Why Everything is a Mental Health Issue When You Cast Your Ballot

Never have our mental health system’s shortcomings been clearer. According to a recent poll, 8 in 10 Americans say that COVID-19 has impacted their mental health, with many being unable to getthe help they need. The same poll showed that 91% want their elected officials to focus more on mental health.  
 
COVID-19 will be on the ballotnext month — and so will mental health. In fact, mental health is always on the ballot, even if not directly. Every major political issue has an impact on mental health and the needs of the mental health community. 
 
This is why everyone must vote. We must vote for us, our loved ones and our community. We must #Vote4MentalHealth. 
 
To help you assess candidates and their platforms, here are some of the mental health considerations related to three of the major political issues in this election: health care, the economy and education. 

Health care

 
Parity
We need parity to be realized for mental health care. People living with mental illness should have the right to affordable and accessible care. While recent legislation has improved this situation, disparities remain. Compared to physical health patients, people with mental illness are over 5 times more likely to go out of network for both inpatient and outpatient care.
 
Sample question to ask political candidates: How can you help to improve and enforce mental health parity?  
 
Integrated care
Integrated care can lead to positive health outcomes. Especially as people with mental illness are at higher risk for chronic disease, and some people with chronic disease are at higher risk for mental illness. In other words, these issues are inextricably linked.
 
Sample question to ask political candidates: What would you do to improve the integration of mental and physical health care?
 
Telemental health 
The federal government significantly expanded access to telehealth, which includes telemental health, at the beginning of the pandemic. Most notably, the expansion allowed Medicare patients to be seen remotely by a provider in any state. This change has led to greater accessibility to care, which is especially beneficial for residents of the 60% of U.S. counties — and 80% of rural counties — with no practicing psychiatrists. 
 
Sample question to ask political candidates: How will you preserve and expand access to telemental health care?
 
Alternatives to hospitalization
In-patient hospitalization should not be the only option during a crisis. Some research has shown that hospitalizations can be harmful to patients as they lose their freedom and experience trauma during their hospital stay. Additionally, there is a critical shortage of psychiatric beds, forcing acute patients to be held in emergency rooms, hospitals and jails while they wait for one to open up. 
 
Calls to 911 often lead to hospitalization without considering alternatives, such as community services. A few things that could help with this problem:

• More Crisis Intervention Teams (CITs) among law enforcement that can connect people in crisis to community services

• Psychiatric advance directives, which outline a person’s desired crisis treatment plan before a crisis occurs

• More access to outpatient care

• The implementation of 988, a mental health crisis number people can call instead of 911. 

Sample question to ask political candidates: When a person is experiencing a mental health crisis, they should receive mental health care—not handcuffs. What policies would you implement to help?

Economy

Unemployment can trigger many mental health stressors, such as a loss of identity and purpose, envy for those still working, loss of health care coverage, fear and uncertainty. It has been shown that the rate of psychological problems among people who are unemployed is over twice that of people who are employed. Even more important for our community, we must address the unemployment rates of people living with chronic mental illness, which are extraordinarily high.
 
Sample question to ask political candidates:  How would you address the high unemployment rates of those living with chronic mental health conditions?

Education

Mental health education in schools should be as common as physical education. Our students, from elementary school through college, are struggling, and rates of mental illness and suicide among young people are far too high. Better mental health education for students and teachers could allow for early identification, referral to services and treatment. This can also help students to complete their education.
 
While schools and educators can, and should, provide mental health support for students, there is a significant shortage of school counselors and trained staff who actually do provide this support. 
 
Sample question to ask political candidates: What do you propose to ensure there is more mental health support for students?
 
There are so many more mental health issues to consider and address, and we can no longer stand by. We must exercise our power, make our voices heard and make them matter. The best way to do so is to vote. This is our moment. This is our time. 
 
To begin, take the pledge at #Vote4MentalHealth.
 
 
 
KATHERINE PONTE, BA, JD, MBA, CPRP is a mental health advocate, writer, entrepreneur, and a lawyer. She has been living with severe bipolar I disorder with psychosis and extended periods of suicidal depression for 20 years. She is now happily living in recovery. Katherine is the Founder of ForLikeMinds, an online mental illness peer support community, and Bipolar Thriving: Bipolar Recovery Coaching and the Creator of Psych Ward Greeting Cards, which visits and distributes greeting cards to patients in psychiatric units. She is a member of the Board of the National Alliance on Mental Illness-New York City. Katherine is the author of ForLikeMinds: Mental Illness Recovery Insights and a monthly contributor to the NAMI National Blog. She also actively collaborates with the Program for Recovery and Community Health, Department of Psychiatry, School of Medicine, Yale University. A native of Toronto, Canada, Katherine calls New York City and the Catskills home. Her life’s mission is to share her hope and inspire others to believe that mental illness recovery is possible and help them reach it. In two years since reaching full recovery and starting to share her story publicly, her work has reached over one million people.