Thursday, January 13, 2011

Speaker Boehner's Remarks on Resolution Condemning the Attack in Tucson, AZ

JohnBoehner | January 12, 2011 | 31 likes, 0 dislikes

House Speaker John Boehner (R-OH) delivered remarks on the House floor today during consideration of a resolution condemning the tragic shooting in Tucson, AZ and honoring the victims. Following are Speaker Boehner's remarks as prepared for delivery:

"Today, we are called here to mourn. An unspeakable act of violence has taken six innocent lives, and left several more -- including our colleague, Gabrielle Giffords -- battling for theirs. These are difficult hours for our country.
"Among the fallen is Gabe Zimmerman, a member of Congresswoman Giffords' staff ... a public servant of the highest caliber ... one of our own.

"Even in our shock, we are composed and determined to fulfill our calling to represent our constituents. This is the great cause for which Gabe gave his life. Like us, Gabe swore on oath to uphold and defend the Constitution. At the time of the attack, he was engaged in the most simple and direct of democratic rituals: listening to the people ... to his neighbors.

"The brutality that shattered Saturday morning's calm was devastating, but brief. Bravery and quick thinking prevented a massacre, turning innocent bystanders into heroes. The service and skill of first responders and medical professionals saved lives. Law enforcement officials are working to ensure swift justice. Look to Tucson right now, and you will be reminded that America's most plentiful source of wealth and strength is her people.

"We are so thankful Gabby is still with us. We are so thankful that two of her staffers who were also wounded -- Ron Barber and Pam Simon -- are still with us. These are days they were not supposed to see, and we can only pray there will be more of them.

"In her stead, Gabby's staff has pressed on, opening for business Monday morning, right on schedule. The men and women who faithfully serve the people of Arizona's Eighth Congressional District have signaled that no act -- no matter how heinous -- will stop us from doing our duty and being among the people we serve.

"To all of the dedicated professionals we rely on to make this institution work, to each of you: thank you for what you do. To Gabby's staff -- and their families: please know that our hearts and prayers go out to you.

"This body has yet to fully register the magnitude of this tragedy. We feel a litany of unwanted emotions no resolution could possibly capture. We know that we gather here without distinction of party. The needs of this institution have always risen above partisanship. And what this institution needs right now is strength -- holy, uplifting strength. The strength to grieve with the families of the fallen, to pray for the wounded, and to chart a way forward, no matter how painful and difficult it may be.

"Today it is not ceremony, but tragedy that stirs us to renew our commitment to fulfill our oaths of office. Let us not let this inhuman act frighten us into doing otherwise. The free exchange of ideas is the lifeblood of our democracy, as prescribed by the First Amendment, that beacon of free expression Congresswoman Giffords recited in this well just days ago. These rights have not been handed down by dictate -- they have been preserved and protect through generations of hard sacrifice and commitment. We will continue this unfinished work.

"We will do it for Christina Taylor Green, Dorothy Morris, Phyllis Schneck, and Dorwan Stoddard, ordinary citizens who died participating in their democracy. We will do it for Judge John Roll. We will do it for Gabe Zimmerman. And we will do it, God-willing, with Gabrielle Giffords.

"Our hearts are broken, but our spirit is not. This is a time for the House to lock arms, in prayer for those fallen and wounded, and in resolve to carry on the dialogue of democracy. We may not yet have all the answers, but we already have the answer that matters most: that we are Americans, and together we will make it through this. We will have the last word.

"God bless this House. God bless this Congress. God bless America."

Remedies that go too far

What our democracy doesn't need is more distance between politicians and constituents.

Posted at 8:59 AM ET, 01/12/2011

By Ezra Klein

Marc Ambinder spoke to a bevy of former Secret Service agents and current physical-protection specialists who said that "members [of Congress] can take commonsense steps to reduce the likelihood of an incident, steps that only mildly compromise their access to the public, if at all." But fairly few of the steps mentioned in the article actually seem like good ideas.

