To RFK JR.: Undo This Federal Policy That Exacerbates Homelessness - It'll Help the Mentally Ill
Dear Mr. Kennedy,
As someone who carries the weight of a historic name synonymous with justice and compassion, your campaign has the potential to ignite transformative change.
Amid the many critical issues facing America today, I urge you to consider the plight of one of the most underserved and misunderstood populations: those suffering from severe mental illness.
The history of how we, as a nation, have treated individuals with severe mental illnesses is one of profound neglect and misplaced priorities.
In the mid-20th century, the deinstitutionalization movement aimed to liberate individuals from the horrors of overcrowded and abusive asylums. While noble in intent, the movement’s execution left much to be desired.
State mental hospitals were shuttered without adequate community-based systems of care to replace them. Many individuals with severe mental illnesses fell through the cracks, landing instead in jails, prisons, or homelessness.
Today, nearly one-third of the nation’s homeless population and an estimated 20 percent of the incarcerated have untreated severe mental illnesses like schizophrenia or bipolar disorder.
Central to this crisis is the Institutions for Mental Diseases Exclusion, a federal policy born in 1965 as part of Medicaid’s creation. The IMD Exclusion prohibits Medicaid from covering care in psychiatric hospitals with more than 16 beds for individuals aged 21 to 64.
While its original purpose was to incentivize community-based care, it has instead created an insurmountable barrier to treatment for those who need it most. The exclusion forces states to either shoulder the costs themselves — an increasingly rare occurrence — or leave individuals to languish without the care they desperately need.
Mr. Kennedy, your emphasis on environmental toxins such as red dye and fluoride reflects a commitment to addressing public health issues.
However, banning additives and chemicals, while commendable, will not rectify the systemic failures of our mental health system. Severe mental illnesses are complex neurological conditions that require nuanced solutions.
While reducing environmental risk factors plays a role, we cannot afford to ignore the structural and policy-driven obstacles perpetuating the suffering of millions.
The question, then, is this: Will you lead the charge to end the IMD Exclusion, a policy that has, for decades, functioned as an institutionalized barrier to care?
Doing so would honor the legacy of your uncle, President John F. Kennedy, who championed the Community Mental Health Act in 1963 with the vision of a robust and humane mental health care system. Addressing the IMD Exclusion would be a monumental step toward fulfilling it.
Your platform could highlight the broader need for comprehensive reforms, including:
Enhancing Assisted Outpatient Treatment: Expanding and funding AOT Programs to ensure individuals with severe mental illnesses receive consistent, court-ordered treatment while living in the community.
Expanding access to assertive community treatment teams — proven interventions that help individuals with severe mental illnesses lead stable lives.
Increasing the availability of psychiatric hospital beds and housing with comprehensive support, ensuring individuals in crises or requiring long-term care have access to appropriate facilities and services.
The American people are ready for a leader who understands that the moral test of a society lies in how it treats its most vulnerable. The crisis of untreated severe mental illness is a solvable policy failure.
Ending the IMD Exclusion would be a bold, humane, and historically significant step — one befitting the Kennedy legacy.
The time for half-measures has passed. We need bold action. Will you be the leader to take it?
Sincerely,
Deborah Geesling
Advocate and President of P82 Homes
The views expressed in this opinion article are those of their author and are not necessarily either shared or endorsed by the owners of this website. If you are interested in contributing an Op-Ed to The Western Journal, you can learn about our submission guidelines and process here.
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