Sunday, November 4, 2018

Mental Health Voting in 2018

Obligatory voting selfie
Like a whole lot of the rest of the country, I've been hearing a ton about voting these days. 

It's midterm election season, of course, and races all over the country are being closely watched. I've been thinking and posting quite a bit about voting in order to work toward a better mental health system. As I've shared my story of mental health struggles and recovery over the past year, I've become increasingly aware of the need to challenge the systemic brokenness of our mental healthcare system in this country. We can't encourage people to challenge stigma by sharing their stories if we're not also working to break down the barriers to care that keep people sick and silent. 

And so as I shared on social media, I voted this year thinking about mental health, about protections for millions of people like myself with preexisting conditions, about the Medicaid expansion that I relied on for health care coverage during an important time of my life:


But what does it mean to vote for a better mental health system? NAMI, the National Alliance on Mental Illness, has some good information on their #Vote4MentalHealth website.  And while I'll be trying to articulate some more thorough responses to that question throughout this year as I work on my next book, Grace is a Preexisting Condition, I thought it would be important to share a few thoughts of my own during this midterm election week. Maybe many of you have already voted, as I have, in a state with early voting, but if you haven't, here's a few things to think about as you go to the polls.

Mental Health Voters in 2018 Should...

...Vote to protect coverage for preexisting conditions and parity in coverage for mental health. Bipolar disorder, like many other mental health conditions, is considered a preexisting condition. Prior to the ACA's protection of coverage for preexisting conditions, it was entirely legal for insurance companies to deny coverage based on preexisting conditions, including but not limited to mental health conditions. In fact, this was exactly my experience, as I've written about here. Any attempt to repeal or dismantle the ACA without a viable replacement that protects preexisting conditions will be harmful to folks with mental health struggles. And in fact, the federal government has joined with 20 states to argue in federal court against these protections, while at the same time allowing for healthcare plans which lack such protections and which also lack mental health parity, another issue that the ACA was designed to address. Mental health voters should challenge these attempts to return to the discriminatory policies of the past at the federal and state levels.

...Vote to expand Medicaid. 
As I mentioned earlier, I relied on expanded Medicaid to access mental and physical healthcare during a crucial time in my recovery. Many people with mental health struggles lack the resources to access care; the expansion of Medicaid, while not a magic fix, would provide coverage for millions more people including people with mental health struggles.

...Refuse to let mental health struggles be used as a scapegoat for difficult political conversations.
I've written more extensively about this topic here and here, but after acts of violence (particularly when the perpetrator of the violence is a white male), mental illness is often brought up as the "real issue" in order to avoid difficult political conversations around guns, extremism, gender, and race. This is in spite of the fact that people with mental illnesses are much more likely to be victims, rather than perpetrators, of violence in this country. Mental health voters in 2018 are willing to have a robust conversation about the importance of mental health care in creating a safer society for all, without allowing people with mental health struggles to be used as scapegoats by politicians who, often, turn out to not really be serious about the conversation around mental health care.

...Recognize that homelessness and mass incarceration have taken the place of a functioning mental health system in our country. 
I've written a bit here about institutions and deinstitutionalization. It's a complex topic in many ways, but one thing that is clear is that deinstitutionalization, while originally designed to end abuses and put more of a focus on care in community, has actually -- when paired with budget cuts to health care and community programs -- led to homelessness and an increase in mass incarceration. Mental health voters in 2018 will pay attention to rhetoric around homelessness, incarceration, and crime, knowing that often these conversations demonize people who are in fact struggling with mental health and trauma.

...Recognize that tax cuts for those with the most mean losses in care and services for those with the least.
Related to the last point, we'll pay attention to budget cuts -- often hidden under language about tax cuts -- which continue to make it difficult for people to receive the care they need, whether in a psychiatric bed or in a community setting.

...Recognize that behind headlines about drug overdoes and the opioid crisis are stories about mental health struggles, substance abuse disorders, and trauma. 
We ought to be talking about the public health crisis of opioid addiction -- as we ought previously to have talked about crack cocaine in terms of public health rather than crime (see the point above about language around incarceration and crime) -- and we ought to be talking about it in terms of underlying causes such as substance abuse disorders, trauma, and mental health struggles. If politicians are seeking to use the opioid crisis to bolster their campaigns but aren't talking about increasing resources for care and recovery while decreasing punitive measures and homelessness, we should raise questions. And if they're doing so while also talking about cutting taxes for those with the most, we ought to remind them of the previous point: tax cuts for those with the most mean losses in care and services for those with the least.