One idea is to "request the presence of a police officer from the local jurisdiction" when holding community meetings. That would be from the perspective of constituent access, but is it a good use of resources? Attacks on meetings held by members of Congress happen almost never, while many communities have too much crime and too few police. As Ambinder says, it's not reasonable to ask "the California Highway Patrol to provide officers for every congressional event held by all 54 members of the state’s congressional delegation during a recess." So there is a cost here, but the benefit is unclear.

Another proposal is to have aides "assume some responsibility" over event security to their list of duties. "If the member is sitting at a table, make sure the table is positioned near some sort of concrete pillar that could provide cover. Make sure that the member can quickly move to a vehicle if something happens. A bit of training can help staffers detect unusual behavior in a crowd." And so on.

But will congressional aides make for good bodyguards, even if they get "a bit of training?" I doubt it. Because field organizers actually don't know how to find the one nut who will pull a gun every few decades, they'll start throwing out lots of people who seem a little off. Better than safe than shot at. But if you've ever been to a community meeting, "seems a little off" pretty much describes the whole room. And people who "seem a little off" should have access to their member of Congress, too.

Other ideas in the article include rope lines, a distance of at least seven feet between politician and public ("Safety is nearly assured when the setup keeps the nearest members of the public more than 25 feet away from the protectee”) and proactive threat assessment. In Congress, Rep. Peter King wants to make it a felony to bring a gun within 1,000 feet of a government official, which seems fine until you realize that it'salready a felony to shoot at a member of Congress, and so the individuals in question have probably made their peace with a bit of lawbreaking. I could imagine various gun control ideas that might make sense here, but that's not one of them.

And all this would solve ... what? In the past three decades, there haven't been five members of Congress shot by constituents. There haven't been two. There's been one. And it's not at all clear that most of these proposal would've even prevented that shooting.

I don't want to downplay the horror of what happened in Arizona. But attaching a police officer to every congressional event or trying to train aides who're supposed to be listening to constituents to instead try and assess the threat level they pose is not the right way to grieve. We've suffered a tragedy, but there's no evidence, at least as of yet, that legislators are in much everyday danger. That's in stark contrast with, say, people who live in Detroit, who perhaps could use more security.

By Ezra Klein | January 12, 2011; 8:59 AM ET

Obama in Tucson: The Right Loses a Meme

— By David Corn

| Wed Jan. 12, 2011 7:16 PM PST

President Barack Obama's speech in Tucson was undeniably a high moment of his presidency. But you can judge that for yourself. (As the father of a nine-year-old daughter, I could not imagine delivering such an address—and keeping it together.) The initial reviews—even among pundits on the right—appeared overwhelmingly positive, proving that most of us can live in a shared reality. But here's what to look for in the coming days: how the die-hard Obama-haters will behave. Since the campaign, this gang has argued one or more of these variants: Obama is anti-America, Obama wants to wreck the economy, Obama wants to weaken America, Obama hates liberty and freedom, Obama is a socialist, Obama is a communist, Obama is not truly (and literally) an American, Obama is a secret Muslim. After this speech, will they be able to make such claims? (Rush Limbaugh, I am indeed talking about you.)

During the 2008 campaign, Obama did appeal to those voters who yearned for a leader who could rise above the partisan fray. The process of governing—and GOP obstructionism—made it tough for him to keep that promise. But this speech offered him an opportunity to renew that connection with voters of this particular stripe. The leader on the stage in Tucson was not a man who fits the Rushian or Beckian caricature. So what are Rush, Glenn, and the others going to do? (And by the end of Obama's speech, Sarah Palin's silly Facebook videolooked even more small-minded and self-centered.) The Obama Hate Machine better pray that Obama doesn't get other chances to address the nation in this manner. The White House, after all, cannot manufacture such opportunities. They come precisely because of events that are beyond our control. Yet it is in these moments that presidents can define themselves—especially for those voters who do not pay attention to the daily tussles of politics and policy. Obama did that well on Wednesday night, and the Obama haters must hate that.

