Opinion/Pisciotta: Turning anxiety into action for a healthy RI

Laurie-Marie Pisciotta, Guest columnist


Laurie-Marie Pisciotta is the executive director of the Mental Health Association of Rhode Island.

I don’t know about you, but I have been feeling anxious. So much feels beyond my control. As someone who has been in therapy for much of my life, I know I should have acceptance of the things I cannot change, courage to change the things I can, and the wisdom to know the difference. Of course, this is easier said than done for someone with an anxiety disorder and clinical depression.

Part of my anxiety relates to statewide crises in Rhode Island. As a mental-health consumer and advocate, I see firsthand how the state’s chronic under-investment has eroded our continuum of behavioral health care. I have been on a waitlist for an outpatient psychiatrist for medication management for 5 months. There are also waitlists for adolescent inpatient psychiatric beds and residential treatment centers. These services are lifesaving, and yet people have to wait. Would we let cancer patients wait for treatment? Of course not. Other illnesses elicit sympathy, but mental illness is still dismissed as a character flaw, self-inflicted ailment, or imaginary.

I’m deeply concerned about the staffing shortages in health and human services across Rhode Island. This too can be attributed to the state’s neglect. Thousands of Rhode Islanders with disabilities, youth, and older adults are at risk of going without basic services like home care. Low wages cause high staff turnover, burnout for the remaining staff, long waitlists for consumers, and poor quality care. Medicaid reimbursement rates are so low that many providers will not accept it. Mental Health Association of Rhode Island spearheaded legislation this year requiring commercial insurers and Medicaid to raise their reimbursement rates. It passed the Senate but died in the House.

It is worrisome that the pandemic’s economic devastation has caused a 17% increase in the number of homeless families. It is estimated that 90% of our homeless population could achieve self-sufficiency and never be homeless again if we had enough affordable housing. The remaining 10% are chronically homeless due to untreated serious persistent mental illness, substance use disorders, and other disabilities. These vulnerable people deserve supportive housing, yet there is not enough of that either.

The number of people living outdoors in Rhode Island increased by 52% during the pandemic. Winter is coming. People will die. This should alarm every leader in our state. We must invest in temporary measures like shelters and hotel vouchers, as well as permanent solutions like affordable housing and increased wages. People can’t stay well without permanent housing.

Lastly, while we might enjoy summer temperatures of 70+ degrees in October, it is indicative of global warming. We will pay for this in the long term with warmer water temperatures, collapsing ecosystems, extreme weather events, and sea level rise. This weighs on my mind. It should worry you, too.

All these crises could be mitigated with proper financial investment and political will. Homelessness is a policy choice. Staffing shortages are a policy choice. Waitlists for behavioral health care are a policy choice. Climate change is a policy choice. Our leaders are making these choices for us everyday. Rhode Island has been pennywise and pound-foolish for too long.

Under-investment is counterproductive. A robust continuum of care and housing are the foundation of a healthy citizenry. A healthy citizenry is the backbone of a prosperous state.

What can we do? Therapy has taught me that the antidote to feeling worried and powerless is to take action. That is why the Mental Health Association of Rhode Island and other organizations are holding a virtual “Town Hall For A Healthy RI” on Oct. 27 at 10 a.m. Gov. Dan McKee and State Rep. Carlos Tobon, co-chair of the ARPA Task Force, will participate. This is our opportunity to tell our leaders to take bold action now. Every Rhode Islander should attend this event. I am tired of feeling powerless. What about you?

Register for the event at