Elevate Difference

subCITY: Out of Sight. Out of Mind.

In less than forty-five minutes, subCITY will shatter any notions you may have about access to mental health care in the United States, in Oregon in particular, the state where I live. Working for a mental health advocacy group, I'm reminded daily that the system is broken. But I didn't realize just how broken until I watched this film.

The director/producer team of Kevin and Dawn D'Haeze has created a powerful indictment of our current mental health care system. Tracing our currently underfunded system back to the early 1980s, subCITY shows how initiatives launched by former President Reagan have left a painful legacy for states like Oregon, which now has more people with mental illness in its correctional system than in its mental health hospitals.

Soon after taking office in 1981, Reagan rescinded the Community Mental Health Systems Act, slashing federal funding and placing the burden of cost for community mental health care on states. At the same time, Congress launched parallel initiatives, such as the War on Drugs, which created the rise of the prison industrial complex. The result? The combination of less funding for community mental health care and increased penalties for nonviolent drug crimes has put more people with mental illness in jails and prisons instead of allowing them access to treatment.

Does this make fiscal sense? No. But as Oregon State Representative Chris Garrett notes in the film, ballot measures and other moves to be “tough on crime” don't offer alternatives to incarceration. This sucks up funding, leaving less and less for community mental health care. This is in spite of the fact that this kind of care is far less costly than prison, and far less of a drain on the law enforcement agencies that are increasingly relied upon to “take care of” people with mental illness who end up on the streets.

Beyond proving their point with statistics, the filmmakers have candid and heartbreaking interviews with people whom the system has chewed up and spit out. They also speak with the counselors, police officers, and other community members who are trying to help them. More than anything, subCITY is a call to action. So do what the film intends by watching subCITY in its entirety on the web. Then visit the “take action” section of the film's website, which provides tips on how you can make a difference on this issue that affects us all.

Written by: M.L. Madison, March 10th 2010

Midevil: Great! BPG: It is a horribly broken system indeed - it's ridiculous that people have to get so sick before they get access to treatment. I'm so sorry you had to go through that. The organization I work for, NAMI, is pushing for full parity and inclusion.

I was bipolar but not on medication in Portland, Oregon, in 1997, when I started kicking into what I'd recently found out was a bad bipolar episode. I decided to do the responsible thing and find help. Like most twentysomethings, I was uninsured. I was also broke.

My sob story includes being partially disabled by a work injury, and having recently been homeless. But basically, I'm a lucky person. I came from a privileged background and went to one of the top ten colleges in the US. I had a phone. I knew how to talk to doctors and governmental agencies.

STILL, I found no help. I called the County mental health people, I called hospitals and the State and whoever else I could find in the phone book. They offered me a suicide hotline and the option to wait until things got bad enough that I really was fully insane and/or had hurt myself. THEN I would be admitted to a hospital.

The system is broken indeed. Now a few of my friends have gone into social work or worked as psychiatrists in public health. Some services are available, but many times, a desperate crazy person isn't going to know how to access those services. Lulling lunatics into taking their meds may take years of gentle prodding by a doc who's also a good conversationalist-- oh by the way? Largely not all that helpful if the lunatics in question don't also get adequate talk therapy and some sort of help navigating the big scary world and all its sane-people bureaucracies.

Truly universal health care, including "parity" for mental health care (the insurance companies can't discriminate between mental and physical health care --- which are frequently the same thing anyway), is the only way to confront this problem.

thanks for this review! i'm definitely going to watch the movie!