010, the incidence of mental illness has gone up by 38 percent, and depressive disorders account for 40 percent of worldwide death and disease burden.

Professor Harvey Whiteford from Australia, who led the data analysis that revealed these shocking statistics notes, “Cost-effective interventions are available for most disorders but adequate financial and human resources are needed to deliver these interventions.”

We must reclaim the new frontier, revitalizing the original intent of community behavioral health — where community resources address and build on community needs. We must embrace scientific advances that promise new discoveries in brain research and advocate for public policies that emphasize prevention and early identification as well as treatment.

We have pockets of innovation and excellence in every community, but we need policies that take these practices to scale. We have three decisive opportunities —three current bills in Congress — that advance our mission to reduce the burden of disease and death caused by mental illness and addictions:

  • The Mental Health First Aid Act offers education and training to teachers, health workers, firefighters, police officers, emergency services personnel, and other community members.
  • The Excellence in Mental Health Act creates Certified Community Behavioral Health Centers to better meet the needs of people currently being served, and those who will seek care as a result of coverage expansion and parity.
  • The Behavioral Health IT Act provides financial incentives for the adoption and “meaningful use” of health information technology — the bedrock of improved care and coordination among practitioners— for mental health and addiction treatment providers and facilities.

The challenges of the new frontier do not seem as daunting after reading about those profiled in our magazine. Their bittersweet stories of hope, recovery, and in many cases, redemption, counter desperate battles with mental illness and addiction. They inspire us to march forward.