NORTHVILLE, MI – Tom Watkins knows about mental health issues in a way few ever do, both professionally and personally.
Watkins, now 68, has worn many hats in a long career. He was barely 30 when he became health director for the state of Michigan. From 2013 to 2017, he was president and CEO of the Detroit-Wayne Mental Health Authority, which meant overall responsibility for a system that provided care and treatment to more than 70,000 people battling mental illness.
Nor is mental illness just something he understands professionally. He is open about the fact that he had two brothers who committed suicide, and a son, Daniel, who struggled with alcohol addiction for most of his life before dying on Feb. 18 at age 37.
For many years, he has trumpeted the need for better care and more facilities for Michigan’s mentally ill, an estimated 300,000 of whom are largely dependent on Medicaid. But now there is an ongoing major attempt to largely privatize mental health care in the state, and that deeply worries him.
“Think about the consequences of turning it over to private insurance companies. How do you make money providing care? You maximize profit by denying care wherever possible,” he said.
Watkins, who has also been Michigan’s superintendent of schools, was devastated by the loss of his son, to whom he was very close, and he has an eight-year-old now fatherless grandson who he is helping to raise. But rather than retreating into a personal shell of suffering, he has vowed to “continue to speak out about these matters, because it matters. Silence, shame and stigma are enemies, and only by demanding change can we get change to come.”
What he thinks is most necessary is to “put human faces on the tragic consequences of not addressing addiction and mental health issues, something that has reached a public health crisis in both Michigan and America, as the surgeon general has correctly noted.”
He is dismayed that after years of supposedly more enlightened thinking about mental illness, there is still so much stigma involved. “These things – addictions and diseases of the brain – are often preventable, and can be addressed with proper diagnosis, treatment, programs and support,” he said.
Unfortunately, all too often we, and our politicians and lawmakers aren’t willing to make the sometimes minimal investment needed. “As a society we ignore problems, usually until they can be ignored no longer, and then we continue to ignore them for decades. People die, families are torn apart, and the cycle continues.”
He paused, and added “problems of addiction, depression, suicide and mental health issues are not about ‘those people.’ Those people are family members, neighbors, and friends.”
Watkins, who has held high posts in Michigan government under two Democratic governors, knows how to play the political game, but has become increasingly intolerant of it.
He resigned from a well-paying job running the Wayne County health system in 2017, mainly because he could not break a long-established culture of cronyism that permeated everything and affected how contracts were awarded and paid.
Twelve years ago, he was about to be offered a job as Toledo’s superintendent of schools, but turned it down because the board wasn’t unanimous, and “I would have needed a united board behind me to make the changes I knew needed to be made.”
Now, he thinks it is crucial to stop a pair of bills that have been sponsored by State Senate Majority Leader Mike Shirkey, a Jackson County Republican. They would turn over coverage of those on Medicaid who need mental health care, something that involves about $3 billion a year in federal funds, to private insurance companies.
When he introduced the bills last year, the senator noted that private companies already handle the patients’ physical health care, and said “when mental health and physical health care are addressed and evaluated together, it leads to better outcomes for both.”
The bills have been vigorously opposed, however, by a large number of community health care facilities. Many of their leaders came to Lansing to testify against them after they were introduced last fall, and the bills seem to be stalled.
But Watkins fears they will suddenly reappear and be rammed through as part of the overall state budget this spring. While Michigan’s legislature has Republican majorities, the governor is a Democrat, and could veto such bills if she so chose.
However, some, including Watkins, are worried that the governor, who faces a reelection battle this year, may cave in and make a deal, as she did two years ago on a package that weakened car insurance protection in the state.
“Yes, integrated care is a good idea, and so is eliminating inefficiencies. And there’s nothing wrong with making a reasonable profit,” he added. “But are we really ready to use this money to help pay an insurance executive $20 million a year?”
He hopes not. Instead, we thinks what we should be doing is trying to find the equivalent of the “sweet spot” for mental health and addiction services. “That’s when the person in need recognizes they have a problem and are ready, motivated to do something about it, and the services are readily available.”
Today, he knows they may be put on a waiting list that could last a year. What he doesn’t know is how to get lawmakers to recognize what a tragic waste that is, and care enough to do something about it.
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(A version of this column appeared in the Toledo Blade)