And finally, mental health voters in 2018 should refuse to shame or demonize people whose voting behavior is different than their own. 
I think it's really important to vote this year. I also think we shouldn't shame or demonize people who don't vote or who vote differently than us, especially when we're talking about mental health voting. For some people with severe mental illness, getting to the polls or accessing the polls is difficult under normal circumstances, much less in a time in which voting rights are being eroded by voter ID laws, the closing of polling places, and the purging of voter rolls. Rather than criticizing those who don't vote, we ought to be voting with those who can't get to the polls in mind, while helping cast an inspiring vision that can catch the hopes and interest of those who might, in the past, have stayed home out of disengagement and disinterest. Those of us with mental health struggles ought to understand, more than anyone, that feelings of disengagement and disconnection can be really powerful, and that shaming and demonizing language, far from motivating us, tends to drive us deeper into the corner. 

Obviously, there's many more aspects of this conversation to consider, but these are a few topics I've noticed rattling around in the political sphere this year. So if you are able to vote, consider these thoughts about mental health voting. The more we tell our stories, the more the system will have to change. The more the system changes, the more people will be able to access care. The more people are able to access care, the more sacred stories we will be privileged to hear.

My next book, Grace is a Preexisting Condition, will tackle conversations at the intersection of faith, practice, and the mental health system. You can learn more about my first book, Christ on the Psych Ward, here






"Showing Up" -- A sermon for All Saints' and the Sunday before midterm elections



I was invited to preach at First Christian Church (Disciples of Christ) in Fayetteville on Sunday, November 4, which was All Saints' Sunday as well as the Sunday before the 2018 midterm elections. My sermon was called "Showing Up," and was based on Exodus 1:8-22 and Luke 18:1-8.

I was nervous to preach this sermon. But this has been a year, and a week, of stepping outside of some of my comfort zones, and this felt like an important time to take a risk.

(I snapped the photo to the left, of a rabbi addressing the Department of Justice building in Washington, D.C., during a Poor People's Campaign rally this past summer.)





You can listen to the sermon, and/or read the manuscript, below:




“Showing Up”
A Sermon for All Saints and the Sunday Before Midterms
First Christian Church of Fayetteville
November 4, 2018

