Claudewell S. Thomas, MD, MPH, DLFAPA, is an established psychiatrist currently retired and living in Rancho Palos Verdes, California. He received his medical degree in 1956 at SUNY Downstate College of Medicine and specializes in social psychiatry, public health psychiatry, and forensic psychiatry. Dr. Thomas was board... more
The May issue of Psychiatric Times declared the USA an unhappy nation based on reports from psychiatric centers across the country. Anxiety and depression are the primary indicators of our national unhappiness but addiction may be a more identifiable sign because of its recordability. Public health records across the nation show that drug abuse, associated criminal activity, violence, and death are likely to be recorded. Gun violence is also an epidemic studyable by public health methods, although blocked by NRA actions (although not absolutely interdicted by restrictions on the use of public monies).
The role of Public Health Departments and facilities has been declining since the late 70s with the advent of Medicare and even more so with so-called Obamacare. This is probably because of the monetization of the poor so that they have become "clients" of existing non charitable care systems. The substitution of short-term accident-focused health insurance and the penalty of being removed from medicaid rolls or being subject to fitness tests in the relative absence of public health facilities is akin to pulling the rug out from under large segments of the population.This is reminiscent of Reganesque dependence on non existent community mental health Hospitals in the state (California) system while pulling support from public Mental Health hospitals.
How much does a population need to know before voting their choices intelligently? It would seem a great deal but perhaps not. Is there a role for health care professionals to indicate what the issues are to patients and clients? The politicization of everything makes it difficult to decide, but if politics is defined as "the art of the possible" as Bismarck did, it may be easier.
Since concern about health and aging are so important and since the use of opioids and the proliferation of gun violence are defining us as an unhappy nation, we cannot expect America or Americans to supply the leadership that the world has demanded and perhaps requires. That leadership and its expectation has been essential to the perception of America's greatness. Catching up with other nations in provision of our own health and fitness needs is essential to making America Great.