An Open Letter to Barack Obama

November 7, 2012 Becky Oberg

Dear Mr. President:

Congratulations on your recent victory. Now, as you plan the next four years, I'd like to offer a few suggestions on how you can help those of us living with mental illness. Fight for parity in mental health treatment, work to reform the fragmented mental health system, and attack the stigma behind mental illness.

Insurance companies and legal discrimination

In 2001, President Bush established the New Freedom Commission on Mental Health. According to the National Alliance on Mental Illness, in 2002 the Commission found three barriers to mental health treatment: stigma, a fragmented mental health services delivery system, and unfair treatment limitations and financial requirements placed by private insurance.

Insurance companies legally discriminate against people with severe mental illness, both by pre-existing clauses (which your Affordable Health Care Act will ban in 2014) and by offering different coverage for mental health than physical health. Even the Mental Health Parity Act of 1996 did not entirely alleviate the problem. According to the Centers for Medicare and Medicaid Services, the act prevents insurance companies from offering lower mental health benefits than physical health benefits—for example, if a health plan has a $1 million lifetime cap for medical and surgical benefits, it can not cap mental health benefits at $100,000. However, there is no prohibition against increasing co-pays or limiting visits, imposing limits on the number of covered visits even if there is no comparable limit in medical or surgical benefits, or having higher co-pays for mental benefits than physical or surgical benefits. In addition, if meeting the MHPA’s requirements would increase the employer’s costs by one percent or more, they are exempt. Employers with less than fifty employees are also exempt. In addition to this, there was no requirement mental health benefits were offered.

This is wrong and needs to be fixed. When one in four people in this country has been diagnosed with a mental illness at one point, it is irresponsible to put unfair treatment limitations on mental health treatment. Work with Congress in order to address this lack of parity. Close the loopholes. You may have to drag the insurance companies into the Twenty-First Century kicking and screaming, but it's the right thing to do.

"Fragmented and in disarray"

According to the New Freedom Commission on Mental Health, our mental health care delivery system is "fragmented and in disarray ... lead[ing] to unnecessary and costly disability, homelessness, school failure and incarceration." ". This fragmentation included gaps in care for children, gaps in care for adults with serious mental illness, high unemployment and disability for people with serious mental illness, lack of care for the elderly with mental illness, and lack of national priority for suicide prevention and mental health treatment. This needs reformed.

The gaps in care for children, adults such as myself who have serious mental illness, and the elderly are caused largely by insurance companies. There simply is no will to treat mental illness. It's not profitable. We need to offer incentives such as tax breaks to insurance companies that offer generous mental health benefits.

We need community-based treatment with the ultimate goal of recovery. We need to integrate research results into community-based treatment instead of institutions. We need incentives (such as student loan forgiveness) for mental health professionals who serve under-served populations. We need improved access to care, especially for those of us in poverty.


The stigma to mental illness is so strong that a National Mental Health Association (NHMA) survey ranked it the number one barrier to treatment, according to a PRNewswire article. According to former U.S. Surgeon General Dr. David Satcher, nearly two-thirds of all people with diagnosable mental disorders do not seek treatment, in large part due to this stigma. Satcher wrote "Stigma leads others to avoid living, socializing or working with, renting to, or employing people with mental disorders, especially severe disorders such as schizophrenia. It reduces patients’ access to resources and opportunities (e.g., housing, jobs) and leads to low self-esteem, isolation and hopelessness. It deters the public from seeking, and wanting to pay for, care. … More tragically, it deprives people of their dignity and interferes with their full participation in society."

As an elected official, you have the power to speak out about this stigma. Former President George W. Bush tried to attack the stigma behind mental illness. He said "Americans must understand and send this message: mental disability is not a scandal - it is an illness. And like physical illness, it is treatable, especially when the treatment comes early." He's right. You can do the same by speaking openly and honestly about mental illness.

The future of mental health treatment is in your hands, Mr. President. I pray that you'll work for a better system.


Becky Oberg

APA Reference
Oberg, B. (2012, November 7). An Open Letter to Barack Obama, HealthyPlace. Retrieved on 2024, July 14 from

Author: Becky Oberg

Michelle Lande Hughes
November, 8 2012 at 7:10 am

I commend you for your efforts. Thanks.

In reply to by Anonymous (not verified)

Becky Oberg
November, 9 2012 at 9:34 am

Yeah, I should've added that. In 2008, I was in the state hospital. A mental health organization sent letters to both McCain and Obama about the mental health system and asked what their plans were. McCain did not respond, but Obama sent a 12-page plan. He does appear to have an interest in fixing things, which is good--reform is desperately needed.

November, 8 2012 at 11:42 am

The above letter is great. If that letter could be written as to where anyone could sign it and send it to the president that would be even better.

In reply to by Anonymous (not verified)

Becky Oberg
November, 9 2012 at 9:35 am

Thanks. If I figure out how to do that I will.

Dr Musli Ferati
November, 22 2012 at 2:51 am

Congratulation Ms Oberg for your open letter to Mr President on great misunderstanding to Mental Health Service and non-forgiveness mistakes on mentally ill patient. Indeed, there are many failures on psychiatric treatment of mentally ill patient worldwide and in USA as well. Firstly, it is ten fold time greater expenditures for somatic illnesses than for mental illnesses. This is an exemption that should eliminate as soon as possible, because mental health statement exhibits the foundation of global welfare of mentally ill person and wellness of community as well. The goverment of any country should promote and affirm the complex care-giving system of mental health by concrete measurex not only in declarative manner. Mentally ill patient are humane creatures that devote appropriate psychiatric treatment like others non-psychiatric ones. Stigma behind mentally ill patient indicates very immediate intervention from healthy institutioins, instead the restriction of insurances Company that undertaken they agaist mentalli ill patient. The consequences of this indignate approach are catastrofic and discriminate. As conclusion of this comment I would to stress the real possibility that the next decade will be the decade of mental disorder as the up to date decade.

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