I’ll be honest with y’all. My heart has felt heavy over these past few weeks.
            My heart has felt heavy as it has stretched to absorb a recent national news cycle dominated by violence and threats of violence. Last Saturday, the deadliest anti-Semitic attack in the history of our country occurred in Pittsburgh, with a shooter targeting Jewish worshipers at the Tree of Life Synagogue in the Squirrel Hill neighborhood. Earlier that same week, there was a deadly shooting at a grocery store in Kentucky in which the perpetrator first attempted to attack a predominantly African American church. Both shooters, in other words, targeted faith communities – places that should be sanctuaries, places of refuge – and targeted these faith communities out of bigotry and hatred.
            And of course all of this happened in the course of two weeks with headline news about bombs being sent to prominent political figures and journalists, with a divisive political environment that seems deeply committed to playing on the worst fears and biases of our public debate, with confusing announcements of troop deployments which I know have impacted folks here in Fayetteville, with a shooting of a state trooper and a shooting following a fight at a high school here in North Carolina, with a shooting at a yoga studio in Florida which killed a college student and a college professor and was again preceded by racist and misogynistic rants from the shooter – friends, my heart has been heavy this week.
            So I don’t know about you, but I know I am in need of the words of Jesus this morning. I need a story that Jesus tells his disciples and friends. A story about their need to pray always. And not to lose heart.
              It’s a story about showing up, over and over again, in the face of seemingly impossible odds. It’s a story about wearing down structures of power and injustice and violence. It’s a story about refusing to lose heart.
            “In a certain city,” Jesus says, there is a public official, whose job it is supposed to be to serve people, particularly, as in this story, people like a widow, vulnerable to mistreatment and harm in their society. And yet this corrupt public official cares little for a God of love and justice, and has no respect for the people he is meant to serve. Can you imagine?
            Now this widow – someone who, in the ancient world, would have been viewed as personally and economically vulnerable – goes to this corrupt official and asks for a measure of protection and equal treatment. The official ignores her claims. And, to be frank, “Powerful man ignores powerless woman” isn’t frontpage news. That’s just the way things go, right? Game over, widow – time to go home.
            But this widow refuses to stay home. She keeps showing up and showing up and showing up until the official exclaims, “I can’t take it anymore! Sure, I don’t care about God or about people, but I’m going to give this woman justice so that she doesn’t keep coming back and wearing me out.”
            Now remember, friends, this is a story Jesus tells about the need to pray always and not to lose heart. Jesus is giving us a picture here of prayer that is not just about bowed heads and closed eyes. A picture of hope that is not about wishful thinking or sunny optimism. In this story, prayer is pictured as a showing up, in body and in spirit and in voice, a showing up with the conviction that the impossible is possible. Showing up for justice, showing up for mercy, showing up for the good and the right, showing up again and again until even powerful corrupt people with no respect for God or for anyone are so worn out that they just do the right thing out of fatigue – this, says Jesus, is what prayer looks like. This is a form of prayer that we pray with our whole lives. When we show up like this, Jesus says, the God who is a Just Judge, a Merciful Judge – this God shows up with us. This showing-up faith is the cure, says Jesus, for a heavy heart.
            Our Hebrew Bible reading today gives us yet another picture of folks who show up for what is good and right; two more Jewish women, just like that persistent widow, who refused to lose heart. Shiprah and Puah were Hebrew midwives. Their people were oppressed, enslaved under Pharoah. They were ordered to assist Pharoah in his hateful and genocidal scheme against the Israelites; but they refused to obey this immoral and unjust order. Instead, they resisted in the most important way they knew how – they showed up and they did their jobs, with persistence and moral courage. They continued to deliver and care for children in spite of the edicts of powerful corrupt people with no respect for God or anyone. And when they were questioned, they cleverly played on the same racist and bigoted tropes that the powerful ruling class believed about their people, saying, “Oh, you know those Hebrew women, like big animals, pushing out babies before we even get there!” Subverting the very lies being told about their people in order to save their people. And they kept doing what they knew they were called to do. And they kept saving the lives of children. They kept providing health care for people who were supposed to be denied coverage by the Egyptian Pharoah Health Care System. And in spite of the impossible odds against them, they didn’t lose heart. They prayed with their whole lives. They showed up.
            When I reflect on the showing-up prayer of the persistent widow, the showing-up faith of the Hebrew midwives, I can’t help but think of other examples of those who have refused to lose heart, who have shown out their faith by showing up, even in the face of violence, in the face of hate, in the face of impossible odds.
            I’m thinking today of the medical team at Alleghany General Hospital, many of whom are Jewish, who treated Robert Bowers, the man who killed 11 people and wounded 7 at the Tree of Life Synagogue in Pittsburgh. In an interview, Dr. Jeff Cohen, the president of Alleghany General and synagogue attendee, said that the shooter was like a lot of people his team treats in the hospital – “some mother’s son,” said Cohen, who was “scared and confused and didn’t quite understand.” Of his medical team, Cohen said, “They did their job. They confronted the problem and they were true to their core beliefs.” Understand that Cohen’s team treated Bowers even as he continued to hurl anti-Semitic threats and insults at them. And how did he and his team respond? They showed up, and they did their jobs, and they were true to their beliefs, even and especially in the face of violence and hatred. They treated a man because he was a human being, because human beings deserve to be treated with dignity and respect – the humanizing impulse that is the opposite of violence and bigotry. I learn from these doctors what faith looks like. They showed up. They did their jobs. They didn’t lose heart.
