07/30/2014 05:59 pm ET Updated Sep 29, 2014

Engaging Politicians in Meaningful Conversation About Mental Health: An Effective Format

Mental health is a growing political issue. From preventing
teen suicide, to easing the suffering of soldiers returning
from war, to PTSD, to stopping an out-of-control rate of
opiate abuse, mental illness is in the news and in our thoughts. -- Tom Ashbrook, Host, "On Point," WBUR Radio

Everyone knows someone who has struggled with mental illness. There was a time, not so long ago, when mental illness was considered strictly private and was discussed mostly behind closed doors. Today, there is growing awareness of the terrible toll mental illness exacts on individuals, families, and the community at large. The news abounds with stories about post-traumatic stress disorder (PTSD) in veterans, teen suicide, drug abuse, guns and violence, the social impact of casinos and marijuana legalization, and challenges to access to mental health care for children and families. In an effort to engage politicians in meaningful conversation about these subjects, Massachusetts School of Professional Psychology convened the 2014 Massachusetts Gubernatorial Forum on Mental Health and asked me to lead the effort.

I felt honored to offer welcoming remarks at the Forum and to introduce the moderator, Tom Ashbrook, the nationally renowned host of WBUR's "On Point." Republican candidate Charlie Baker and Democratic candidates Don Berwick, Martha Coakley, and Steve Grossman shared center stage. Yet this was not a debate. It was not about sound bites, sparring, or squaring off. Instead, Tom Ashbrook interviewed each participant based on research he had done prior to the Forum to inform himself about mental health issues and about the candidates' experiences. The 90-minute Forum offered each candidate two minutes to respond to an opening question, an 18-minute interview, and two minutes for closing remarks.

Before conducting his interviews, Ashbrook asked each of the gubernatorial hopefuls how mental illness had touched their lives. This was the only question provided to the candidates in advance of the event. One described a close friend's experience of depression. Another recalled reaching out to an ill and troubled child who later suicided. Still another depicted the early adult suicide of a brother with bipolar disorder, and the final participant talked about losing a college roommate to suicide. These stories set a thoughtful, reflective tone for the evening.

To open his interview with attorney general Martha Coakley, Ashbrook pointed to the highest court's recent ruling to include a casino repeal question on the November 2014 ballot. "This ruling overrules you," he said. "Why were you more willing than the high court to put corporate casino interests ahead of the public voting?" A few minutes into her response, Ashbrook pressed further: "Are the economic benefits of casino gambling worth the mental health consequences?"

"I don't think any of us on this stage know exactly," Coakley replied. "I do not think [casino gaming] is where we should have gone for economic benefits."

Next, Ashbrook turned to Don Berwick, former Centers for Medicare and Medicaid Services Administrator. "You are fully committed to single-payer health insurance in Massachusetts ... Can we afford the upheaval of yet another health care overhaul under the next governor?"

"We can't afford not to," replied the candidate and proceeded to describe his plan.

Ashbrook continued: "You ultimately withdrew as Medicare head when it became clear that Republicans would not confirm your recess appointment to that post. What does that say about your political skills -- that you couldn't break that opposition? "

"I wish I could have stayed," asserted Berwick. "The Republicans threw me out."

State treasurer Steve Grossman voiced concerns about the mental health crises that arise out of poverty and unemployment and identified himself as a "progressive job creator." When challenged by Ashbrook about his support of casino licensing, Grossman acknowledged the seriousness of gambling addiction. "But there's a huge amount of damage to be[ing] unemployed," he emphasized. "Think about the destruction within a family when the chief earner in the family hasn't had a job for two, three, four years ... the mental health issues ... the alcoholism and substance abuse that go on when financial issues overwhelm a family and they cannot pay for their home."

Charlie Baker -- like his colleagues -- faced difficult questions. "What did you learn, as CEO of Harvard Pilgrim Health Care [a health insurance company], about the cost of full, good mental health coverage? Could Harvard Pilgrim afford full coverage for all its clients' needs? Can the Commonwealth?"

Baker suggested that the state work with the provider-community to seek new ways to manage health care costs. When Ashbrook asked him whether he plans to "cut the number of human service agencies," he replied that he would prefer a "simpler state government" and called for better communication between departments that provide services to individuals and families.

The event was valuable, not only because it was the first time these four politicians came together to discuss mental health, but also because it was the Commonwealth's first Gubernatorial Forum on this topic. The more than 600 attendees in the audience sent the message that mental health matters and that Massachusetts can do a better job caring for those suffering and at risk. I look to the vision and leadership of our future governor and I am grateful to Charlie Baker, Don Berwick, Martha Coakley and Steve Grossman for participating in the Forum.

A recording of the Forum is accessible at WBUR's website.


Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.

Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.