What the candidates forgot to debate

Last night, I waited again in vain for the Democratic presidential rivals Senator Hillary Clinton and Senator Barack Obama to talk turkey about a worsening public health crisis:  the deplorable state of mental health services in America.

We do not have to look far to see how the lack of innovative, affordable mental health care services has hastened a Great Unraveling:

   -- Last Sunday, police in Long Island, New York (the state represented by Seantor Clinton) took a call from a 27 year-old woman named Leatrice Brewer.  She had killed her three children, Brewer said, then helpfully spelled her name for the 911 operator, according to The New York Times.

When law enforcement officers arrived, they quickly learned that Brewer appeared to be seriously mentally ill: in addition to allegedly drowning, cutting the throats, and poisoning her three small children, she had inexplicably jumped from a second-story window mintues after she'd phoned the police.

Child welfare officials had been aware of Brewer's troubles; they had investigated complaints of neglect and drug abuse in the year or so since Brewer's mother died. Several months ago, according to The Times, Brewer broke up with the father of two of her three children, and he had been seeking custody of them.  She was well-known around the neighborhood for showing signs of "bizarre" behavior, including panhandling neighbors, and walking around outdoors in her pajamas.

A neighbor of Brewer told The Times, "People can snap, and I think she just snapped."

  -- In Washington, D.C. in January, law enforcement officials attempting to serve an eviction notice on a Southeast resident, Banita Jacks, stumbled upon the bodies of her four children. Jacks, according to officials, had a long history of mental illness, and had allegedly killed her children several weeks earlier.

  -- In the past year, in Virginia, Missouri, California, and Nebraska, gun-wielding assailants have killed dozens of people at shopping malls, on college campuses, and in one instance, during a public planning commission meeting.  The youngest gunman -- a 14 year-old boy suspected of shooting a gay classmate in the head at their Ventura County, California middle school two weeks ago - was said by neighbors and classmates to have been the subject of a nasty custody battle between his drug and alcohol abusing parents.

All the alleged assailants, it is not hard to surmise, were gripped with some form of mental illness.  And all, as The New York Times columnist Gail Collins recently observed, apparently had no trouble getting guns, despite their muddled mental conditions.

Yet none of the leading presidential candidates makes a big deal of these tragedies, or rather, of the tattered state of the country's mental health care system, a key component in each case. Could it be because the constituencies -- those affected by poor mental health  -- are so debilitated, emotionally, financially, and by the shame of their own or their loved ones' illnesses that they can't get onto the candidates' radar?

It is hard to believe that none of the leading candidates -- including Republican frontrunner John McCain, a Vietnam War veteran who probably knows more about Post-Traumatic Stress Disorder than most Americans -- have bothered to speak forcefully to Americans' concerns about mental health care. The numbers of Americans who are touched in some way by mental illness, and the frustration of attempting to find services and relief in that realm, are undoubtedly as high as those who struggle with dwindling jobs, mortgage foreclosures, and inadequate educational opportunities.

And while I appreciate Senator Obama's reluctance to get typed as "the president of black America," he damn well better know that African-Americans are more likely to suffer longer from serious mental illnesses, and receive much less preventive and acute care, than the general population, according to the U.S. Department of Health and Human Services.  Senator Obama has talked movingly about wanting to improve health care services for veterans, especially those suffering from psychic and physical woulds received in war zones. But about the millions of black and brown residents of American cities who's day-to-day struggles leave them with symptoms of  PTSD, we hear nary a word.

For Senator Clinton, there is a first-person story she might grab on to, the better to make a case during debates and other big public appearances for shoring up funding, public awarness and political will to improve mental health in America. A few months before the New Hampshire primary,  a mentally troubled man strapped fake explosives to his chest and took hostages at one of Senator Clinton's campaign offices in the Granite State.

Clinton did, at that time, say appropriately measured and compassionate comments about the incident, but failed to draw a strong line between the troubled man's challenges and the larger dim picture of mental health care in the U.S.

In fact, on the official campaign website of Senator Clinton there is no language at all about increasing funding for mental health programs, not even amidst the long, detailed portion outlining the candidate's plan to overhaul health care in America.

On Senator Obama's website, there is a paragraph outlining the candidate's desire to bring "parity" to insurance formulas for patients seeking reimbursement for mental health services, as well as language detailing the senator's plan to improve health care services (including mental health care) for veterans.

Both candidates completed a "2008 Presidential Candidate Questionnaire" from the National Alliance for the Mentally Ill, in which they separately outline common-sense plans for improving access and affordability.

But out on the trail, they seem unwilling to take that bull by the horns, even as it stampedes across the land, wrecking lives and creating legacies of pain and hopelessness among millions.

Nevermind the hype over NAFTA, the low-blow appearance of that Obama-in-a-turban photo that surfaced the other day; forget the endless, sniping between the two candidates over when to negotiate with Iran:  Both candidates have to start talking with urgency about America's frayed mental health. We want to see their detailed plans to stem the tidal wave of conditions that lead some Americans to wake up one day and just "snap."