TIPPER GORE and the Overreaching of Mental Health Coverage.

• Author: VATZ, RICHARD E.

"Mrs. Gore's well-motivated, but not so well-thought out, expansion of mental health coverage to the point of actual parity [with physical illnesses] would represent an irresponsible and overly expensive change in the status quo."

IT WAS MAY, 1993, the year of the major health care battle that First Lady Hillary Clinton became famous (or infamous) for, and I had been invited to a party given by talk show host Larry King for Al and Tipper Gore at the late Duke Ziebert's restaurant in Washington, D.C. I was introduced to Mrs. Gore's aide, who, upon hearing the name of my university affiliation, said, "You know, Mrs. Gore was just infuriated by an article written by a colleague of yours in The Wall Street Journal." I asked if the article was about mental health insurance. Told that it was, I indicated that the aide was talking about an article written by me, and he asked if I would mind speaking to Mrs. Gore. After saying "no, not at all," I was confronted by a livid Mrs. Gore, who lambasted me for 15 minutes on the irresponsibility of my recommending that substantial changes be made in the Clinton-Gore mental health plan.

Tipper Gore is no newcomer to the battles over mental illness and the costs of health care for those who are seen as mentally ill. In fact, it is likely that organized psychiatry has never had as intrepid and important an advocate at such an advantageous time as it has in Tipper Gore, wife of Vice Pres. Al Gore, a candidate for the Democratic nomination for the presidency. Mrs. Gore majored in psychology at Boston College and received a Master's Degree in Psychology from George Peabody College in Nashville, Tenn. Her initial public work in psychology focused on aiding the homeless, and more than a decade ago she worked with the National Mental Health Association on an exhibit, "Homeless in America: A Photographic Project." Mrs. Gore's work for mental health issues earned her the title of Mental Health Policy Advisor to Pres. Clinton.

The first White House wife who engaged in major lobbying efforts on behalf of the interests of the mentally ill and those who care for them was Rosalynn Carter. Since 1970, when Jimmy Carter was campaigning to be Governor of Georgia, Mrs. Carter has been arguing for more money and sympathy for the mentally ill. During Carter's presidency, his wife was the honorary chair of the President's Commission on Mental Health. In the years subsequent to her husband's presidency, Mrs. Carter founded the Carter Center's Mental Health Task Force, of which she is chair. In recent years, Rosalynn Carter has been speaking out nationally on television shows like "Larry King Live" and emphasizing the view that psychiatric disorders are invariably biological disorders. Her book, Helping Someone with Mental Illness, which, according to Mrs. Carter, attempts to make the arcane language of psychiatric...