RUTHFULLY YOURS

Yes, President Trump is shaking up Washington, but some things definitely need to be shaken up. Exhibit A is the nation’s mental-health services — or lack of same. As if we needed another reminder, when a man with a gun walks into an FBI office hearing voices and complaining that the CIA is pushing him to become a member of al-Qaeda, he is asking to be treated for his psychosis. Instead, he was given some anti-anxiety medication, released after three days, and given back his gun, which he then took to Ft. Lauderdale. Alaska or Arizona, Colorado or Connecticut — it is the same story, year after year, differing only slightly in detail and diagnosis. But the outcome is the same: innocent people needlessly killed and injured.

On the horizon of this bleak landscape, a light recently appeared. Within the 21st Century Cure Act, passed by Congress in an unusually bipartisan fashion in December, is a provision for an assistant secretary of mental health and substance abuse. This new position will have authority to coordinate efforts by the dozens of federal agencies that have mental-health programs. Equally important, the person will also have authority to reform the dysfunctional Substance Abuse and Mental Health Services Administration (SAMHSA), the $3.5 billion federal agency that is officially charged with reducing “the impact of substance abuse and mental illness on America’s communities.” Thus, it is critical that Representative Tom Price (R., Ga.), now confirmed as secretary of the Department of Health and Human Services, select as assistant secretary a mental-health professional who is strong, clinically and administratively experienced, and unafraid to rattle federal cages. Changing the direction of an aircraft carrier is simple compared with changing the direction of a federal agency.

What might we expect from successful leadership by an assistant secretary? We should expect improvement in the many measures of a failing mental-illness-treatment system that were brought to light by congressional hearings held by Representative Tim Murphy (R., Pa.), the author of the original legislation that proposed the creation of an assistant-secretary position.

These measures include homicides by people with untreated serious mental illness, suicides, homelessness, increasing numbers of mentally ill individuals in jails and prisons, increasing numbers sitting for days in emergency rooms waiting for psychiatric beds, and increasing encounters between mentally ill individuals and law-enforcement officials. Since SAMHSA came into being in 1992, the nation is significantly worse off on every one of these measures.

We should also expect the many federal agencies that have mental-health programs to speak to one another and meet regularly, which has not happened for years. Medicaid, Medicare, Social Security, and the Veterans Administration, for example, all spend huge amounts on mental-health care, but there is virtually no coordination among them or with SAMHSA’s mental-health block grant to the states. Since the states have the ultimate responsibility for delivering the services, there must also be coordinated, federally funded demonstration projects and data collection to identify the programs that are most effective in stabilizing and providing rehabilitation and recovery for mentally ill individuals. The funding of assisted outpatient treatment (AOT) programs under the recent legislation is a step in this direction.

A White House spokesman said Monday that President Trump is “evaluating the situation” regarding national security adviser Michael Flynn over his pre-inaugural contacts with Russian officials. (See the editorial nearby.) While the President is at it, how about asking if the spooks listening to Mr. Flynn obeyed the law?

Mr. Flynn is a retired general who ran the Defense Intelligence Agency, so surely he knew that his Dec. 29 call to Russian ambassador Sergey Kislyak would be subject to electronic surveillance. U.S. intelligence services routinely get orders from the Foreign Intelligence Surveillance Court to monitor foreign officials. But under U.S. law, when they get those orders they are supposed to use “minimization” procedures that don’t let them listen to the communications of Americans who may be caught in such eavesdropping. That is, they are supposed to protect the identity and speech of innocent Americans. Yet the Washington Post, which broke the story, says it spoke to multiple U.S. officials claiming to know what Mr. Flynn said on that call.

The questions someone in the White House should ask the National Security Agency is why it didn’t use minimization procedures to protect Mr. Flynn? Or did it also have a court order to listen to Mr. Flynn, and how did it justify that judicial request?

If Mr. Flynn was under U.S. intelligence surveillance, then Mr. Trump should know why, and at this point so should the American public. Maybe there’s an innocent explanation, but the Trump White House needs to know what’s going on with Mr. Flynn and U.S. spies.

In case you’ve been spending a lot of time thinking about all of the different genders, and wondering if any of your or your friends’ many genders might be cultural appropriation, there’s a piece making the rounds on Social Justice Internet that’s here to help.

In a piece titled “What Does Multigender Mean? 10 Questions You May Be Afraid to Ask — Answered,” Jenny Crofton explains that there’s “an infinite diversity of genders in the world” and “at least as many genders as there have been humans who lived.”