Boehner to Host RNC Party During Tucson Memorial

By Jennifer Bendery
Roll Call Staff
Jan. 12, 2011, 3:25 p.m.

Updated: 5:48 p.m.

Speaker John Boehner will host a cocktail party for the Republican National Committee at the same time that President Barack Obama will be addressing the nation at the memorial service for victims of the Tucson shooting.

The Ohio Republican is holding a 7 p.m. cocktail reception Wednesday night for 168 RNC members, who are in the Washington area for an annual meeting. The event is sponsored by Boehner’s political action committee and will take place at Maryland’s National Harbor resort.

The RNC party coincides with the 8 p.m. EST memorial ceremony at the University of Arizona in Tucson, where Obama will honor the victims of Saturday’s shooting rampage that left six dead and 14 wounded, including Rep. Gabrielle Giffords (D-Ariz.), who is in critical condition.

A Boehner aide said the Speaker plans to leave the RNC party before Obama begins his remarks.

“Speaker Boehner will attend an organizational meeting with RNC members this evening, but will leave before the president’s speech begins,” Boehner spokesman Cory Fritz said.

Another Boehner aide emphasized that the RNC reception was scheduled before the memorial event was set.

Boehner turned down a Tuesday invitation from Obama to fly to Tucson with him, Minority Leader Nancy Pelosi (D-Calif.) and other lawmakers for the Wednesday night memorial service.

A Boehner aide said the Speaker “made it clear to the White House all along that he would be in the House today” and that the president’s “last-minute invite was a courtesy” because the White House knew Boehner was going to stay in Washington, D.C.

“Today, Rep. Giffords’ colleagues on both sides of the aisle honored her and mourned those who were lost. The Speaker felt his place was here in the House, with them,” Boehner spokesman Michael Steel said.

Separately, Armed Services Chairman Buck McKeon (R-Calif.) told reporters Wednesday that he canceled a meet-and-greet event Tuesday night for new members on the committee and the defense community because it would not be appropriate in light of the tragedy. Giffords is a member of the committee.

Earmark Myths and Realities

November 10, 2010 4:39 P.M.

By Sen. Tom Coburn

As Senate Republicans prepare to vote on an earmark moratorium, I would encourage my colleagues to consider four myths and four realities of the debate.

Myths of the earmark debate:

1. Eliminating earmarks does not actually save any money

This argument has serious logical inconsistencies. The fact is earmarks do spend real money. If they didn’t spend money, why defend them? Stopping an activity that spends money does result in less spending. It’s that simple. For instance, Congress spent $16.1 billion on pork in Fiscal Year 2010. If Congress does not do earmarks in 2011, we could save $16.1 billion. In no way is Congress locked into to shifting that $16.1 billion to other programs unless it wants to.

2. Earmarks represent a very tiny portion of the federal budget and eliminating them would do little to reduce the deficit

It’s true that earmarks themselves represent a tiny portion of the budget, but a small rudder can help steer a big ship, which is why I’ve long described earmarks as the gateway drug to spending addiction in Washington. No one can deny that earmarks like the Cornhusker Kickback have been used to push through extremely costly and onerous bills. Plus, senators know that as the number of earmarks has exploded so has overall spending. In the past decade, the size of government has doubled while Congress approved more than 90,000 earmarks.

Earmarks were rare until recently. In 1987, President Reagan vetoed a spending bill because it contained 121 earmarks. Eliminating earmarks will not balance the budget overnight, but it is an important step toward getting spending under control.

3. Earmarking is about whose discretion it is to make spending decisions. Do elected members of Congress decide how taxes are spent, or do unelected bureaucrats and Obama administration officials?

It’s true that this is a debate about discretion, but some in Congress are confused about discretion among whom. This is not a struggle between the executive branch and Congress but between the American people and Washington. Do the American people have the right to spend their own money and keep local decisions at the local level or does the federal government know best? Earmarks are a Washington-knows-best solution. An earmark ban would tell the American people that Congress gets it. After all, it’s their money, not ours.

