Red Fish in a Sea of Blue

I’m a Republican and I care as much about behavioral health as any Democrat I’ve met. Despite preconceptions we may have about each other, there are areas of agreement when it comes to the importance of helping those with mental health and substance use disorders. Just because the solutions may be different, doesn’t mean the goal isn’t the same. Last year I attended my first conference as a new consultant working in behavioral healthcare. Though new to the industry as a professional, I have a lifetime’s experience personally. My brother has a severe mental illness and my family has rallied to support his treatment and recovery for the past 25 years. I spent 21 years in the Marine Corps as an aviator, communications officer, international military representative, foreign engagements subject matter expert and multi-national training and exercise evaluator and program manager. I retired as a Lt. Colonel. The military, in general, is made up of individuals with more conservative leanings, and as an organization spends considerable effort, time and monies on physical, spiritual, and mental health. We know that there are significant issues with returning soldiers and their families, with post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), depression, substance use disorders, and suicide. We know we have room for improvement. By the end of my first conference, I felt like the only red fish in a sea of blue. To say that I was shocked by how “blue/Democratic” the overall tenor of the conference was would be an understatement. For example, there were several speakers that made jokes disparaging Republicans during their remarks. Even more surprising, I felt that, as a Republican and someone with conservative beliefs, my ideas weren’t welcome. Later in the year, I attended the National Council’s Hill Day. I was excited and grateful for the inclusion of the opening keynote speaker, Nicolle Wallace. Nicolle is the current anchor of Deadline: White House, and the chief political analyst for MSNBC and NBC News. She also served as the White House Communications Director for President George W. Bush including his 2004 re-election campaign and she served as senior advisor for John McCain’s 2008 presidential campaign. For me, she was a breath of fresh air. Throughout the week, I thought the organizers did a good job balancing recognition of both Democrats and Republicans as champions of behavioral healthcare. While the program was balanced, many of the interactions and conversations with other attendees were less so. Many of the people I interacted with or was just standing in line next to while waiting to get into a Senate building, were comfortable openly, and nastily disparaging Republican voters. I wanted to tap them on the shoulder and say, “Hey, just so you know, you’re talking about me. And for the record, I don’t think like that and I’m not like that at all. Maybe you should ask a Republican what they think before you default to bad-mouthing them. You may be surprised you know more conservatives than you think.” Of course, I didn’t say that. I didn’t say anything, but I walked away upset and disheartened realizing that something like mental illness, which doesn’t discriminate, could be so divisive and politicalized. And at a time and in a place where we were trying to find non-partisan solutions to a common problem, a common passion. In a later conversation, I commented that it would be nice if some of these programs included means by which we could help people get an education and back to work. One of the women at our table responded, “That’s so Republican. All they’re concerned about is getting people back to work.” Yes, I am concerned about getting people back to work. There are sometimes significant barriers people face in getting a job (language, education, disabilities, etc.). I also recognize that having a job doesn’t necessarily mean you have access to the health care and behavioral health supports you need, but it’s well worth the effort to address these serious issues, it’s a shared goal. There’s tremendous value in being able to work, to support yourself and your family, to having an accomplishment, and yes, even to be a “productive, contributing member of society.” Work has intrinsic value. It makes people feel good about themselves and provides a sense of purpose and community. Employment offers social connectedness and a group of people that can notice when things aren’t right and can be a resource in difficult circumstances. Work is an important part of a SAMHSA recovery-oriented system of care. I’m pretty confident and don’t mind being outspoken but I most certainly felt like the outsider. And I felt like my ideas weren’t welcome. I’m a red fish in a sea of blue and I care about mental health and addiction issues. I don’t think people should “pull themselves up by their bootstraps” alone without support. The current Republican administration has made a tremendous commitment to substance use disorders, supporting (and funding) prevention, treatment, and recovery supports. I believe sometimes people are trying to shove a round peg into a square hole. Take Medicare for All: if it becomes a reality, it wouldn’t solve all our problems. If people can’t access services, or are afraid to reach out for help, or don’t know where to go, or can’t get to the care they need, throwing all the money in the world at it isn’t going to make things better. As you’ll read in my interview with Brent McGinty, CEO of the Missouri Coalition for Community Behavioral Healthcare, Missouri has very purple solutions. I like the way Missouri has dealt with Medicaid expansion and providing services to the populations that need it. It’s not one size fits all. But it is a good fit. Health care solutions generally, and behavioral healthcare specifically, are very complicated issues and because people aren’t spending the time talking to one another to figure out how to get people the resources they need, it becomes a perpetual political fight. It’s my side vs. your side and it’s really the people that are hurting in that struggle between political parties. Listening, good communication, and cooperation, on the other hand, does help to solve the problem and often results in the most innovative and successful solutions. So, the next time you find yourself considering solutions in the complex world of behavioral health care, consider talking to someone whose ideas might be different than yours. You might be surprised to find an ally.


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