(12-31-17) Who were the most impactful mental health players during 2017? While many come to mind, my choices are Dr. Elinore F. McCance-Katz and Mary Giliberti.
Both faced considerable challenges and overcame them.
The White House named Dr. McCance-Katz the first-ever Assistant Secretary of Health and Human Services for Mental Health and Substance Abuse in August even though she found herself being publicly opposed by then-Pennsylvania Rep. Tim Murphy, the Republican congressman most responsible for creating that job.
(Ironically, before the end of the year both HHS Secretary Tom Price, who swore her in, and Rep. Murphy, each had become entangled in separate highly publicized scandals that led to them departing Washington.)
Since taking charge Dr. McCance-Katz has overseen publication of the first Congressionally mandated annual report about federal mental health and substance abuse recovery programs and quietly started steering the Substance Abuse and Mental Health Services Administration in a different direction. Before taking office, Dr. McCance-Katz had sharply criticized SAMHSA in a Psychiatric Times commentary , writing:
“There is a perceptible hostility toward psychiatric medicine: a resistance to addressing the treatment needs of those with serious mental illness and a questioning by some at SAMHSA as to whether mental disorders even exist—for example, is psychosis just a “different way of thinking for some experiencing stress?”
From what I’m hearing, Dr. McCance-Katz has been building bridges with those deeply entrenched bureaucrats in SAMHSA who were the targets of her comments while working on improving morale at a federal agency that its own employees once had rated near the bottom ranks when it came to being a good place to work.
Mary Giliberti also faced internal drama during 2017 when the executive director of the National Alliance on Mental Illness came under fire by former NAMI Board Member D. J. Jaffe and three other well-known advocates who ran for the NAMI board of directors on what they called a “Focus on Serious Mental Illness” platform.
A Harvard and Yale Law School graduate, who once worked for both NAMI and also the Bazelon Center for Mental Health Law, Giliberti and the current board were accused by the Jaffe slate of turning NAMI away from its traditional focus on schizophrenia, bipolar disorder and major depression (the three big serious mental illnesses) by opening its rolls to “a wide range of ‘conditions’ that NAMI now claims to represent even though there are scores of other organizations advocating for them.”
Five seats were open on the NAMI board and Jaffe’s slate was hoping to take all five because it was spiritually aligned with a fifth candidate employed by the Treatment Advocacy Center. Their campaign prompted NAMI’s board president to send out a “big tent” letter reproaching them while one state NAMI leader attacked Jaffe’s group by name, even though NAMI policy prohibits such internal campaigning.
Tempers flared and some 1,600 individuals signed an online petition demanding NAMI and Giliberti return their focus on SMIs (serious mental illnesses) but when the ballots were counted, those challenging the board and her leadership failed to win a single board seat.
Since that flare-up, Giliberti has worked diligently to reunite NAMI, explaining that while serious mental illnesses will always be at the core of the organization, NAMI will not turn its back on others who need mental health treatment because of less life impairing problems.
During 2018, Dr. McCance-Katz and Director Giliberti will continue to face the daunting tasks of unifying those they lead.
Under the 21st Century Cures Act, Dr. McCance-Katz is responsible for bringing federal bureaucrats that administer nearly 100 federal programs to the table to better coordinate their actions. That’s going to be much tougher now that Rep. Murphy is gone. Plus, the White House has shown little urgency in replacing Tom Price at HHS. (Except for the Department of Housing and Urban Development, the other seven federal agencies have only shown lip service in working together. The Department of Education didn’t bother to show up at the last meeting of the Interdepartmental Serious Mental Illness and Serious Emotional Disturbance Committee, which is supposed to oversee federal reforms and coordination.)
Meanwhile, NAMI’s Giliberti must deal with her organization’s long simmering identity crisis. Initially founded by parents, NAMI has added more persons with lived experiences to its ranks and has branched out to address trauma and mental health issues such as those faced by the LGBTQ community. Even though sexual orientation is certainly not considered a mental illness, prejudice against LGBTQ members can result in depression and other mental health problems.
Both Dr. McCance-Katz and Director Giliberti were tested by fire during 2017. I suspect that will continue during 2018. For the sake of all of us who care about improving our fractured mental health care system, I hope they do well.
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