An earmark moratorium would not result in Congress giving up one iota of its spending power. In any event, Republicans should be fighting over how to cut government spending, not how to divide it up.

4. The Constitution gives Congress the responsibility and authority to earmark

Nowhere does the Constitution give Congress the authority to do earmarks. The concept of earmarking appears nowhere in the enumerated powers or anywhere else in the Constitution. The so-called “constitutional” argument earmarks is from the same school of constitutional interpretation that led Elena Kagan to admit that Congress had the authority to tell the American people to eat their fruits and vegetables every day. That school, which says Congress can do whatever it wants, gave us an expansive Commerce Clause, Obamacare, and a widespread belief among members of Congress that the “power of the purse” is the power to pork.

Earmark defenders are fond of quoting Article I, Section 9 of the Constitution which says, “No money shall be drawn from the Treasury, but in consequence of appropriations made by law.” They also refer to James Madison’s power of the purse commentary in Federalist 58. Madison said the “power of the purse may, in fact, be the most complete and effectual weapon with which any constitution can arm the immediate representatives of the people.”

Yet, earmark proponents ignore the rest of the Constitution and our founders’ clear intent to limit the power of Congress. If the founders wanted Congress to earmark funds to specific recipients, micromanage American society, and ride roughshod over state and local government they would have given Congress that authority in the enumerated powers. They clearly did not.

Our founders anticipated earmark-style power grabs from Congress and spoke against such excess for the ages. James Madison, the father of the Constitution said, “With respect to the two words ‘general welfare,’ I have always regarded them as qualified by the detail of powers connected with them. To take them in a literal and unlimited sense would be a metamorphosis of the Constitution into a character which there is a host of proofs was not contemplated by its creators.”

Thomas Jefferson, in a letter to James Madison, spoke directly against federally-funded local projects. “[I]t will be the source of eternal scramble among the members, who can get the most money wasted in their State; and they will always get the most who are the meanest.” Jefferson understood that earmarks and coercion would go hand in hand.

Also, if earmarks were a noble constitutional tradition, how did we thrive for 200 years without an earmark favor factory in Congress?

Finally, for those worried about ceding constitutional authority to the executive branch, I would respectfully remind them that the president has zero authority to spend money outside of the authority Congress gives him. The way to hold the executive branch accountable is to spend less and conduct more aggressive oversight. Earmarks are a convoluted way for Congress to try to regain authority they have already ceded to the executive branch through bad legislation. The fact is there is nothing an earmark can do that can’t be done more equitably and openly through a competitive grant process.

Beyond these myths, I would encourage members to consider the following realities.

1. Earmarks are a major distraction

Again, earmarks not only do nothing to hold the executive branch accountable — by out-porking the president — but take Congress’ focus away from the massive amount of waste and inefficiency within federal agencies. In typical years, the number of earmark requests outnumbers oversight hearings held by the Appropriations Committee by a factor of 1,000 to 1. Instead of processing tens of thousands of earmark requests the Senate should increase the number of oversight hearings from a few dozen to hundreds. The amount of time and attention that is devoted to the earmark chase is a scandal waiting to be exposed.

2. This debate is over among the American people and the House GOP

If any policy mandate can be derived from the election it is to spend less money. Eliminating earmarks is the first step on that path. The House GOP has accepted that mandate. The Senate GOP now has to decide whether to ignore not only the American people but their colleagues in the House. The last thing Senate Republicans should be doing is legislative gymnastics to get around the House GOP earmark ban.

3. Earmarking is bad policy

In recent years the conventional wisdom that earmarks create jobs has been turned on its head. The Obama administration’s stimulus bill itself, which is arguably a collection of earmarks approved by Congress, proves this point. Neither Obama’s stimulus nor Republican stimulus — GOP earmarks — is very effective at creating jobs.

Harvard University conducted an extensive study this year of how earmarks impact states. The researchers expected to find that earmarks drive economic growth but found the opposite.

