The age-old debate of governance extends into mental health and its administration, policymaking, and implementation of state and federal regulations. We now have an absolute need to reform the system.
Only a natural leader can take decisive action when the need emerges to avoid imminent disaster and collateral damage in the community. I recommend a health czar’s immediate appointment as the final solution to the ethical and moral questions left unanswered by our current mental health system.
In mental health treatment, questions over AOT (assisted outpatient treatment) orders and the status of ‘forced’ treatment linger. People wonder if the systems ‘teeth’ need to be sharper and strengthened or the converse. Still, no one seems to dispel arguments that the continuing need for involuntary in-patient treatment is still genuine, albeit open conversations seem to have become more taboo.
These are conversations by policymakers, and those charged with revising and renewing the reform agenda are missing a big part of the issues at hand. People want to talk about minor and ancillary trite problems than the real problems and issues needing reform. In mental health treatment and its reform, we’ve hit a wall.
The wall is a political barrier created by stakeholders interested in posturing to their constituents rather than moving the system towards full community integration. To further reform the system, we need to tear down this wall at all costs. I fully believe the arena for real change and reform hinges upon a mental health czar’s immediate appointment.
In the US, state regulatory bodies have appointed local county commissioners. These bodies alone will not take the reins and right the ship.
At present, the ship is sinking, and before the complete disaster, an urgent revision and resection of the system must occur. The Health Czar’s immediate appointment will be the timely and swift change agent to transform a system in crisis.
The czar is no sovereign. Yet, this leader is never subject to the ebb and flow of political trends in a system that needs more guidance and revision than commissioned regulatory bodies can address. We must first be authentic in our desire for reform and then charge our most exemplary and most selfless patriot of healing and recovery with the task ahead.
The czar is the final word in resectioning the system. The Czar cuts through red tape and the cancers deep within our ranks with one hand and justifies doing so with the other. In this regard, creating lasting reform is urgently needed. Health issues should be a distant nightmare in the new power of the czar to re-regulate the state.
All the trite and political grey areas darkening the system will be re-painted in brighter, more sustainable, and more organic healing colours. In doing so, we will anoint a leader ready to take the system on and not further the existent legacy past leaders have left us. It was a legacy wrapped up in taboo, stigma, discrimination, and disparities beyond repair by the very system that broke its inception. Indeed, the cracks run deep in the system, and the czar’s tasks ahead are steep.
When the crisis has abated, the czar will lay down its emergency powers. Power will be re-balanced upon completing the czar’s revisions to the system and give back to the state regulatory bodies. These state and local bodies of mental health commissions, too, will be reconfigured. A new policy must replace the old codes and regulations that went awry and haven’t met the community’s needs since institutionalization ended when people landed at the shores of the community health system.
Until then, this healing patriot will create a new legacy. One for our generations to talk about, without fear or taboo. The czar is the ‘final solution to the mental health crisis in modernity.
We look forward to its ultimate timely and urgent resolution and the reign of the health czar.
Max E. Guttman, LCSW is a psychotherapist and owner of Recovery Now, a mental health private practice in New York City.
