By Jennifer Fiorillo
Mental Health
Jennifer Fiorillo
In 1908, Clifford W. Beers published his autobiography, A Mind That Found Itself. His work laid a foundation on the challenges of mental illness and inhumane treatment that he and other patients received while institutionalized. Beers was diagnosed with bipolar disorder – or at that time manic depressive illness – and was placed in a straightjacket for 21 consecutive nights while in treatment at an institution.
Beers highlighted the deficiencies in care for those challenged by mental illness in his work, and he sparked a movement with his colleagues that would lead to the creation of what we know today as Mental Health America (formerly the National Committee on Mental Hygiene and the National Mental Health Association).
More than 100 years of history is behind us, and during those hundred-plus years innumerable milestones have been reached to raise awareness around mental health, improve services, address prevention and establish policy that would increase parity, recognizing mental health as a vital element of one’s overall health.
We’ve come a long way, from the formation of more than 100 child guidance clinics between 1910 and 1920 addressing prevention, early intervention and treatment to 1963 when the Community Mental Health Centers Act was issued, calling for deinstitutionalization and increased community supports for people with mental illness and developmental disabilities. The act also provided construction grants to establish community mental health centers. The community-based behavioral health system was being built before us, providing a safety net of services for individuals who otherwise might remain institutionalized, untreated and possibly homeless for most of their lives.
In 1966, another major milestone was reached when Mental Health America successfully advocated for the inclusion of mental health services under Medicare – a huge step toward payment parity. And in 2008, strong advocacy efforts resulted in the inclusion of mental health as an essential health benefit under the Affordable Care Act.
More recent progress in advancing mental health care involves policy that prioritizes helping families in crisis. The Helping Families in Mental Health Crisis Act of 2016 focused on court-ordered treatment and hospitalization, addressing mental health across the lifespan and integrating mental health into primary care. This act, followed by the creation of the National Certified Peer Specialist in 2017 by Mental Health America, moves the needle of treatment toward a more person-centered and integrated approach.
In the last five years, we have continued to build upon the tenets of person-centered care and meeting an individual where they are in treatment and recovery. Between 2018 and today we have taken a much closer look at workplace, school and campus mental health, explored challenges in the LGBTQ+ community to inform treatment and provide necessary support, begun to more thoroughly address equity in behavioral health from a racial and social justice lens and aggressively challenged the overdose and opioid use epidemic that has been ravaging our communities.
I challenge our policymakers and leaders to continue this conversation and address behavioral health needs in a way that shows how we’ve transcended the early days of questionable treatment to a place where mental health is normalized and seen as a pathway to healthy communities.