“Equal Opportunity to Pursue the American Dream” by Dr. Rajiv Tandon, President of NAMI Florida
Dr. Tandon gave this speech during National Mental Health and Dignity Day, 2016.
STIGMA = DISCRIMINATION
More than two centuries ago, our founding fathers laid the basis for our great nation with these introductory words “We hold these truths to be self-evident, that all men are created equal… .” Throughout our history, we have been a beacon of freedom and liberty in the world defending the civil rights of every human being inhabiting our planet. Yet in our own country, we have had to continually fight to ensure that all citizens of our hallowed land are truly free to exercise their unalienable rights of life, liberty, and the pursuit of happiness. A new battle needs to be fought about every 50 years. 150 years ago, our 16th President Abraham Lincoln issued the Emancipation proclamation abolishing slavery leading to the 15th amendment explicitly recognizing the right of Black Americans to vote. Around that time, the women’s suffrage movement began culminating in the 19th amendment 50 years later that explicitly recognized every woman’s right to vote. That was 100 years ago. Fifty years later, Martin Luther King led the march in Selma that led to the Civil Rights Act and the 24th amendment abolishing poll taxes and other obstacles that impeded the ability of black Americans to vote. And while our work to ensure equal freedoms for people irrespective of color or gender is not fully complete, we are in a much better place today. As we consider our generation’s challenge in forming a more perfect union, one large group of people in our country suffers pervasive discrimination. 25 million citizens with severe mental illness are systematically discriminated against in multiple spheres of life- opportunities for education, employment, and housing; access to healthcare; ability to vote and other legal rights. What is even more alarming is the fact that the gap between this group and the rest of the population has been increasing—for example, the gap in life-span between persons with severe mental illness and the rest of the population has increased from 12 to 20 years over the past three decades. Fifty years ago, President Kennedy signed the Community Mental Health Centers Act to “liberate” persons with mental illness from large psychiatric hospitals, but today many are incarcerated in jails and prisons or comprise a big part of our growing homeless population. Persons with mental illness have poor access to healthcare, receive lower quality care when they get it, and are often recipients of abuse and maltreatment. Systematic discrimination against them in employment and housing is rampant. Their right to exercise legal capacity is often denied and barriers are placed in their ability to vote.
There are many ironies in this systematic societal discrimination against persons with mental illness. Mental illness affects many of those functions that we consider central to our identity as human beings-our ability to think and plan, experience and express emotion, relate to others, have a sense of ourselves, distinguish reality from imagination, etc. The broad range of mental illnesses has one thing in common—the organ that malfunctions is the Brain. The fact that mental illness is common (affecting one in four people over one’s lifetime) should not be surprising as the brain is the most complex and intricate organ of all; while it is extremely resilient, it can and does malfunction. It can be repaired! Today, we have effective treatments for various mental illnesses that enable individuals to lead very productive lives—if society gave them a chance, an equal chance. Because of our systematic discrimination, the enormous human waste is staggering—both personal and social.
Conditions in our state of Florida are particularly dismal. We are ranked 49th among the 50 states in terms of per capita spending on mental health. Our state’s rank in terms of its mental health system slipped from a C to a D six years ago and remains there today. And we score an F for health promotion and measurement. Reports of blatant abuse of persons with mental illness in our jails and prisons are increasingly frequent as are reports of poor quality mental and other healthcare they receive leading to preventable deaths and high mortality. Almost half of our growing homeless population suffers from some mental illness. ENOUGH, this is unconscionable. This is a moral issue, a human rights issue!
The recently concluded legislative session saw a modest beginning to the process of repairing our broken mental health system. With the Governor’s signature, both Senate Bill 12 and House Bill 439 will become Florida law. The purpose of both bills is to improve access to quality mental health and substance abuse services, define clear performance standards, align and simplify the Baker and Marchman Acts, increase accountability at all levels, and reduce inappropriate and wasteful incarceration of individuals with mental illness in our jails and prisons. We owe a special gratitude to Judge Leifman, Associate Administrative Judge in the nth Judicial Circuit in Miami and the Chair of the Florida Supreme Court Task Force on Mental Health and Substance Abuse, who has been a strong
advocate for improving mental health services for Florida’s citizens for over a decade. We thank the legislature and the Governor for their recognition of the importance of mental health issues and the leadership of Senators Rene Garcia and Lisbeth Benacquisto and Representatives Gayle Harrell, Charles McBurney, and Kathleen Peters in the Florida senate and house, respectively. Overall funding for state mental health services was increased by about 65 million dollars; this needs to be considered in the context of a decrement of 700 million dollars in inflation-adjusted state expenditure on mental health over the past 15 years. We are second-to-last in per-person state expenditure on mental health and will remain there with this small increase. THERE IS A LOT MORE TO DO EVEN AS WE HAVE MADE A GOOD SMALL START. MENTAL HEALTH IS EVERY FLORIDIAN’S ISSUE.
On this occasion of National Mental Health and Dignity Day, NAMI Florida is launching a civil rights campaign to demand “Full Citizenship” for all who are impacted by mental illness. We ask for equal treatment- not special treatment. We demand our equal opportunity to pursue the American dream and meaningfully contribute to society. NAMI Florida is initiating a one-year civil rights campaign to fight against the systematic discrimination against persons with mental illness. We are encouraged by the interest shown by the Florida legislature in improving the quality of mental healthcare in our state and putting a stop to the gross injustice against persons with mental illness. NAMI Florida has developed a mental health platform and will provide an information package to guide voters about mental health friendly candidates.
Today, we recognize the enormous strength and dignity of persons with mental illness who inspire us. Even as we applaud their resilience in the face of enormous challenges, we promise to make things right.
NAMI Florida’s public awareness campaign focuses on the following areas:
HEALTHCARE: There must be mandatory coverage and full parity for mental illnesses that is equal in scope and duration to coverage of other illnesses, without limits more restrictive than those required for other illnesses or disorders, and covers all clinically effective treatments appropriate to the needs of individuals with mental illnesses.
HOUSING: Persons living with mental illnesses have no less rights to dignity, privacy, security and stability in their living arrangements. They should not be at risk of losing housing during periods of crisis, hospitalization or inpatient treatment.
EMPLOYMENT: People living with mental illnesses have the right to be meaningfully employed, including continuation and advancement on the job.
EDUCATION: People living with mental illness must have full and fair access to education, continuing education, vocational rehabilitation, training, professional development, personal development, employment, and business assistance.