Behind The Rhetoric

Presents the politics of mental health and the mental health of politics or politicians in the United States. Discussion on the politics of policy; Personality analysis of the presidential candidates. INSETS: READING BETWEEN THE LINES; READING THEIR LIPS.

By Sarah Blustain, Christopher Peterson, Fiona Lee, published on September 01, 2000

The rights and resources of people with mental illnesses have taken theirlong-overdue place in American politics. The Surgeon General's office issued its first Report on Mental Health (there have been 22 on smoking) and the White House hosted its first-ever conference on mental health, both under the guidance of the vice president's wife, Tipper Gore. At the state and national level, grassroots advocacy to increase funding and support--and decrease prejudice--for the mentally ill is gaining momentum. And as the presidential campaign evolves, voters now have every reason to expect the candidates to take these issues seriously.

At the same time, questions of mental health and character are being applied increasingly to our leaders. In this age of scripted, media-savvy campaigns, how can we decode the political language and political expressions of our candidates to make sure we're getting the leader we want? Political psychology can help. Here, PSYCHOLOGY TODAY presents the politics of mental health, and the mental health of politics (or politicians, anyway).

The Politics of Policy

In February, when the National Mental Health Association (NMHA) put out its report card on the presidential candidates' health plans, Vice President Albert Gore got an A-, while Governor George Bush received an F+.

It seemed that anyone voting on the basis of mental health policy had a clear choice. During his vice presidency, Al Gore and wife Tipper had become the gold standard for mental health advocates. The couple had emerged as leaders in the fight against mental illness stigma, and had promoted legislation that would increase resources and protection for the mentally ill.

In 1996, Tipper Gore came forward with the story of her own mother's serious depression (and periodic hospitalization) in her book Picture This: A Visual Diary. Three years later, she disclosed her own clinical depression, brought on when the couple's 6-year-old son was hit by a car. President Clinton appointed her Mental Health Policy Advisor, and she helped bring forth the first-ever Surgeon General's Report on Mental Illness. And in June 1999, she and the vice president created the first-ever White House conference on mental illness, where they were joined by the president and first lady in a day of discussions that culminated in the announcement that all federal employees would heretofore receive insurance coverage for mental illnesses on par with other illnesses. Whatever else might be said, the vice president had mental illness on his radar screen.

"Having Al Gore and Tipper, who are good parents and respectable people, talk about mental health issues has made my job so much easier," says Kim McPherson, policy advocate for the Mental Health Association in Bush's home state of Texas. The public relations benefits are immeasurable, she says, when the spokespeople could easily be the couple next door.

The NMHA's report card, however, is already outdated, and it turns out Governor Bush may deserve a higher mark. While mental health advocates in Texas who have worked with Bush don't call him a leader on these issues, they do credit him with some major shifts in state legislation, policy and funding that have benefited the disabled community,

"He definitely isn't in the forward movement, carrying the banner," comments Joe Lovelace, advocacy coordinator for the National Alliance for the Mentally Ill-Texas. "But he's also not an extreme right-winger who believes that mental illness is nothing more than a character flaw."

When George Bush was president, he signed a proclamation declaring the 1990s the "Decade of the Brain." What has his son done to promote that? In 1997, George W. signed the Texas parity law, becoming the first Republican governor to do so. In 1999, responding to state-funded research proving the efficacy of new-generation medications for severe mental illness, he recommended allocating tens of millions of state dollars. When the negotiating was done, $70 million in additional funding was added to provide new-generation medications and community support organizations for the poor.

Texas' Health and Human Services Commissioner Don Gilbert, a Bush appointee, also praises the governor for decentralizing supports for the mentally ill, a move aimed at handing over care to local organizations, which may know better than state offices what's needed in their regions. When Bush took office, Gilbert recounts, nearly half the counties in Texas had services provided directly by the state. By year's end, he told PSYCHOLOGY TODAY, all these supports will be offered by local organizations, supervised by the state.

On the other hand, advocates for the mentally ill say Governor Bush's actions have not been entirely to their liking. According to NAMI, even with the new appropriations, Texas ranks 43rd in the 50 states for per capita spending on mental health services; Texas State Representative Garnet Coleman has been frustrated by recent efforts to get more funding for people with bipolar disorder and schizophrenia; and in 1999, Bush authorized his attorney general to file a friend of the court brief in the Olmstead case in the Supreme Court that could chip away at protections for the disabled and the mentally ill in the Americans With Disabilities Act.