Jack Betts is an Observer associate editor at The Charlotte Observer. His piece this past Sunday was about a speech given in Chapel Hill, NC about ethical problems in public life by Joel Fleishman professor of law and public policy at Duke University. The draft of the full speech is available at a link at www.charlotte.com/jackbetts. The following is a short excerpt from the speech.

“Why has it begun to happen in N.C. and elsewhere at this particular time? I think that the explanation is deeper than simply a recurrence of the same old thing. I think it has to do with the increasing migration of individual and institutional behavior from the for-profit sector, in other words the market system, where self-interested motivation, in behalf of corporations and their employees, is not only acceptable but laudable, to the public and nonprofit sectors where naked self-interested behavior is usually inappropriate and often unethical if not illegal.”

I was in south Florida when South Florida State Hospital was turned over to a for-profit corporation. I sat on the governing body both when it was run by the state and when it was run by the corporation. I walked the grounds of the hospital when it was run by the state and also did many trainings there which meant I met both staff and my fellow sojourners living there. I was barely allowed on the grounds after the corporation took it over even though I was a member of their board, but then what can you expect from a company with a primary business of operating prisons. The hospital had felt like a college campus (I do not deny the problems there and I fussed with my usual loud voice about them), but when the corporation built the new hospital it felt like you were going to a place to be locked away.

Has the “migration of individual and institutional behavior from the for-profit sector” changed our public mental health system? Has it caused corruption? There may not be a simple answer, but I am going to give you one. YES!

Some of you may never have seen a three legged stool. Years ago in the hills of Kentucky some people had them in their barns to sit on as they milked their cows by hand. A good public mental health system stands on three legs. Heart. Knowledge. Money.

First, the public system must have folks working in it that have a heart. I have done many trainings and seminars with mental health professionals plus I have been going to them since I was 15 and I will be 59 next month. My calculator says that is 44 years. I always look to see if I detect a heart by which I mean do they see me and my fellow sojourners as people or simply as defective machines to be fixed. I fear the fix-it syndrome more than almost anything else. For me personally, if I can feel any kind of vibe other than a chill coming from the other person then there is a starting point.

Secondly, the people have to have knowledge. We have learned a great deal since 1964 when I first came in contact with the mental health profession, but that does not matter if the person working with me is stuck back in the dark ages. Keeping the workforce updated with the latest and best knowledge is extremely important. It doesn’t happen mainly because training does not bring in dollars. Billing services does.

Thirdly, it can not be done on the cheap. Ever since the powers that be decided to empty us out of the big institutions and start community mental health centers, the public mental health system has lacked the funds to do the job. Yes the big institutions were deplorable, but let me let you in on a secret so is living on the streets when you are so sick you don’t even know who you are. How do I know? Because I have been in that position.

One time in New York City when I was on the streets they gave me a subway token to go to another place for help and I thought it was money. I went into a restaurant to try and spend it. They called the police.

From 1969 when I got out of the Army until 1989 when I started Project Dream Again, I worked in sales, management, and started my own tire company. In 1989 I started a not-for-profit corporation which is still what Project Dream Again is a division of. All my life I have been involved with churches which are nonprofits. My point is I have been in the military (government), for-profit corporations, and nonprofit corporations. The more you bring market system into the public mental health system the more corruption you are inviting and the less likely you will find the three legged stool there.

You can reach me directly at [email protected]

faithnet.nami.org.

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