Community Mental Health: A Forgotten Initiative

Lately, I have been conjuring with a way to settle once and for all the question of which Presidential candidate is the most committed to bringing about "real" change, that is, change that will really matter to real people and not just to Washington-minded bureaucrats. My idea was inspired by a re-reading of Matthew 25:31-46, Jesus' words about feeding the hungry, quenching peoples' thirst, being hospitable, providing clothing to the naked, caring for the sick, and visiting the imprisoned --- and his startling idea that we can expect to see him especially in the faces of the least of all of these. The body blow is delivered at vs. 45: "…anything you failed to do for one of these, however insignificant, you failed to do for me." (REB) As the most powerful nation on earth, and by our own grandiose declaration the most generous, our country has not done well with most of this little homily, except in sporadic crises. I am not the only one worried about what Jesus may make of our systemic failure some day.

A particularly distressing example of making ourselves the goats and not the sheep of God's Kingdom is our unwillingness to bring about real change in caring for the mentally ill. If there are any doubts about how far down on the food chain many of these folks are, following a few off-medication, homeless schizophrenics around a street or two downtown will dissolve those doubts in less than an hour. What makes the short-changing of the mentally ill especially noxious is that not all that long ago, we had in place at the Federal level just what would have made lasting change possible, the Community Mental Health Act, signed into law in 1963 by President John F. Kennedy. It called for building mental health centers all over the country, mostly in low-income communities, that would provide access to comprehensive treatment to to all who needed it, especially those previously warehoused in state mental hospitals. A linchpin of this approach was the empowerment of clients and communities.

During the 1980's not only the vision but the legislation died, with the systematic, federally-initiated tearing down of its own nation-wide network of by then adequately funded and staffed clinics. On the basis of "less government" ideology --- as laughable then as it is today --- money was transferred in significantly diminished amounts to the states in the form of block grants. The all too predictable result has been rising expectations met by demoralizing fiscal restraints, increased caseloads, stifling regulations, and a general falling-off in the quality and accessibility of mental health care. There is little evidence to date that our current Presidential candidates have thought very much about this desperate situation, and even less that they and their running mates have had even a single anxious moment pondering what the indifference of Christians --- all four of them included --- is doing to Jesus.

From one vantage point, of course, these failures are beyond even the possibility of correction, primarily because this country no longer has the financial resources needed to complete the job. In a word, we are broke. Not dead broke yet, but just wait. Like too many consumers with too much charged on their credit cards, government --- whether Republican or Democrat --- has run up its own (that is, our) tab too, and no politician now seems willing to say the one politically-incorrect word that would begin to fix the problem: priorities. They, like we, are more content to keep bandying about the more familiar but no longer helpful ones, such as lower taxes, less government, military hegemony, family values, entitlements, trickle down economics, and most importantly of all, consumption as the vital center of the good life. But "priorities" is the one word most in need of amplification, and the one priority most in need of an upward advance on our lists is making a decent life possible for those in our society who are least able to make it possible on their own. Rethinking the uses and misuses of accumulation can still make it happen.

So my idea for the morning is that the Presidential candidate who makes the first move to talk about this priority deserves the accolade of being considered the more serious about making a real difference and bringing about real change in society. I plan to keep on listening for the first hint from either candidate --- or from his running mate, for that matter --- that caring for those mentally ill who are least able to care for themselves matters, and matters greatly, to him/her. Without getting too weird, Fundamentalistic, or Swift-Boaty about it, I think that Jesus will be listening, too.