Mental Illness and Inequality in Medical Care
There have been many steps taken over the years to understand mental illness and to help treat those affected. Varcarolis (in Stanley, 2009) notes that in 1946, the National Mental Health Act made federal funds available for mental health research, education, and care; the 1940s and 1950s saw psychiatric journals publish information about guidelines for treatment; and the 1990s made available a wide range of medications to treat specific mental disorders, as well as promote the idea that many mental illnesses were caused by neurological or biological processes, making them effectively “medical” problems, as well.
Still, the stigma surrounding mental health remains (Close, 2009), and the result is that two two-tiered systems of medical care have developed – in the first, one for “medical” illnesses and one for mental illnesses, and in the second, one for those who can afford treatment and one for those who can’t (Henslin, 2008). At issue is whether we have a fundamental right to equal treatment or whether it is a privilege, one to be paid for only by those who can afford it. On the one hand, Democratic Representative Dennis Kucinich (in ProCon.org, 2012) says, “Health care is a legitimate function of our government. Health care is a basic right in a Democratic society. It is no more a privilege based on ability to pay than is the right to vote, which was once accorded only to property owners.” On the other hand, Republican Representative John Campbell (also in ProCon.org, 2012) says, “Rights are not about giving you something for free; they are about protecting natural liberties from those who would take them away from you.”
It is true that there is a certain cost for mental health services provided, just as there are for “medical” services. However, in the case of those who can’t afford such services, should we expect that they should somehow make do without? How does that affect our concept of democracy, and what does that say about our responsibilities to protect the social welfare, something guaranteed by the U.S. Constitution? Perhaps we should treat such costs as we do taxes – each person should pay according to his/her ability to do so. It would not be a new tax, something the American people vigorously oppose, but, rather, it might be incorporated as a part of a universal health insurance system. In this way, it would protect the poor while not causing an undue hardship for the rich. It would also develop an inclusive society while reducing the medical costs associated with indigent populations, such as the Medicaid program and the underwriting of public clinics.
No matter what we decide to do, open discussion and education are the keys. The more we know about mental illness, its causes, and its treatments, the better able we will be to help those who are affected and society as a whole.
References
(2012). Should all Americans have the right (be entitled) to health care? ProCon.org. Retrieved from http://healthcare.procon.org/view.answers.php?questionID=001602
Close, G. (2009). Mental Illness: The Stigma of Silence. Huffington Post. Retrieved from http://www.huffingtonpost.com/glenn-close/mental-illness-the-stigma_b_328591.html
Henslin, J.M. (2008). Mental Illness and Inequality in Medical Care. In Essentials of Sociology: A Down-to-Earth Approach (8th ed.), (225). New York, NY: Allyn & Bacon.
Stanley, L.D. (2009). A Brief History of Mental Health Care. Yahoo Voices. Retrieved from http://voices.yahoo.com/a-brief-history-mental-health-care-3882446.html
