How Mental Health Practitioners Can Get Involved in the Legislative Process

The Association for Private Practice Therapists Fall Conference was held on November 20, 2009. Anne Buettner was one of the panelists. Anne Buettner, MA., is a therapist in private practice in Grand Island. She is the current legislative chair of NAMFT, and immediate past president of Nebraska Association for Marriage and Family Therapy. Anne had served as president of NAMFT for three terms in three decades. She is a previous member of the mental health practice credentialing board, 1993-2003, and has been actively involved in various legislative processes, including the successful quest for independent mental health practitioner licensure.

By Anne Buettner

To talk about legislative process as a mental health professional, I could be preaching to the choir here. I think most mental health professionals in this room have some legislative experience, be it making that phone call to a senator or providing language for a bill. In short, you all have been instrumental in trying to succeed or succeeding in the passage of a bill.

For the few minutes that I have, it is not so much sharing the knowledge but the sharing of philosophies or attitudes as one single mental health professional who had walked through the passage of the law of Licensed Mental Health Practitioners in 1993 and the passage of the law of Licensed Independent Mental Health Practitioners in 2007.

As therapists, we are change agents. In the legislature, we need to be change agents too. The skills are transferable. The macro impact is law making. You can equate helping clients in your office to change as micro impact. That is our livelihood. But changing or making law is making an impact on our profession and our livelihood.

Look at LIMHP. Yes, it is the “I” that makes the difference. It does not just affect LMHPs. It affects psychologists, psychiatrists, nurses, etc., -- i.e. the entire mental health profession.

At first there were the naysayers, but when the train arrived most of them got on. They said it was a pie in the sky. Building castles in the air. So you say to them, “If we have built castles in the air, our work need not be lost; that is where we should be. Now put the foundations under them.” This is a saying from Henry David Thoreau. So first of all you need to have that belief. And as a matter of fact, the belief needs to be a passion.

You need to have a core group that shares the passion. Not everyone needs to have the passion. But the core group, no matter how small, needs passion because the journey is usually long and arduous.
Independence (as therapists) took us four years. Mental Health Practice took us eight years.

Even though clients give you permission to help them to change, you know there is the resistance to change. It is the same with legislators except they have not given us permission to change them. They may give us permission to talk to them. Sen. Mike Gloor, my senator from Grand Island, once quoted a wise man who once said, “Change has many enemies and few friends.” So keep in mind, if their first response is “no,” you should not take it as last response. “No” may mean ‘no’ on that day. 

You have to realize the 49 senators do not become legislators to make changes in credentialing law of mental health practitioners. They have loftier goals. How do you get them to become interested, to listen, to understand ( how do you explain major mental disorder?!), and care to vote? Yes, you need a lobbyist. But a lobbyist will tell you that you need to do grassroots advocacy. You need to find constituents to make the contacts. How do you find a constituent in Louisville or Cortland or Platte Center? You need a large number of constituents and you need a coalition; coalition among the mental health disciplines.

Fifteen years ago I polled some legislators with whom I worked, and I asked them which interests group that they experienced as most feisty and divisive. I expected them to say the business sector. To my chagrin, they said unanimously the mental health professionals have the most amount of fighting among themselves. Fifteen years hence, I do not know where we stand. But for sure there are different view points and different sound bites. We are sometimes painfully as well as respectfully aware of this reality.

I like what Sen. Dubas wrote in this past summer …the art of compromise. You notice that there are three avenues to become independent in the independence law. (One for each of the three disciplines! ) You need to be positive…and realistic. “I am an optimist, but an optimist who carries a raincoat.” (Harold Wilson said that.) The cynics would say that you cannot trust anybody in politics. I would say in politics, there are no friendships, there are alliances. By the same token, there are no friendships, no enemies. Of course, alliances can shift from time to time. Nonetheless, like good attorneys, you can fight in court and you can go out to lunch afterwards. You can be holding hands at one issue, and testifying against each other’s position at another issue.

Compelling stories and statistics help. But most importantly, the message needs to be simple and brief. A one-page fact sheet is all legislators have time to read seriously. I am so used to giving elevator speeches. Always find an angle that engages them. Do not underestimate that contact, be it a phone call and that short note or email, however electronically scripted. Voices for Children reported that
“ the Appropriation Committee and the Governor received thousands of e-mails from Nebraskans indicating what they think are the priorities of the state budget should be. Their voice is making a difference. The Governor proposed budget cuts seemed to recognize the vulnerability of Nebraska’s children and families struggling to make ends meets during these difficult economic times and made few cuts to the social safety net.”

I do not want to leave you with the impression it’s all about who’s making the loudest noise and maneuvering to bend the ears of the legislators. You need 25 senators to pass a bill. In the final analysis, I do see that legislators want to do good for their communities. The fact remains is that there are different options to do it. When we embrace any legislative project, we have to believe that we are doing good not just for the providers such as ourselves, but for the consumers too. Of course, we can be consumers any day too. That common ground… we need to negotiate. The overarching argument is to do good for the consumers.

In the end, in the arena of legislation, just like in any battlefields, “ You’re never as good as everyone tells you when you win, and you’re never as bad as they say when you lose.” 

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