When the Bush Administration was not yet in office three weeks, new programs had already been proposed that have immense potential for rural mental health. This brief article will summarize some of the major developments that have occurred during this brief period.
New Freedom Initiative
The New Freedom Initiative represents a bold program to mainstream all persons with disabilities, including those with mental illnesses. Through a combination of employment, housing, social supports, and appropriate
treatment and wrap-around services, the Bush Administration hopes to
re-engage all disabled persons in community life. This is a bold undertaking and an immense challenge.
Of particular interest for mental health are two proposed Presidential Executive Orders that are part of the New Freedom Initiative. One Executive Order will require implementation of the Supreme Court Olmstead Decision (which mandates deinstitutionalization of persons who only require a lesser level of care) by the 13 Federal agencies that offer
programs and services to persons with mental illnesses. The second Executive Order will create a Commission on Mental Health Services Reform to identify and
propose solutions to the major problems confronting our mental health system. Both have the potential to expand community-based services in all States and both have implications for rural mental health services.
If you wish to read more about President Bush’s New Freedom Initiative, you can do so on the Internet at www.white house.gov.
Community and Faith-Based Initiative
The Community and Faith-Based Initiative is intended to permit churches, synagogues, and mosques to apply for Federal funds to support social services, including mental health services, offered through these organizations. This represents a major departure from past practice that is intended to strengthen community institutions. President Bush has said that this will "level the playing field" so that faith-based organizations can compete for Federal resources on a par with other types of local service providers.
An Office of Community and Faith Based Initiatives has been organized in the White House, and workgroups have been set up in five federal departments, including the U.S.
Department of Health and Human Services. Guidance from these offices regarding grant funds for fiscal year 2001 is expected shortly.
Dr. Beth Merwin, Director of the Rural Mental Health Research Program at the University of Virginia, in Charlottesville, Virginia, has examined the role that black churches in southeastern states play in the delivery of mental health and health care services in rural areas. Her work provides a benchmark for future endeavors to be undertaken with faith-based organizations.
More to Come
Over the next several weeks, detailed proposals are expected regarding a Medicare prescription drug benefit; a bill of rights for patients in managed healthcare plans; and updated legislation to promote parity for mental health insurance benefits.You will need to watch the national news closely for these developments and discussions of their implications for rural mental health services.
A Reflection
As one reviews what President Bush has proposed, or intends to propose, it is very clear that he would like to re-energize communities in America to counteract the recent period of rapid decline. Dr. Amitai Etzioni, University Professor at George Washington University, in
Washington D.C., has initiated a movement noted as communitarianism—a planned effort to promote the rights and well being of communities in the face of radical individualism. In this sense, President Bush is clearly a communitarian.