Ye, stigma, and mental health reform

Mental health is the new pet cause for internet sensationalists, but when the chips are down, advocates rarely rally around people they deem a lost cause.  Ye — the artist formerly known as Kanye West — has a lot to say about it.

"It's the ultimate stigma.  People feel like they have the right to come to my face and call me crazy like it doesn't hurt my feelings," said Ye during his YEEZY Season 9 show in Paris earlier this month.

During that release, which featured a controversial t-shirt with text reading "White Lives Matter," Ye spoke vehemently on his experiences with mental health.  In what felt like seconds after, Hollywood, the fashion industry, and Millennials all did just what Ye had predicted — they called him crazy.

They're not wrong — Ye does have a history with mental illness.  He was diagnosed with bipolar disorder after a psychiatric hospitalization in 2016.  But our culture's offhand dismissal of his complaints is indicative of how the mental health crisis is continuously swept under the rug.

Our president can say he's been steadfast in his commitment to ease the nation's ongoing mental health crisis exacerbated by the pandemic, but really all he's done is throw money at the problem.  The Biden administration has proposed increased funding for behavioral health, the launch of a crisis hotline, and investments in new practice models.  More recently, the administration announced a $27-million investment to expand support for pediatric mental health care.  But the president and advisers are ignoring the real problem: that overregulation has kneecapped psychiatric care providers.

Since 1974, states across the nation have been beholden to an outdated and egregious regulation titled "Certificate of Need" (CON).  CON is a law that requires health care providers to receive authorization from an appointed state board to open new, or expand existing, health care facilities.  Moreover, the law permits would-be competitors to propose vetoes in the application approval process.  Notably, psychiatric care is one of the most regulated CON services in 35 states and the District of Columbia.  It's time for these states to reform these laws.

According to a 2021 study, researchers found that CON laws that target psychiatric services are associated with 20% fewer hospitals (per million residents) and 56% fewer inpatient psychiatric clients (per ten thousand residents).  Thus, states with CON laws substantially reduce access to psychiatric care.  There is no substantiated proof that CON laws should remain.

Across the nation, thousands of individuals lead lives of great instability due to schizophrenia and bipolar disorder.  But apparently, these disorders aren't sexy talking points for mental health advocates.  Support for mental health remains superficial, and the taboo symptoms create bad P.R. for the new age of mental health advocacy — a marketing scheme that dodges conversations around what structural reform for mental health and rehabilitation could look like. 

Instead, social media influencers and their posses retain monetary compensation for the promotion of online therapy ads that prove to be erroneous "one size fits all" resolutions.  Rather than looking for meaningful structural reform, advocates insist that more government spending and sponsored content is the answer.

Ye's notorious 2016 hospitalization demonstrated the urgency of the mental health crisis.  After delivering a lengthy speech during a "Saint Pablo" tour stop, Ye was willingly admitted to the UCLA Medical Center for further evaluation.  Thankfully, California abolished its CON law in 1990, so Ye received the medical attention he needed.  And it doesn't hurt that he's a billionaire.

Whether or not you're a fan, Ye's story is an important representation of the ways our mental health system and its advocates continue to fail this nation. 

Ye's behavior is concerning, but even more concerning is the way nearly everyone dismisses or ignores the severity of the illness responsible for his erratic conduct.  It would be intimately familiar to those involved with bipolar disorder.  Mental health advocates and the media must learn to tread lightly — a severe illness is only exacerbated by limelight. 

Advocates who focus their efforts on exclusionary social-media campaigns — cutting deregulation from the conversation — do more harm than good.  CON is just a single example of this failing system.  To truly alleviate ongoing mental health concerns, we have to reform the way we discuss and regulate meaningful support.  You shouldn't have to be an infamous billionaire to receive necessary medical attention.

Jessica Dobrinsky is a policy analyst for the Cardinal Institute for West Virginia Policy.  You can follow her on Twitter at @jldobrinsky.

Image: Peter Hutchins.

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