Tuesday, March 18, 2008

What is the Value of Bear Stearns and what is the value of a person with a chronic, mental health problem?

Efficient Markets Can Value Assets. Ours Can't

“…..And it's really as simple as the difference between $84 and $2 per share. Efficient markets are those that can tell what something is worth. Ours can no longer make that claim, whether in regard to financial stocks or, by extension, about the much larger pool of private debt. The numbers Bear Stearns posted last year, the numbers it clung to until the bubble finally burst, proved in the end not to be worth the recycled paper they were printed on. Just like the mortgage debt that had been rated AAA but ended up at the bottom of the junk pile. Invest in America, where the numbers can be anything you want…..”

There is something eerily reminiscent about that statement above: “Efficient Markets Can Value Assets. Ours Can’t’

Let’s see: where have I heard that before…just an echo of that. OH! That would be North Carolina Mental Health Reform failure----now playing at your local LME and across your county.

Basically, just as the US finds itself in the position of not knowing the value of anything (Bear and Stearns: January, 2007: $171/ share // March, 2008: $2/ share) there is no value put on mental health care because there is no value assessed for people who have serious, chronic mental health challenges. Many things contribute to this tendency:

(1) people with mental illnesses are commonly in poor positions to argue for themselves. (this is akin to a recent observation by someone re: pancreatic cancer and its stuck in the mud morbidity/ mortality rates: no survives to go after Congress for funding re: research or advancing a cure or at least better treatment)

(2) what is provided re: mental health services, specifically, therapy or whatever orientation, is not in an observable form. Its not a pill; its not a manual that can be pulled out and refreshed. It is a visit to the provider. That’s about the sum of the similarity to more physically-mediated health challenges.

(3) People with mental illnesses are not valued in American culture, the ‘can-do’ culture. Quite commonly, they cannot work at the same rate or for the same pay. There are special accommodations that must be created, frequently, for them to do so. Thus, they are the weak members of the herd. In a word, they straggle---and stragglers are eaten or must be defended.

(4) One of the tools for treatment associated w/ NC mental health reform, Community Support Services (CSS) has been manipulated by NC DHHS to the point that it doesn’t work any longer. We’ve been ‘warned’ by NC DHHS that CSS is NOT: handholding. It’s NOT, in terms of the mandated service notes which are a description of what the CSS worker did with the client, doing things with the client. Its orientation is ‘skill building’ but written about, as re: the service notes, and assumably spoken about, in terms of working with the client, as if it were ‘rubber to the road’ actions between the CSS worker (not even a master’s level person) and the client. What NC DHHS is aiming for is an advanced notion of therapy carried outside the clinician’s office (Moe & Chandon champagne) on Budweiser $$.

So, what is the value of the life of someone with a mental health challenge? That really is at the heart of what is taking place re: NC mental health reform and that is the overarching question being asked of US business----and thus of our culture-----at this point in time.


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