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The Skyrocketing Costs of Mental Health Care

Ensuring the mental health of Americans is a costly affair. Three recent unrelated occurrences should help us realize there is no inexpensive way to prevent, diagnose and treat mental illness. By now most of us have heard about the “broken” Veterans Administration and its failure to provide timely services that has led premature deaths of veterans. Newspapers, broadcast media and numerous blogs have reported about various calls for the resignation of VA Department Secretary Eric Shinseki following a few damaging reports about unacceptable medical practices involving veterans—particularly the report out of Phoenix that veterans were dying after secret waiting lists were discovered falsifying wait times for treatment.

VA Summit
Veterans from several generations offered first-person insight to nearly 100 community partners at the VA Palo Alto Health Care System’s Mental Health Summit Aug. 29, 2013

While the focus of the VA investigation has been on medical services, many of the veterans who are not receiving timely treatment are suffering from post-traumatic stress disorder (PTSD) and other brain injuries because the VA simply was not prepared for the huge numbers of soldiers returning from deployments with serious mental health issues. Approximately 2.6 million soldiers were deployed in Afghanistan and Iraq and it is estimated that 20 percent of returning veterans have screened positively for PTSD and depression. The VA estimates as many as 22 veterans commit suicide every day.

So far, President Obama is standing by Shinseki but finds himself faced with another crisis that questions his ability to lead. Unfortunately, there are few topics too sacrosanct not to politicize. But the woes of the VA go farther back than the Obama Administration. The VA budget has been increased significantly over the years even during the sequestration. However, as battlefield medical advances save more soldiers’ lives, they are returning with more complex problems that are quite expensive to treat.

The Veterans Affairs fiasco comes on the heels of the rejection of the National Football League’s offer of $765 million to settle lawsuits by 4,878 former NFL players (and 1,000 family members) who suffered concussions during their careers. U.S. District Judge Anita Brody rejected the settlement reached by the NFL with its former players because she was concerned that the settlement was not sufficient to cover the needs of the claimants. The lawsuit was sparked by the discovery of the degenerative brain disease, chronic traumatic encephalopathy (CTE) in the brain of the late Pittsburgh Steelers center, Mike Webster who died in 2002 at the age of 50 years old. That story was the subject of a Frontline documentary, League of Denial: The NFL’s Concussion Crisis.

Subsequent to the concussion lawsuit, 500 players have filed another lawsuit accusing the NFL of obtaining and administering illegal drugs in an effort to mask the pain and symptoms of various injuries such as broken legs and ankles. Turning a blind eye and even denying the traumatic brain injuries (TBI) suffered by NFL players resulted in incalculable costs to families and children. The NFL has taken dramatic steps to reduce the chance of TBIs but concussions are still a staple of a very violent game.

The third occurrence—another mass killing—in Santa Barbara, California, happened Friday night when Elliot Rodger, the 22-year-old son of Hunger Games assistant director Peter Rodger went on a hate-filled rampage, killing six and injuring 13 others before shooting himself. More human life destroyed by someone who obviously should not have been able to purchase guns. Yet Congress consistently fails to pass laws requiring stricter background checks despite the fact that 90 percent of Americans favor stricter background checks. The last serious attempt to pass a gun sale background bill, S.22—the Gun Show Background Check of 2013—failed last year when five skittish Democrats voted against a bill offered by West Virginia Democrat Joe Manchin and Pennsylvania Republican Pat Toomey. The National Rifle Association has ensured that no gun control law gets passed by holding many of our nation’s lawmakers hostage.

There is no way to address mental health on the cheap. Failure to provide adequate resources for prevention, screening and treatment often come with a heavy price. Threats to mental wellbeing will increase as we become more socially isolated, consumed and fixated on our device of choice. We no longer have to leave home to bowl alone.

Photo Credit: Courtesy of US Dept. of Veteran Affairs

Written by Dr. Charles Lewis, Jr.

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Dr. Charles E. Lewis, Jr. is President the Congressional Research Institute for Social Work and Policy. He has served as deputy chief of staff and communications director for former Congressman Edolphus “Ed” Towns and was the staff coordinator for the Congressional Social Work Caucus.

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