FAREWELL from KAREN SHORE, PhD,
Founder and Past-President

My Dear Friends,

It is a little shy of nine years since I sat in someone’s living room with a dozen social workers to discuss a new threat called “managed care.”  There, in September 1992, the National Coalition was conceived.  Two months later, three dozen mental health professionals gave birth to the National Coalition and invited consumers of mental health care to join us.

So many Coalition co-chairs, newsletter editors, board members, committee chairs and members, and others worked so hard to nourish this newborn organization.  We were criticized by the professional “establishment” for saying that managed care was a totalitarian system run by bullies.  We feared being blacklisted or worse by the managed care bullies for speaking out. But we spoke out anyway. We made national news in our first months of life as we vowed to fight the managed care industry and to preserve quality and the patient’s rights to choice, privacy, and decision-making power.  We circulated petitions visited the Clintons’ Health Care Task Force.  We prepared our members for lobbying and they and we lobbied with great energy at the state and federal levels.  

We had a strong growth spurt from 1993 through 1995.  We grew to include 19 affiliated state and local coalitions, and we were able to hire our most dedicated office manager, Michelle, who still serves us with love.  Almost all newspaper articles and television and radio spots on managed mental health care were initiated by us or included us.  We were everywhere!  Consumers were finding out about our work and their calls and letters confirmed how right we were and how necessary our work was.  The “industrialization” of mental health care was indeed a disaster, and people were being hurt and some were dying needlessly, because mental health services and quality were being cut drastically.  Our adolescence and early adulthood, from 1995 through 2000, saw us increasing our range of influence through connections with major consumer and professional organizations.  Our “rite of passage” into mature adulthood was Rescue Health Care Day, April 1, 2000, when our efforts to unite and organize culminated in rallies and protests against managed care in 37 cities across the U.S.

Unfortunately, everything we predicted has come true.  Training programs have largely stopped teaching intensive therapies.  Few new professionals have any idea what goes on inside a person or what to do beyond 15 therapy sessions.  A new generation of clinicians is being trained to do what they are told, rather than to think on their own. Patients who must rely on their insurance are worse off than before the 1960s.  Many have trouble finding someone to treat them.  As we predicted, “parity” has paradoxically forced managed care into almost all mental health plans, depriving people of privacy, choice, and anything more than brief treatment.  Only the well-to-do can buy the clinicians, medications, and treatments they want without the influence of their cost-conscious insurers.

While the power balance has changed little so far, we did help to achieve the almost universal distrust and dislike of this greedy, destructive industry and a desire on the part of many to create something better.

I am delighted to turn over the leadership of the Coalition to the able hands of Deborah Peel, M.D., and to an excellent Board of Directors.   I will continue to devote time to the Coalition, for there is still much I want to do and much I hope to write.  However, I have only done a portion of the professional studying, training, and teaching that I wanted to do these past nine years, and I still have so much more to learn and to do professionally.  And, I hope to have a little time over to develop personal interests. 

My professional and political work has always been about values, excellence, freedom, and meaning, and about healing some of the pain found in our nation’s people.  I thank all of you who share these values and have supported me and the Coalition emotionally, financially, and with your time and energy.  Please continue your support for the Coalition and its new President.  There is still so much to be done and you are needed.

Warmest regards,

Karen Shore, Ph.D.

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