In this election year billions will be spent for control of the House, Senate, and White House. Immigration, abortion rights, and the economy already poll as major issues assuring substantial blocks of votes for Republicans and Democrats. The majority may be won or lost, however, by razor thin margins in swing districts, on issues outside of those big items. Supporting issues bringing in 10, 5 or even 2 percent of swing votes will play a big role in swaying elections.
These four issues have been the subject of legislative proposals and debate for years, yet action has been wanting.
Two new polls indicate care for mental illness is a decisive issue for voters. Bottom line up front: an overwhelming number of survey respondents said they are more likely to vote for a candidate who makes treatment of mental illness a high priority: 89 percent for individuals and families dealing with mental illness and 79 percent among women.
First, some background.
Several polls over the past two years have consistently found a mega majority of voters believe more needs to be done for mental health. A Kaiser Foundation/CNN poll reported 90 percent of U.S. adults surveyed in October 2022 said America is experiencing a mental health crisis, 20 percent defined their own mental health as poor and most of that group said they could not access services.
A National Alliance for Mental Illness/IPSOS poll from November of 2023 reported 86 percent wanted their elected officials to do more, and a mere 7 percent thought their elected officials were doing enough. Difficulty accessing care also stood out as a problem.
A Newsmax/TPP poll from February 2024 echoed the concern that 87 percent feel we are in a mental health crisis, and nearly half of 18-24 year old’s rate their own mental health as poor. A Gallup poll in May of 2024 found three out of four adults believe the U.S. health care system treats mental health worse than physical health.
When such a large plurality of voters say they are concerned, candidates better listen. But what specifically needs to be done?
The two surveys were conducted May 9-12 by Schizophrenia and Psychosis Action Alliance and by Women2Women network. S&PAA surveyed persons with mental illness, their families, and providers (Mental Health or “MH” group). W2W is a non-partisan network of women ages 40-60 from suburban areas (“Women” group). Surveys were sent out to thousands in their email lists. Seventy percent of the Women group self-reported they or a family member have a mental illness. Over 300 survey responses were received from each group, (a typical response rate). Responders are viewed as those who are highly motivated on the issues.
Our two parallel surveys indicated overwhelming support for four major issues:
- As medical and recreational marijuana is legalized in more states, multiple studies indicate there is a strong link between use of marijuana and an increase in mental illness (psychosis, schizophrenia, depression, drug abuse), and poor school/job performance. Respondents overwhelmingly said tax revenue from marijuana should be dedicated to the treatment of mental illness: 83.9 percent for MH, 78.1 percent for Women. Currently marijuana taxes are spent on a wide range of community projects, administration, education, the state’s general funds and some states put a portion into drug treatment. Across the nation 50 million go without any treatment, and there are massive shortages of mental health providers and treatment facilities.
- Homelessness is an immense problem in many cities. Up to 90 percent of homeless people have a mental illness, and 30 percent suffer from severe mental illness (e.g. schizophrenia). Respondents strongly support subsidized housing for the homeless, but only if the housing has on site access for treatment services: 82 percent MH, 83 percent Women. Providing free or subsidized housing with no treatment is only supported by 12.8 percent of MH and 13.1 percent of Women.
- Half of those with severe mental illness such as schizophrenia are not in treatment in part because they are not self-aware that their symptoms of delusions, hallucinations, and paranoia are a problem. When treatment is refused the risk for incarceration, violence, unemployment, and inability to care for themselves greatly increases. In most states courts may order treatment only when a person is an imminent danger at that moment to harm themselves or someone else. Otherwise, the patient would be released from treatment. A change in laws to permit judges to take into account a person’s ability to understand they are ill, and the likelihood of harm to themselves or others if not treated is supported by 75.8 percent of the S&PAA group and 72.2 percent of the W2W group. Support for court ordered treatment only in cases where the person is a current threat is supported by 17 percent of the SPAA group and 19 percent of W2W.
- There is an urgent and worsening shortage of psychiatric hospital beds for those who would benefit from inpatient treatment. Since the 1960’s the federal government had prohibited Medicaid payment coverage for psychiatric hospitals with more than 16 beds. The current shortage in beds is between 70,000-100,000. This crisis has directly led to more homelessness and incarceration for those with severe mental illness not in treatment. The largest psychiatric facilities in most cities and counties are jails, where most receive no treatment at all. The two groups surveyed overwhelmingly support lifting the 16-bed limit: 83.9 percent MH and 85.9 percent Women.
Although these issue surveys are not a random sample of the general population, they do define strong beliefs among a highly motivated subset of voters. Ninety percent of the MH group plans to vote this November.
Control of the U.S. House may be decided in the 22 districts (evenly split between Democrats and Republicans) now considered toss ups, with an additional 13 Democrats and 9 Republican in highly competitive races. In the 55 battleground districts, 39 percent of Independents are undecided. Even if mental health issues sway a small percent of voters, they may make the difference between victory and “almost.”
Candidates would be wise to place treatment of mental illness high on their list of campaign priorities. It is not enough, however, for candidates to say they are in favor of doing something. They need to have something specific to say. These four issues have been the subject of legislative proposals and debate for years, yet action has been wanting. Meanwhile the numbers of those with mental illness grows. Deaths, costs, and incarcerations soar for those who cannot find the care they desperately need.
Families are looking to vote for those who will deliver. If candidates are interested only in the numbers, support for these issues is a good thing to do. If candidates are interested in helping people and saving lives, then these are the right things to do.