LETTER TO SENATOR WYDEN/SENATE COMMITTEE ON FINANCE by Dede Ranahan

November 1, 2021

Dear Senator Ron Wyden, and other members of the Committee on Finance:

This is in response to your request for input from stakeholders to help you better understand how Congress can address behavioral health care challenges.

First, thank you, Senator Wyden, for keeping at it. I’m sure you don’t remember, but back in the late 1990s you intervened for my son who was delusional and psychotic in Oregon. He died in a California hospital psych ward in 2014. He never did receive the help he needed for schizo-affective disorder. In the interim, I became a mother bear and mental illness activist. I’ve written two award-winning books, Sooner Than Tomorrow — A Mother’s Diary About Mental Illness, Family, and Everyday Life (Nautilus Book Awards Gold Medal Winner, Memoir, 2019) and Tomorrow Was Yesterday, Explosive First-Person Indictments of the US Mental Health System — Mothers Across the Nation Tell It Like It Is (Nautilus Book Awards Silver Medal Winner, Social Change, Social Justice 2020). The second book includes stories from 65 mothers from 28 states, and a fifteen-point plan to address serious mental illness (SMI - schizophrenia, schizo-affective disorder, bipolar disorder, clinical depression, etc.). The plan was developed in 2019 by advocates/activists from across the country.

In January 2021, 150 Tomorrow Was Yesterday readers, from every state in the nation, volunteered to send a copy of the book to the White House (Joe Biden, Jill Biden, Kamala Harris, Xavier Becerra, and individual legislators) thinking 150 copies of the same book from every state might get someone’s attention. Five months later, we all began receiving form letters from the White House thanking us for our “gifts” and for welcoming Joe Biden to the Presidency. No mention of the topic. No reference to the books. It was hurtful and insulting.

The 15-part plan was prioritized by the participants. The number 1 priority on their list is to "Reclassify Serious Mental Illness (SMI) from a Behavioral Condition to what it is, a Neurological Medical Condition." Until we look at SMI through a biological/physical lens, the significant changes we users of the system need will not happen.

I’m not trying to specifically address the questions you’ve posed in your letter. The SMI Plan cuts through all of them. More significantly, it raises issues not included in your list. The suffering in the SMI community (11-13 million diagnosed individuals plus their families) is intense. We’re screaming to the heavens for help. So far, no one seems to be listening.

Summary from Tomorrow Was Yesterday:
“As it stands today, the US mental health/illness system is filled with political landmines and gut-wrenching divisions: parents vs. children, peer organizations vs. family organizations, voluntary vs. involuntary treatment concepts, psychiatrist vs. psychologist turf wars, state vs. federal jurisdictions, HIPAA restrictions vs. parental rights, lack of beds vs. incarceration, unions vs. providers, psychiatry vs. anti-psychiatry, civil rights vs. dying with your rights on, NIMBYism vs. housing, traditional medicine vs. holistic medicine, and funded advocacy organization vs. unfunded grassroots advocacy efforts. I watched my son Pat die because the system is tied up in bureaucratic and philosophical knots.”

I would be happy to send you a copy of Tomorrow Was Yesterday which includes the 15-point plan to address SMI. My hope is that you, and others on the committee, might read our stories, take the plan seriously, and pursue some of its recommendations. It’s a beginning. It’s from the people in the trenches -- the sufferers, the families, the folks the system is supposed to help.

Thank you for reaching out. Let me know if/where I should send a copy of Tomorrow Was Yesterday.

Sincerely,
Dede Ranahan

Available on Amazon.

PLEASE HELP US REACH THE 2020 PRESIDENTIAL CANDIDATES by Dede Ranahan

Sooner Than Tomorrow Readers,

I’ve been working hard the last couple of weeks, with advocates from across the country, in the development of this Five-Part Plan. Individuals, professionals, writers, journalists, and mothers (always the mothers) have been brainstorming and refining this document. Our intent is to get it in front of every 2020 presidential candidate - Republican, Democrat, Independent. Our goal is to encourage them to talk about serious mental illness (SMI) on the campaign trail and in their debates, and to include a SMI plan on their websites. Right now, no candidate is talking about SMI. It’s as if it didn’t exist.