            I’m thinking today of February, 1960 – of Ezell Blair Jr., Franklin McCain, Joseph McNeil, and David Richmond – four African American men, young men at the time, students at North Carolina A&T University, who started the sit-in movement at a lunch counter in Greensboro. These four students who decided, in the course of a late-night hangout in their dorm room, to stand up for the good and the right by sitting down where they were told “people like them” were not supposed to sit. Just four of them, at first – but of course, that’s two more supporters than the midwives had at first and three more than the patient widow. Just four of them, but soon their friends came, and friends of friends, and then when college students left for summer break, high school students started showing up to take their place. And they challenged a system of segregation that cared little for a God of equity and justice, a system that had no respect for people. And they wore down the powers that be. Oh, friends, never doubt that when young people, when high schoolers and college students decide not to give up on something that they can’t wear you down eventually! From these students, and from their modern-day equivalents who stand up and speak out and walk out and sit down for what they believe in, I learn what faith looks like. I learn what it means to pray with our whole lives. I learn what it means to show up.
            And I am thinking, this morning in particular, of my parents. My father, Gary, a two-tour Vietnam veteran who has struggled with mental and physical health conditions throughout my life, showed up yesterday to knock on doors and encourage people to vote along with my wife Leigh and me. My father is 79 years old, and he walked miles with us yesterday, standing with us as we encouraged people to show up to the polls. On Tuesday, my mother Marion, a retired public school teacher, will be volunteering for 12 hours at the polls, making sure people, no matter their political party or identity, are able to exercise their democratic right and responsibility.
My parents are retired. In my opinion, they’ve earned a bit of a right to relax, to unplug, to remove themselves from the fray. They could, if they wanted, just stay home. And yet they refuse to just stay home. They are showing up this week because they refuse to lose heart. Because hope doesn’t look like wishful thinking. It looks like walking miles and knocking doors and talking to people who might or might not agree with you, talking in a way that humanizes and respects our shared dignity. They are showing up. Because prayer doesn’t just look like closed eyes and bowed heads but like a commitment of our whole lives. A showing-up kind of faith.
            Friends, on this Sunday, we honor All Saints Day – a day to remember that we are surrounded by a great cloud of faithful witnesses who have persevered, who have run the race, who have shown us a showing-up kind of faith. Perhaps you have your own saints you remember this day, people who showed up for you, whose names and memories you honor and whose stories give you hope and remind you not to lose heart. I want you to add some saints to your list today. I want you to include on your list a patient widow, whose name may be forgotten to us, but who Jesus holds up as an example of how to pray always and not to lose heart. I want you to include on your list of saints Shiprah and Puah, Hebrew midwives who showed up and provided care and saved lives in the face of violence and threats of violence. I want you to include on your list an innumerable caravan of saints who march onward throughout the pages of our faith history, praying with their whole lives – saints who, we proclaim by faith, continue to show up with us so that we never show up alone.
            And I want us all to remember that list of saints this week, as we commit ourselves, once again, to praying with our whole lives, to not losing heart, to showing up. Jesus asks us, at the end of this story, “When the Son of Man comes – when the One Who is Most Human shows up with humanity – will such a showing-up faith be found on earth?” Friends, what would it take this week for us to be able to answer Jesus: “Yes, that faith is here”?
            Perhaps it would take showing up at the polls and voting, not out of fear of the Other, but out of hope for a world in which all are cared for and human dignity is respected. I’m not talking about particular candidates or parties or constitutional amendments here – I’m talking about demanding a politics based on dignity and humanity and values. I’m talking about showing up for justice, for mercy, for the possibility of a kinder and better world.
            Perhaps it would take showing up to care for those who are most vulnerable in our society, to ensure that the modern-day equivalents of the persistent widow don’t have to stand up for justice on their own, but are joined by us as part of their great cloud of witnesses.
            Perhaps it would take showing up in our relationships, in our caregiving, in our jobs, in our daily interactions, in a way that shows forth our values, that refuses to let our differences divide us but rather calls us all back to our shared dignity and humanity.
            Perhaps it takes walking, or marching, or sitting-in, or standing up, or having difficult conversations, or holding hands, or speaking up, or singing out.
            Perhaps it takes thousands upon thousands of seemingly small, insignificant acts, in the face of impossible odds, in the face of violence and threats of violence, in the face of bigotry and fear – thousands upon thousands of acts of praying with our whole lives, of showing up, of refusing to lose heart.
            Friends, I confess to you. My heart has been heavy these past few weeks. And so I need the words of Jesus this morning, reminding me that there is a cure for a heavy heart. And that cure looks like a persistent widow. It looks like two Jewish midwives. It looks like a type of prayer that is a commitment of our whole lives. And it looks like a faith that shows up.
            May we make it so – by the grace of God.