“It was an enormous surprise, at least to us, to learn that the average firm in the chairman’s state did not benefit at all from the unanticipated increase in spending,” said Joshua Coval, one of the study’s authors. The study found that as earmarks increase capital investment and expenditures by private businesses decrease, by 15 percent specifically. In other words, federal pork crowds out private investment and slows job growth. Earmarks are an odd GOP infatuation with failed Keynesian economics that hurts local economies.

Earmarks also crowd out funding for higher-priority items. Transportation earmarks are a good example. Pork projects like the Bridge to Nowhere and bike paths divert funds from higher priority projects according to a 2007 Department of Transportation inspector general report. Thousands of bridges continue to be in disrepair across America in part because Congress has taken its eye off the ball and indulged in parochial spending.

4. Earmarking is bad politics

If the Senate GOP wants to send a signal that they don’t get it and are not listening they can reject an earmark moratorium. For Republicans, earmarks are the ultimate mixed message. We’ll never be trusted to be the party of less spending while we’re rationalizing more spending through earmarks. The long process of restoring fiscal sanity in Washington begins with saying no to pork.

— Sen. Tom Coburn represents the state of Oklahoma in the U.S. Senate.

WHY THERE ARE SO MANY MENTALLY ILL AMONG US

HARRY SHEARER

Posted: January 10, 2011 11:02 AM

NEW ORLEANS — In the race to “explain” the Tucson shooting, the sprinters have been those who’ve found the cause in the rhetoric of one side or the other of the political spectrum. Close behind them have been those who see once again the folly of a society, almost unique in the civilized world, that views gun possession as a birthright.

Now comes another view, at least from me. This country has had toxic political rhetoric since its birth pangs, and there has undeniably followed in the past two centuries an occasional outbreak of political violence. But now we’re being told that toxic political rhetoric is dangerous, because of its possible effect on the less rational, more mentally unhinged folks among us. So, maybe it’s time to ask this question: Why are they among us?

In the bad old days, this nation had a system of mental hospitals — sad, dreary institutions in which the unhinged were quite often warehoused, sometimes for life. The worst of them were exposed as “snake pits,” cruel and uncaring, and a reform movement sprang up. We should, we were told (by, among others, then-California Governor Ronald Reagan), close down these shameful institutions, and return the patients to their communities, where a system of community-based mental health clinics would administer care that was, well, more caring.

So we closed down the mental hospitals. And we neglected to set up community mental health clinics. And suddenly we had a crisis of homeless people, many if not most of whom were mentally ill.

And now we have this: a society where we’re being lectured to temper our political rhetoric lest we inflame the crazies to acts of violence.

This moment is, of course, perhaps the worst possible moment to remind ourselves of our unfulfilled pledge to the mentally ill, that promise that warehousing would be replaced by accessible, community-based care. We don’t have the money. We could call off our adventure in Afghanistan and we would have the money, but I don’t advise holding your breath about that one.

I’m the last person to advocate re-instituting the old system. I personally helped get someone who was involuntarily, and improperly, committed to such a hospital out, when I was working for a state legislator. But the least we can do is acknowledge, amid all the fun finger-pointing, that we all, Dems and Reps, libs and cons, have failed the mentally disturbed among us. And the bill continues to come due.

We’re too quick to use “mental illness” as an explanation for violence.

By Vaughan BellPosted Sunday, Jan. 9, 2011, at 12:52 AM ET

See Slate’s complete coverage of the Gabrielle Giffords shooting and arrest of Jared Lee Loughner.

Shortly after Jared Lee Loughner had been identified as the alleged shooter of Arizona Rep. Gabrielle Giffords, online sleuths turned up pages of rambling text and videos he had created. A wave of amateur diagnoses soon followed, most of which concluded that Loughner was not so much a political extremist as a man suffering from “paranoid schizophrenia.”

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For many, the investigation will stop there. No need to explore personal motives, out-of-control grievances or distorted political anger. The mere mention of mental illness is explanation enough. This presumed link between psychiatric disorders and violence has become so entrenched in the public consciousness that the entire weight of the medical evidence is unable to shift it. Severe mental illness, on its own, is not an explanation for violence, but don’t expect to hear that from the media in the coming weeks.