These are baby steps. We can’t address everything that needs to be addressed in our messed up mental illness system, but we have to start somewhere. We’re trying to help the candidates along. If they don’t have SMI on their radar before the election, they probably won’t have it on their radar once elected.

If you agree with the positions in this plan, and would like to send it to politicians of your choice, send me an email and I’ll email the documents (cover letter, plan, an attachment) back to you (dede@soonerthantomorrow.com). The more individual voters the candidates hear from the better.

I, and many others, would really appreciate your support. Dede

A FIVE-PART PLAN TO ADDRESS SERIOUS MENTAL ILLNESS (SMI)
FOR ALL 2020 PRESIDENTIAL CANDIDATES

PLEASE ADDRESS THESE TOPICS IN YOUR CAMPAIGN APPEARANCES AND DEBATES

1. RECLASSIFY SERIOUS MENTAL ILLNESS (SMI) FROM A BEHAVIORAL CONDITION TO WHAT IT IS,  A NEUROLOGICAL MEDICAL CONDITION

WHY RECLASSIFICATION IS IMPORTANT

Reclassification will unlock more research funding and help eliminate discrimination in treatment, insurance reimbursement, and the perception of SMI as “behavioral” condition. SMI is a human rights issue. NIMH ranks SMI among the top 15 causes of disability worldwide with an average lifespan reduction of 28 years.

PRESIDENTIAL ACTION

* Create a cabinet position exclusively focused on SMI.

* Push for Congressional appropriations to include schizophrenia in a CDC program that collects data on the prevalence and risk factors of neurological conditions in the US population.

2. REFORM THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA)

WHY HIPAA REFORM IS IMPORTANT

Overly strict HIPAA laws make it extremely difficult for families and caregivers to partner in the treatment of their loved ones, resulting in important life-saving medical information gaps. By eliminating this barrier, family support will be strengthened, reducing the chance of relapse, homelessness, imprisonment, and death.

PRESIDENTIAL ACTION

* Work with legislators to change HIPAA law to ensure mental health professionals are legally permitted to share and receive critical diagnostic criteria and treatment information with/from parents or caregivers of SMI.

3. REPEAL MEDICAID’S INSTITUTES FOR MENTAL DISEASE EXCLUSION (IMD)

WHY IMD REPEAL IS IMPORTANT

IMD repeal will increase the availability of psychiatric inpatient beds. The IMD exclusion is not only discriminatory of those suffering from neurological brain disorders, it is a leading cause of our national psychiatric hospital bed shortage. It prohibits Medicaid payments to states for those receiving psychiatric care in a facility with more than 16 beds who are 21-65, the age group with the most SMI.

PRESIDENTIAL ACTION

* Work with legislators to repeal the IMD exclusion.

4. PROVIDE A FULL CONTINUUM OF CARE

WHY A FULL CONTINUUM OF CARE IS IMPORTANT

A continuum of care insures that SMI patients receive early intervention at all stages of their illnesses, long-term care when needed, and follow-up treatment (medications and therapies) when they’re released. It reduces visits to jails, ER’s and hospitals, homelessness, and morgues. A continuum of care provides life-time management.

PRESIDENTIAL ACTION

* Create federal incentives to states which are addressing a full array of inpatient, outpatient, and supportive housing care. 

5. DECRIMINALIZE SERIOUS MENTAL ILLNESS (SMI)

WHY DECRIMINALIZATION OF SMI IS IMPORTANT

People suffering with other neurological conditions like Alzheimer’s and dementia can get treatment promptly without being kicked out of their homes to wander the streets until they are arrested and put in jail or prison rather than a hospital. Serious mental illness is the only disease where the doors to treatment are shut unless a crime is committed. This is pure and simple discrimination with the disastrous results we see in our country today — homelessness, incarceration, the disintegration of families, and death.

PRESIDENTIAL ACTION

*Work with legislators to change “must be a danger to self or others” criteria.

*Work with legislators to change involuntary commitment criteria, alleviating the subjective nature of “gravely disabled” and redefining it in objective terms based on scientific medical need for treatment. Psychosis, like a stroke, is a traumatic brain injury and needs immediate treatment for the best outcome.

Me and The Jazz

Me and The Jazz