Guest Columnist

Buttigieg: A plan to address Iowa's mental health care, addiction crisis

South Bend's Mayor Pete Buttigieg speaks during a rally to announce his 2020 Democratic presidential candidacy in South Bend, Indiana, U.S., April 14, 2019. REUTERS/John Gress
South Bend's Mayor Pete Buttigieg speaks during a rally to announce his 2020 Democratic presidential candidacy in South Bend, Indiana, U.S., April 14, 2019. REUTERS/John Gress

A month ago, at an AARP forum in Council Bluffs, I was asked a question that comes up again and again in Iowa: How do we address the crisis in providing access to needed mental health care for our communities?

This isn’t a small challenge. Almost a fifth of Hawkeye State residents live with some form of mental illness. We are failing our family members, friends, and neighbors. And we’re especially failing our young people, when nearly 30 percent of high school students report feeling sad or hopeless almost every day for two weeks in a row. It’s no wonder nearly three-quarters of Iowans report being concerned about the state mental health system’s ability to handle this crisis.

But Iowa isn’t alone. This is an American epidemic — one that’s been building for years. We see in the Native American woman suffering from post-traumatic stress disorder and in the young LGBTQ person who is almost five times more likely than a straight classmate to attempt suicide. It hits home as 20 veterans and active service members take their lives each day, including ones I’ve known and served with. These so-called “deaths of despair” have led to the longest sustained decline in life expectancy in this country since the First World War.

This crisis is largely the result of years of neglect by political leaders in Washington, who claim to prioritize mental health while simultaneously seeking to slash funding for treatment. Our health care system is so broken — and our approach so fragmented and often punitive — that fewer than one in five Americans with a substance use disorder and two in five with a mental illness receive treatment.,

It’s a crisis of care. But more than that, it’s a crisis of not caring. And it must end. To meet this urgent national challenge, we need a new approach to providing mental health and addiction care. That will require a true national commitment to treat this as the crisis it is, rooted in strengthening communities so that everyone feels they have the support and resources to heal. Today, I’m proposing a plan to do just that.

Tackling this crisis begins by empowering each community to prioritize and provide evidence-based approaches to issues most relevant to their own mental health and well-being. Through $10 billion annual Healing and Belonging grants, we’ll encourage our communities to leverage their ingenuity and on-the-ground expertise to help improve health. Keokuk might invest in training schools and teachers to better recognize and manage mental illness in their students. Cedar Rapids might expand its existing crisis intervention team, which embeds a mental health liaison in the police force.

We’ll also create a more integrated approach to care that will allow for universal access to mental health and addiction coverage. We’ll incentivize greater integration of primary care and mental health care. And we will finally enforce mental health parity — meaning that if a health plan offers unlimited doctor visits for a physical condition, it must do the same for a mental health condition — by penalizing insurance companies that do not comply.

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At the same time, we will tackle the opioid epidemic head-on. Having seen how lives in my city were saved when we equipped South Bend first responders with Narcan, we’ll ensure universal access to medication-assisted treatment — and hold drug companies accountable for exacerbating the epidemic in the first place.

We’ll also address the shocking gap in mental health resources across the state. When 72 areas across Iowa have a mental health worker shortage — and when your life might depend on whether you have access to the care you need — we need all hands on deck. So our plan will prepare not only more medical and mental health professionals but entire communities. We’ll train police forces to identify mental illness, so someone in crisis ends up in treatment rather than in jail. We’ll require every school across the country to teach Mental Health First Aid courses, and train teachers and school staff to know how to help students. And we’ll work to break the silence and stigma around these issues and bring its victims out of the shadows.

Finally, we will take on mental illness and addiction by addressing the deeper crisis of belonging in this country. That starts with a national campaign to counter isolation and alienation, raising awareness while supporting those most at risk. Through our national service program, we’ll work to knit together our social fabric so that Americans can find meaning in assisting others — including through a Community Health Corps to help those dealing with addiction and mental illness.

The Iowans I’ve met are ready to meet this crisis with thoughtful, innovative, and locally-driven solutions. When I’m President, the federal government will too.

• Pete Buttigieg is mayor of South Bend, Ind. and a candidate for the Democratic presidential nomination.

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