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Mental health reform at heart of legislation
Legislation to reform the nation’s mental health system is likely to be reintroduced in the House and Senate in the next couple of months – but there is no timeline or written draft yet.
Two lawmakers from different parties and different houses – but with the same last name – are working to create a new version of the Helping Families in Mental Health Crisis Act, which was introduced in the House last year by U.S. Rep. Tim Murphy, Ph.D., (R-Penn.).
“We want to see the system reformed because what we have done in the last 50 years in this country has meant that treatment options for people with mental illness are too restrictive to the point of harm,” said Murphy, who is also a psychologist at Walter Reed National Military Medical Center.
“We have seen the numbers grow in terms of suicides, victimization, substance abuse deaths, incarceration, homelessness, unemployment – all tragic numbers – which speaks to the failure of the system to meet the needs of the severely mentally ill. So we have to push for those reforms to get treatment available,” he said.
In 2012, an estimated 43.7 million adults (aged 18 or older) or 18.6 percent in the United States had any mental illness in the past year, according to a national survey by the federal Substance Abuse and Mental Health Services Administration. The same survey suggests an estimated 9.6 million or 4.1 percent of adults in the U.S. dealt with a serious mental illness in 2012.
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“Severe mental illness is a brain disease,” Murphy said. “Now we know there are many treatments that can be effective with medication, psychotherapy and with peer support. We have to make sure in legislation that people also see this as an opportunity to give us a better spectrum for how we can treat people.”
Murphy said new legislation, while still being tweaked, will be based on three major principles: reform of federal agencies, removing barriers to care, and research.
U.S. Sen. Chris Murphy (D-Conn.) is working on similar but different legislation “anchored in the capacity crisis.”
“We can’t find enough inpatient beds for individuals who are in crisis,” he said. “In Connecticut, we have a crisis of step-down beds for individuals who are coming out of an inpatient setting. We also aren’t paying psychiatrists, psychologists, and social workers enough so that we also have an outpatient patient crisis.”
He said legislation will also address integration of primary care and behavioral health. “There are reimbursement rules today that discourage that,” he said. “We are going to try and fix that.”
The challenge to all of this is funding, both lawmakers say.
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At the end of March, Sen. Murphy worked with U.S. Sen. Bill Cassidy, M.D., (R-La.) to get a budget amendment passed unanimously that created an account for funding to support this legislation. “It shows there is broad partisan support for this new funding; it’s a matter of deciding what level of new funding there is an appetite for,” he said.
Mental Health America and the National Alliance on Mental Illness say legislation is needed, but both organizations are waiting to see what the legislation will look like.
Ron Honberg, policy director for NAMI, said the mental health system in the county is broken as it focuses on crisis rather than prevention.
Paul Gionfriddo, CEO of Mental Health America echoed that sentiment. “I’m very much hoping what we’ll see is a framing of broad set of issues this year that will allow everybody to come together and work out the details and help us move forward to a true system of mental health treatment versus this absolutely horrifying system today where we wait until people are a danger for themselves or others or we arrest them and put them in jail,” he said.