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Can scare tactics sell the state on mental health funding?

Will the Washington Legislature have to bail out any state pension funds? Credit: Wikipedia contributor Cacophany

Early in December, the state's SEIU Healthcare union delivered a report to the legislature predicting the tragic impact of cuts to mental health care services. The cover imagery of “Don’t Look Away” was literally ripped from the headlines of news stories about murders committed by people with mental illnesses.

The not-so-subtle message was, “Don’t Look Away or you might be killed,” said Jennifer Stuber at the UW’s Washington State Coalition to Improve Mental Health Reporting. The coalition sent union officials a letter of concern about the report, signed by nearly 300 Washington mental health professionals, advocates, and clients. Stuber, a UW assistant professor of social work, said, “I think it’s really important to change the discourse within the mental health community and model what we’re hoping journalists will do. There are other effective ways to argue why these services are important.”

Jonathan Rosenblum, assistant to the president of SEIU Healthcare 1199NW, told me the report had to be dramatic because “a more subtle appeal won’t work. The budget is too tight.” The cover “is a way of getting people to read the inside. We were very clear, and it’s right there in the summary, and it’s a well-known fact, that most people with mental illnesses are peaceful, functioning members of the community.”

As for the stories referenced in the cover imagery, he said, “The root cause was the failure of the system. These are not merely random acts of violence. They happen because our programs … are underfunded.”

But Amnon Shoenfeld, who directs King County’s mental health services division, said that “the cover is incendiary and makes the public afraid of people with mental illnesses. Funding for treatment should be provided [not because citizens are afraid but] because treating people’s illnesses is the right thing to do.”

Stuber worries that instead of strengthening political will to fund mental health care, the report weakens it. Associating mental illness with violent behavior creates “a huge barrier to funding services adequately. Why would people want to spend money” on a group presented so unfavorably? She said her larger concern is about the long-term consequences of stigma aroused by the report, especially when reinforced by prevailing media images of mental illness. Stigma "sets up barriers to housing, jobs, forming relationships — it really sets people back. And individuals who are ill won't seek help because they don't want to be considered one of 'those' people."

Providers of mental-health services who signed Stuber’s letter prefaced their remarks to me with praise for SEIU Healthcare’s perennial efforts to secure enlightened care for people with mental illnesses. But John Masterson, CEO of Behavioral Health Resources (BHR), said he was startled when he saw the cover and some later media segments about the report that used graphic video. "Promoting these images for funding … can harm clients. What if someone believes they’re in need of mental health care and are afraid to show up [at a treatment center] because they think other clients will be dangerous?”

Navos CEO David Johnson said, “Fear-based politics in America has led to poor decisions. It’s tempting to use fear to prompt action, but so much is lost when we take that path. So I was sad to see the cover of this publication…. This is one of those learning moments when we can say we can do better.”

Everyone quoted in this article mentioned the lurid media coverage of SEIU Healthcare’s press conference about “Don’t Look Away” at the State Capitol. A Fox13 reporter discussing the event waved a kitchen knife at the camera as she described how a man with schizophrenia had recently attacked a passerby.

Later, The Stranger explained “How a decimated state budget equals more unmedicated loons with hatchets.” (Proof, if you needed it, that people with mental illnesses may be the only group of human beings the media feel perfectly free to call names. Would a Stranger headline warning about STDs and male-male sex without condoms contain the phrase “unprotected fairies with AIDS”? How about an obesity epidemic story concerning "unrestrained fatties with popsicles"?)

Rosenblum, pointing to my article on psychiatric care at Monroe prison, said, “All of us who advocate for better mental health care have a tough job to do, connecting the dots with the general public without causing more fear of ‘the Other.’” There's "always a fine line between hauling out the crisis and stigmatizing,” he said. “It’s a legitimate concern to raise, to say we didn’t find that sweet spot."

However, he emphasized that what advocacy “does not need is a lot of ‘he-said-she-said’ about stigmatizing. We need to work together.”

And that’s true, too.

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