Seena Fazel is an Oxford University psychiatrist who has led the most extensive scientific studies to date of the links between violence and two of the most serious psychiatric diagnoses—schizophrenia and bipolar disorder, either of which can lead to delusions, hallucinations, or some other loss of contact with reality. Rather than looking at individual cases, or even single studies, Fazel’s team analyzed all the scientific findings they could find. As a result, they can say with confidence that psychiatric diagnoses tell us next to nothing about someone’s propensity or motive for violence.

A 2009 analysis of nearly 20,000 individuals concluded that increased risk of violence was associated with drug and alcohol problems, regardless of whether the person had schizophrenia. Two similar analyses on bipolar patients showed, along similar lines, that the risk of violent crime is fractionally increased by the illness, while it goes up substantially among those who are dependent on intoxicating substances. In other words, it’s likely that some of the people in your local bar are at greater risk of committing murder than your average person with mental illness.

Of course, like the rest of the population, some people with mental illness do become violent, and some may be riskier when they’re experiencing delusions and hallucinations. But these infrequent cases do not make “schizophrenia” or “bipolar” a helpful general-purpose explanation for criminal behavior. If that doesn’t make sense to you, here’s an analogy: Soccer hooligans are much more likely to be violent when they attend a match, but if you tell me that your friend has gone to a soccer match, I’ll know nothing about how violent a person he is. Similarly, if you tell me your friend punched someone, the fact that he goes to soccer matches tells me nothing about what caused the confrontation. This puts recent speculation about the Arizona suspect in a distinctly different light: If you found evidence on the Web that Jared Lee Loughner or some other suspected killer was obsessed with soccer or football or hockey and suggested it might be an explanation for his crime, you’d be laughed at. But do the same with “schizophrenia” and people nod in solemn agreement. This is despite the fact that your chance of being murdered by a stranger with schizophrenia is so vanishingly small that a recent study of four Western countries put the figure at one in 14.3 million. To put it in perspective, statistics show you are about three times more likely to be killed by a lightning strike.

The fact that mental illness is so often used to explain violent acts despite the evidence to the contrary almost certainly flows from how such cases are handled in the media. Numerous studiesshow that crimes by people with psychiatric problems are over-reported, usually with gross inaccuracies that give a false impression of risk. With this constant misrepresentation, it’s not surprising that the public sees mental illness as an easy explanation for heartbreaking events. We haven’t yet learned all the details of the tragic shooting in Arizona, but I suspect mental illness will be falsely accused many times over

Identifying the distrubed

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We're Still at War:

Photo of the Day for January 13, 2010

Thu Jan. 13, 2011 2:30 AM PST

U.S. Army Soldiers from 4th Brigade Combat Team, 101st Airborne Division, fire their weapons as part of the “stress shoot” at Forward Operating Base Sharana Jan. 9. The stress shoot is the final phase of the Toccoa Tough resiliency training class hosted by the Task Force Currahee resiliency team to give Soldiers the opportunity to take a break from their daily routine and help them refocus on their physical, mental, spiritual and emotional health. Photo by U.S. Army Sgt. Luther L. Boothe Jr., Task Force Currahee Public Affairs

Study examines link between poverty, mental illness



Christopher G. Hudson, Ph.D., conducted a large-scale study on poverty and mental illness. Hudson is chairman of the School of Social Work at Salem State College. (photo by Andrew Gallagher)