“I say ‘at least’ because as it turns out, people can embody more than one gender in their lifetime,” Crofton writes. “We can even embody more than one gender at once.”

“We can experience them as full and independent, or as partial and mixed,” Crofton continues.

A few examples of possible gender identities offered in Crofton’s article include “amorgender,” which is “gender that changes in response to a romantic partners,” “mirrorgender,” which is “gender that changes to reflect those around you,” “chaosgender,” which is “gender that is highly unpredictable,” and “gendervex,” which is “having multiple genders, each of which is unidentifiable.” Genders can also be negative instead of positive — something Crofton calls “antigender.” For example, some people might identify as “antigirl,” and that’s not to be confused with identifying as “male.”

Now, lest you think that all of this sounds too simple and restrictive, Crofton also clarifies that your gender absolutely does not have to be something that’s included on this or any list, because even though “dominant culture wants us each to conform to a single gender,” you are totally allowed to have as many genders as you want, to change your gender or genders as often as you want, and to identify as a certain gender or genders like only a little bit instead of completely. Basically, anything goes — except, of course, for cultural appropriation.

Yes, that’s right. According to Crofton, certain gender identities can be appropriation, such as “the Two-Spirit genders of some North American Indigenous groups” and “autigender and fascigender, which are exclusive to people with autism.”

“Because it’s impossible to access these genders without being part of a specific cultural context, it’s inappropriate for outsiders to claim any Two-Spirit gender,” Crofton writes, adding that if even one of your genders is “culturally appropriated,” then your whole “overarching identity also becomes problematic” — a situation that can be an issue for “pangender people.”

“Pangender people, in a literal sense, identify as all genders,” Crofton writes. “The problem is that ‘all genders’ includes culturally specific genders that must not be appropriated.”

Populism of the center (as opposed to Bernie Sanders’s socialist populism) has received a bad media rap — given that it was stained in the past by xenophobic and chauvinistic currents. Who wishes to emulate all the agendas of William Jennings Bryan, Huey Long, or Ross Perot? Yet there were some elements of Trump’s populist agenda — mostly concern for redeveloping the industrial and manufacturing base of the American heartland, and with it creating better-paying jobs for globalism’s losers — that were not only overdue but salutary for the Republican party. His idea that broad-based prosperity could diminish tribalism and racial fault lines sought to erode traditional Democratic support.

Populism is certainly identified with lots of grassroots movements, from far left through the center to far right. The common tie is that ordinary voters feel estranged from an elite class in politics, government, the media, and entertainment — a phenomenon that dates from the Solonian crisis at Athens and the Gracchi of Rome to Ross Perot, the Tea Party, and Donald Trump.

Often prairie-fire outrage manifests in emotional responses to existing affronts rather than carefully crafted policies designed to remedy perceived grievances. (One can remember Al Gore’s 1993 pompous but undeniable evisceration on CNN of a stuttering, ill-informed populist Ross Perot, on the NAFTA treaty.).

All that said, these periodic uprisings in consensual societies are needed to disabuse an insular governing class of its sense of entitlement and privilege.

The spark that ignites populist movements is not so much disparities in wealth and status (they are not always French Revolution or Bolshevik-like class-driven attempts to grab power) as rank hypocrisies: Elites condescendingly prescribe nostrums to hoi polloi, but always on the dual premise that those who are dictating will be immune from the ramifications of their own sometimes burdensome edicts, and those who are dictated to are supposedly too dense to know what is good for them. (Think Steven Chu, the former energy secretary, who either did not commute by car or had a short drive to work, while he hoped that gas prices for the nation’s clueless drivers might climb to European levels of $9–$10 a gallon.)

We’ve already seen Trump’s anti-doctrinaire approach to jobs, trade, and the economy: his notion that the free-market in reality can often became a rhetorical construct, not a two-way street when it comes to trading blocs. Free-market purists might see the outsourcing of jobs and unbridled importation of foreign subsidized products as a way to toughen up the competitiveness of American companies and trim off their fat; but people who take this view are usually the ones who benefit from globalism and who are in little danger of having their own job downsized, eliminated, or shipped overseas. Few of us often ask whether full professors are very productive, whether op-ed writers are industrious and cogent, whether Hollywood actors are worth millions per picture, whether politicians are improving the nation’s lot, or whether journalists are disinterested and competent. Instead, we assume that because they all have well-compensated jobs, they are qualified, essential, and invaluable to the economy.