The Jewish Council for Public Affairs has consistently supported comprehensive, accessible, affordable, quality health care coverage for individuals and families regardless of income.  This includes mental as well as physical health care, consistent with our understanding that Judaism concerns itself with the health of the mind and soul as well as the body.  According to the teachings of Maimonides: “When someone is overpowered by imagination, prolonged meditation and avoidance of social contact, which he never exhibited before, or when he avoids pleasant experiences which were in him before, the physician should do nothing before he improves the soul by removing the extreme emotions.”  

Mental illness can shatter lives, bringing suffering not only to individuals but also to family and friends.  Its impact is felt in every sector of life, making access to effective, quality treatment an important social issue with far-reaching economic and human welfare implications.  One in every five adults and as many as three million children of every race, gender, and ethnicity, experience some type of diagnosable mental disorder each year.  Among those 55 and older, nearly 20 percent experience specific mental illnesses not associated with normal aging.  Yet, while those with physical illness are generally treated with solicitude and concern, those with mental illness are more often marginalized, viewed with contempt, fear, or ridicule.  Although many mental illnesses can now be treated effectively, less than one third of adults and half the children with a diagnosable mental disorder receive treatment in any year, largely the result of stigmatization, limited access, and inadequate funding. 

Despite research suggesting that mental health insurance parity would increase premiums only slightly and provide care that would save money over the long term, most health insurance policies set more restrictive annual and lifetime limits for mental health than for other health care benefits.  In the public sphere, Medicare coverage is lower for outpatient mental health treatment than for other outpatient services, and there is a lifetime limit of 190 days on coverage for care in a psychiatric hospital.  Moreover, mental health spending for Medicaid, Medicare, and other federal programs has grown more slowly than overall program spending, while over the last decade state level spending on mental health systems has declined.

The inability of many with serious mental illness to access comprehensive and timely mental health services has caused unnecessary institutionalization, homelessness, dependence and incarceration, all of which carry significant economic and social costs.  As illness prevents people from carrying out the essential functions of daily life, it can push them out of jobs and ultimately out of homes.  Homelessness itself impedes recovery and may worsen illness, pushing many into the criminal justice system.  While some individuals with mental illness are incarcerated for minor crimes and status offenses, others may be driven by their illness to commit violent crimes.  All are in need of appropriate mental health care and treatment while they are incarcerated.  

Finally, among the more tragic outcomes of inadequate mental health care is the high rate of emotional and mental disorder within the juvenile justice population.  The problems these children face are often exacerbated by detention facility staff who are not trained to recognize and deal effectively with mental health disorders. At the same time, many youngsters who are mentally ill commit minor, nonviolent or status offenses and would be better served by a system of closely supervised community-based services.  

While millions of dollars are spent dealing with the consequences of untreated mental illness, investment to improve access and treatment options, and to more effectively coordinate service delivery remains seriously inadequate.  The nation must act to close the gap between what research has revealed about effective mental health care and what is currently available, to expand access to a comprehensive system of care for people with mental illness.  The JCPA will therefore support: 

Further, the JCPA calls on Jewish communal organizations and agencies to: 

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