By Ami Albernaz
For decades, researchers have known that poverty and mental illness are correlated; the lower a person's socioeconomic status, the greater his or her chances are of having some sort of mental disorder. Yet determining if one comes first - if being poor renders a person more susceptible to mental illness, or if mental illness pulls a person into poverty - is decidedly difficult and the relationship between poverty and mental health has long been assumed to be interactive.
Yet a recently published large-scale, seven-year study suggests that poverty, acting through economic stressors such as unemployment and lack of affordable housing, is more likely to precede mental illness than the reverse. Christopher G. Hudson, Ph.D., chairperson of the School of Social Work at Salem State College, examined the records of more than 34,000 patients who had been hospitalized because of mental illness at least twice between 1994 and 2000. He looked at whether or not these patients had "drifted down" to less affluent ZIP codes following their first hospitalization.
Except for patients with schizophrenia, though, Hudson found little evidence of this downward drift. Hudson says his data suggests that poverty impacts mental illness "both directly and indirectly."
"Much of the impact comes through economic conditions such as housing and unemployment," he says. Other hypotheses Hudson tested, including the "downward drift" and the idea that lack of family support acts as a mediator between poverty and mental illness, received little support in his data.
Hudson's study follows a long line of research into the poverty-mental illness link that has been conducted since the late 1930s. These studies have repeatedly found higher rates of mental illness in low-income communities. Hudson's data shows mental illness to be three times as prevalent in low-income communities as in higher income ones; other studies have shown the rate to be anywhere from two to nine times higher in poor communities. Research into causes of mental illness began much later; levels of fatalism among poor people, levels of family and community support and unemployment were all examined as possible factors.
The relationship is still regarded by mental health professionals as a complex one. Elizabeth Childs, M.D., commissioner of the Massachusetts Department of Mental Health (DMH), says while it is not surprising that Hudson's study shows a correlation between serious mental illness and low socio-economic status, she does not infer that poverty leads to mental illness. "Poverty presents risk factors that may exacerbate mental illness," she says, and "can impede access to services that are necessary for early intervention and treatment. The evidence is increasingly clear that there are biological roots to serious mental illness, and as with many other medical illnesses, environmental factors, such as socio-economic status, can play a major role in the course of the disease," she says.
Kelly Anthony, Ph.D., a visiting assistant professor of social psychology at Wesleyan University who has researched poverty and homelessness, says that particularly in the United States, "relative poverty" - dissatisfaction with one's lot in life compared to that of others - seems to correlate with mental illness. "All of these issues [surrounding poverty and mental health] are complex when you lump them all together," she says. Cases of psychological disturbance for which biological evidence is not so strong, mild depression and anxiety, for instance, might be more influenced by social conditions such as poverty, she adds.
Debates on the connection aside, however, the undeniably higher prevalence of mental illness in poor communities has implications for public policy, some say.
Mental health resources should be distributed according to need, rather than on previous usage or on a per capita basis, Hudson says. In states where the latter happens, poor residents are underserved.
"If the rate of mental illness in poor areas is two to nine times what it is in rich areas, then you need two to nine times the levels of servicing and funding in [poor] areas, which rarely happens," he says.
Psychological services for the most vulnerable, Hudson says, should be linked to "concrete services," supported unemployment and assisted housing, for example. "It used to be that mental health workers didn't want to concern themselves with housing and unemployment," he says. "But this is starting to change."
In Massachusetts, where some DMH clients earn 10 to 15 percent of the average yearly income and are often in great need of affordable housing, according to Childs, "a primary goal of our community service system is focused on assisting our clients to obtain housing and employment, through direct housing assistance, linkages with state and federal housing subsidy programs and community programs that foster and develop employment skills," she says.
Bernice Lott, Ph.D., a professor emerita of psychology and women's studies at the University of Rhode Island who has written on social class and health, argues that a stronger social service net is needed to prevent people from sliding into poverty and poor health in the first place.
"To prevent illness and provide the conditions for optimal health, we need structural changes," she says. These changes, she adds, include allotting resources for job creation; increasing the minimum wage; improving public education and increasing access to higher education; providing job training; and offering financial supports for low-income families.
What is ultimately needed, Hudson and Lott suggest, is a leveling of the playing field.
"I find it amazing that so many people will claim that mental illness is equal opportunity. It's true that anyone can breakdown [acknowledged biological factors], but class differentials are often overlooked," Hudson says. "When it comes to mental illness, some people are more equal than others."