A legacy of mental health

This year marks the 50th anniversary of a speech President John F. Kennedy delivered to Congress, where he proposed "...a national mental health program to assist in the inauguration of a wholly new emphasis and approach to care for the mentally ill... Central to a new mental health program is comprehensive community care."

Later that year in 1963, Congress passed the Community Mental Health Act to provide federal funding for community mental health centers and research facilities devoted to the research and treatment of mental retardation. It was the last law President Kennedy signed before his assassination.

For people in Greater Boston with mental illness, JFK's final legislation ended the nightmare of being warehoused in secluded hospitals and forgotten institutions, opening the door to a new era of recovery and the hope of moving back into their communities. Since then, organizations like Catholic Charities and our Family Counseling and Guidance Center have been helping people manage mental illness and live full lives.

Today, as Massachusetts legislators look for ways to strengthen our mental health system in the wake of Newtown and other tragedies, they should remember the intent of this landmark law passed half a century ago. The legislation set the stage for an entirely new approach to recovery in the community, one marked by continually evolving care and treatment for Americans with mental illnesses and addictions.

Unfortunately, despite renewed vitality in Congress to bolster mental health services, this evolving treatment for those with mental illness is not happening. More than $4.3 billion has been cut from state mental health budgets since 2009, according to the National Association of State Mental Health Program Directors.

State budget cuts have closed the doors of hundreds of treatment centers nationwide with drastic results: reducing the number of beds available in psychiatric hospitals by 4,000; forcing the layoffs of clinicians; and reducing subsidies for outpatient counseling, medications, and other services. As a result of cost cutting in Massachusetts, the list of closed state hospitals has grown to include institutions such as: Taunton State Hospital in 1975; Boston State Hospital in Dorchester/Mattapan in 1979; Metropolitan State Mental Hospital in Waltham closed in 1992; and the historic Medfield State Hospital in Medfield 2003.

Making matters worse, as state mental health resources were being whittled down, the need for services increased dramatically over the last three years, with demand for community-based services spiking at 56 percent. Withdrawing community-based resources for some of our most vulnerable members of society typically results in tragic and costly outcomes.

Services must be available for people with mental health issues. Without adequate treatment they can end up homeless, incarcerated, or hospitalized in emergency rooms, costing taxpayers more long-term.

Massachusetts legislators can participate in the legacy of JFK's final bill by supporting the Excellence in Mental Health Act (S. 264). This legislation would establish national standards of care and increased accountability for mental health and addictions services provided by qualified organizations, which would be designated as Federally Qualified Behavioral Health Centers. These centers would have the ability to acquire the resources and skilled staff that people with mental illness and addictions need and deserve.

If we want to truly improve our nation's mental health services today's Congress can learn from their predecessors who passed JFK's historic mental health legislation. Progress must occur, or those struggling with poverty, domestic violence, bullying, depression, addiction, self-harm, abuse, neglect, and lifetimes of trauma will not survive and neither will our neighborhoods.

Please visit www.ccab.org to learn more about our work.

Debbie Rambo, LICSW, is the president of Catholic Charities of the Archdiocese of Boston.

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