Lumping Together Substance Abuse and Mental Illness

by Joseph Merlin Bowers

In 1992 Congress passed legislation creating the Substance Abuse and Mental Health Services Administration SAMHSA. They made one group responsible for dealing with both substance abuse and serious mental illness at the federal level. As anyone could have predicted, this has been nothing but bad news for families dealing with serious mental illnesses.

In the ensuing years more and more state mental hospitals have been closed, more regular hospitals have eliminated psych wards, a serious shortage of psychiatrists has developed and everywhere one looks funds used to treat serious mental illnesses are being cut. At the same time more attention, professional services and funding for those abusing substances is becoming available. There is currently a congressman calling for earmarking 6oo million new dollars to address a growing heroin epidemic. Over the years, big money has been spent researching drug abuse-very little researching serious mental illness.

I understand some of the reasons for greater concern about substance abuse. Wikipedia estimates set the number of substance abusers at 120 million in this country. Serious mental illness is generally accepted to occur in roughly four percent of the population. That translates to a little more than 12 million Americans. So substance abuse effects ten times as many people.

Also drug abusers are much more likely to become violent criminals than people with serious mental illnesses so there is that consideration.

I first became aware that something dangerous was in the wind when I noticed that the clinic where I had gone for treatment for my serious mental illness for years had changed it’s name. What had been the South Lincoln Mental Health Clinic was now High Country Behavioral Health. They no longer employ anyone with qualifications that will result in Medicare or Medicaid paying for someone with a serious mental illness being treated there.

When I first noticed the name change my thought was that if people think that behavioral health has any strong connection to serious mental illness, families like mine are in big trouble. While the term behavioral health is appropriate when discussing substance abuse, when used with regard to mental illness it is insulting, ignorant and dangerous.

At least initially abusing a controlled substance is a choice. It is a chosen behavior. No one has ever chosen to become mentally ill. Almost all of us are totally innocent victims. Our disease almost never had anything to do with chosen behavior on our parts, our parents parts or anybody else’s part. Curing them isn’t simply a matter of changing behavior choices.

Do we not deserve a lot of attention and help?

Substance abuse is a serious problem that must be addressed, but not at the expense of innocent families suffering from serious mental illnesses. Serious mental illness needs it’s own federal agency. And please, please stop referring to mental health as behavioral health!

One thought on “Lumping Together Substance Abuse and Mental Illness

  1. This reminds me of a less serious event, when school funding in Wyoming was changed to a block Grant, thus allowing local districts to take money formerly specifically designated for programs like vocational education or reading to be used elsewhere in the budget — like for band or cheerleader uniforms! Need to keep the mental health funding separate, and by the way, ADEQUATE!


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