For their first date, Pat and Tiffany walk to a neighborhood diner for dinner. Pat orders Raisin Bran. Tiffany, perhaps already giving up on Pat, orders tea.
They proceed to argue about whos crazier. Not whos more daring, quirky or eccentric. They argue about whos more mentally ill.
Pat, just released from a mental institution, is obsessed with his estranged wife and prone to blurting every thought. Tiffany, recently widowed, has been on an insatiable sexual binge that has resulted in her firing from her office job.
In the debate about whos more mentally ill, a good case could be made for either.
Pat (Bradley Cooper) and Tiffany (Jennifer Lawrence) are the lead characters in Silver Linings Playbook, which this week was nominated for an Academy Award for best picture. Perhaps the movie will continue our national discussion about mental health that started 29 days ago after the unthinkably evil school shootings in Newtown, Conn.
A broken system
We need that discussion to continue at work, over dinner, at church and especially at the legislature and the governors office. Gov. Pat McCrory recently said: We have a broken mental health system in our nation and in our state. Weve got to do some serious work to close those deficiencies.
Its hard to argue with him. A decade ago in North Carolina, our legislature set out to treat fewer people in the states three mental hospitals and more in their communities. That might prove ultimately to be a wise strategy. But so far the evidence is that reform has not succeeded.
The state has cut the number of beds from about 1,750 to less than half that during a time in which North Carolinas population grew by more than 1 million.
From 2000 to 2011, the state psychiatric hospitals went from treating 16,789 patients a year to 5,754 a year, according to the N.C. Center for Public Policy Research. Thats left mentally ill people on the streets and crowded into adult-care centers, local hospitals and jails. The legislatures decision in 2011 to cut funding for mental health treatment by $20 million (or 8 percent) made the crisis more dire.
Talking about mental health treatment doesnt get politicians elected. Writing about it doesnt sell newspapers. Nonetheless, weve emphasized coverage of the issue. Our Mental Disorder series in 2008 showed that the state had wasted at least $400 million by relying on private companies for community-based care. Some companies went door-to-door recruiting patients for care they didnt need. You paid the bill, which later was tallied to be $635 million.
Gap for young adults
Weve published numerous follow-up stories. After the Connecticut shootings, Lynn Bonner reported that theres often a gap in the availability of treatment for people in their late teens and early 20s (the Connecticut shooter was 20). That age is a time when mental health issues can first appear or intensify.
As we cover the legislative session that starts Jan. 30, well pay special attention to the discussion about mental health treatment.
By the end of Silver Linings Playbook, Pat and Tiffany stop arguing about whos more mentally ill and start helping each other get better. May our elected leaders work together this year and move toward a satisfying ending. We cant afford to not get mental health reform right. Weve seen that movie before.