A Plan to Improve Mental Health Care and Combat Addiction
We are in the midst of a devastating opioid overdose and addiction epidemic that is harming communities across the country. “Understanding the Epidemic.” Center for Disease Control and Prevention. December 12, 2018. This source notes that almost 400,000 people died from an overdose involving any opioid, including prescription and illicit opioids, and does not include 2018 overdoses due to opioids. According to the CDC, in 2018, there were 47,500 overdoses due to opioids.
In the past two decades alone, almost 450,000 people have died due to opioid overdose. By the end of this year, almost nine times as many will have died as the total number of U.S. military deaths during the Vietnam War.“Vietnam War U.S. Military Fatal Casualty Statistics” National Archives. January 2018. This crisis leaves a harrowing impact far beyond rising death rates. For every person that dies from opioid overdose, countless others are living with opioid use disorder. Family members, friends, and neighbors are deeply affected. Families are being torn apart; since 2000, the number of children placed in foster care due to their parent’s opioid use has doubled to nearly 100,000.Thompson, Dennis. “Opioid Epidemic Doubled Number of U.S. Kids Sent to Foster Care.” HealthDay. July 15, 2019.
Yet for all the attention the opioid epidemic has rightly received, Pete understands that it is only one part of a much larger mental health care and substance use disorder crisis. Last year, for every five people who died from opioid overdose, three died from overdose due to other drugs, Ahmad FB, Escobedo LA, Rossen LM, Spencer MR, Warner M, Sutton P. “Provisional drug overdose death counts.” National Center for Health Statistics. 2019. such as methamphetamine or cocaine; Dembosky, April. “Meth Vs. Opioids: America Has Two Drug Epidemics, But Focuses On One.” Kaiser Health News. May 7, 2019. five died by suicide; “Suicide.” National Institute of Mental Health, National Institutes of Health. April 2019. and nine died an alcohol-related death. “Alcohol Facts and Statistics.” National Institute on Alcohol Abuse and Alcoholism. August 2018. Combined, these deaths have contributed to the longest sustained decline in American life expectancy since World War I. Bernstein, Lenny. “U.S. life expectancy declines again, a dismal trend not seen since World War I.” The Washington Post. November 29, 2018.
Yet for all the attention the opioid epidemic has rightly received, Pete understands that it is only one part of a much larger mental health care and substance use disorder crisis.
Collectively, these deaths due to drugs, alcohol, and suicide are characterized as “deaths of despair,” which are often preceded by people and communities being left behind. Case, Anne and Deaton, Angus. “Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century.” Proceedings of the National Academy of Sciences of the United States of America. December 8, 2015. It is parents being laid off from the job they’ve had for decades and a society’s inability to provide them with the opportunity to take care of their family. It is teenagers coping with childhood trauma or living in constant fear of hearing gunshots at school. Sinha, Rajita. “Chronic stress, drug use, and vulnerability to addiction.” Annals of the New York Academy of Sciences vol. 1141 (2008): 105-30. doi:10.1196/annals.1441.030 It is older people whose aging friends don’t stop by as often, if at all, and a society’s inability to take appropriate care of its elders. Hosseinbor, Mohsen et al. “Emotional and social loneliness in individuals with and without substance dependence disorder.” International journal of high risk behaviors & addiction vol. 3,3 e22688. 25 Aug. 2014, doi:10.5812/ijhrba.22688 Each of these circumstances leaves members of our community searching for ways to numb their pain, manage their anxiety, or cope with their loneliness and isolation.
This crisis of despair is often portrayed as one unique to middle-aged white America. While mental illness and addiction rates have risen significantly for this demographic, this ignores the reality that rates of mental illness and addiction among people of color, other marginalized groups, and other age groups have historically been, and continue to be, high.
Overdose deaths are spiking among Black people, on whose backs the current broken system that criminalizes mental illness and addiction was built during the crack epidemic of the 1980s. James, K, Jordan, A. “The opioid crisis in black communities.” Journal of Law Med Ethics. 2018 Jun;46(2):404-421.Native Americans experience post-traumatic stress disorder twice as often as the general population. Bassett, Deborah, Buchwald, Dedra, and Manson, Spero. “Posttraumatic Stress Disorder and Symptoms among American Indians and Alaska Natives: A Review of the Literature.” Social Psychiatry and Psychiatric Epidemiology. March 1, 2015.LGBTQ youth are almost five times more likely than their straight peers to attempt suicide.Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9-12. U.S. Department of Health and Human Services. 12 Aug. 2016, www.cdc.gov/mmwr/volumes/65/ss/ss6509a1.htm.
Young Americans report being lonelier than any other age group.Ducharme, Jamie. “Young Americans are the loneliest, according to new study.” TIME magazine. May 1, 2018.Among Latinx people, mental health and overall health has deteriorated significantly under the current Administration.Wan, William, Bever, Lindsey. “Trump’s presidency may be making Latinos sick.” The Washington Post. July 19, 2019. And 20 veterans and active service members die by suicide each day, the most shameful indicator of just how badly our nation has failed those who have given so much to our country. Department of Veterans Affairs, Veterans Health Administration, Office of Mental Health and Suicide Prevention. Veteran Suicide Data Report, 2005–2016. September 2018.This crisis of pain and despair is not one unique to whiteness; it is one that is distinctly American.
This crisis of pain and despair is not one unique to whiteness; it is one that is distinctly American.
This crisis is the result of years of neglect by our political leadership. Our health care system is so broken—and our approach to mental health and addiction care so fragmented and often punitive—that less than one in five people with a substance use disorder and two of every five people with a mental illness receive treatment.“10% of US adults have a drug use disorder at some point in their lives.” National Institutes of Health. November 18, 2015. |“Mental Health Facts in America” National Alliance on Mental Illness. The annual economic cost of the opioid epidemic is almost $80 billion a year. Florence, CS et al. “The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013.” Medical Care. October 2016. To meet this urgent national challenge, we need a new approach to providing mental health care: one truly prepared to tackle this as the crisis it is, and one that understands the key driver of change will be based in strengthening our communities.
Pete understands that as a nation, we must begin to take mental health more seriously. All of us either live with these illnesses or may in the future, or we know someone who does. And for hundreds of thousands of us, it is a matter of life and death.
Pete’s vision for the future of mental health and addiction care is rooted in embracing prevention and ensuring that every person with a mental illness or a substance use disorder has the resources and support they need to begin to heal. We will ensure that at least 75% of people who need mental health or addiction services receive the care that they need, an increase of more than 10 million in his first term, and prevent 1 million deaths of despair by 2028. In order to help those who heal remain well—and to build Americans’ resilience to these illnesses—we must ensure that everyone feels that they belong in their community and in our country.
Tackling this crisis starts by ensuring that everyone has access to affordable and comprehensive health coverage, and that mental health and addiction care services are integrated into settings such as primary care. It means using technology to make it much easier for someone to find a therapist to talk to, in person or virtually. It means making it simpler to get a prescription for medication to treat addiction, such as buprenorphine to treat opioid use disorder, so unnecessary regulations don’t prevent physicians from prescribing live-saving medication that could help thousands of people every day. To ensure that people with a mental illness or substance use disorder can heal, we will decriminalize these conditions. When someone is undergoing a crisis or is caught using a drug, they should be treated by a health professional rather than punished in a jail cell.
To ensure that people with a mental illness or substance use disorder can heal, we will decriminalize these conditions.
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