Senate bill reintroduced

By Rivkela Brodsky
December 1st, 2013

Prompted by the Sept. 16 shooting at the Washington Navy Yard that left 12 dead, as well as the shooter, Sen. Kelly Ayotte (R-N.H.) urged for the passage of stand-alone mental health legislation that she says will “strengthen the nation’s mental health system.”

“Given the clear connection between recent mass shootings and mental illness, the Senate should not delay bipartisan legislation that would help address this issue,” says Ayotte and co-author Sen. Mark Begich (D-Alaska) in a Sept. 18 news release.

Ayotte and Begich introduced the Mental Health First Aid Act (S. 153) in January. Portions of that bill were included as an amendment to gun legislation (S. 689) that was adopted by the Senate this spring. “The underlying gun legislation (which included the amendment) was pulled from the floor when it became clear it didn’t have the votes to pass,” says Liz Johnson, a spokeswoman for the senator in an email. “Recently, Senators Ayotte and Begich urged Senate leaders to immediately bring S. 689 to the Senate floor as a stand-alone bill. It’s clear that if it came up for a vote, it would pass with overwhelming bipartisan support. [Co-sponsor Ayotte] believes there is broad bipartisan agreement on the need to address mental health and will continue her efforts on this issue.”

The bill includes a modified version of S. 153 that would provide grants for training programs to help the public identify, understand and address crisis situations safely as well as teach the warning signs and risk factors of common mental disorders, teach crisis de-escalation techniques and provide an action plan for trainees to help those in psychiatric crisis connect to professional mental health care in the community, according to the release.

Other portions of the legislation allow schools to use federal education dollars to develop school-wide positive behavior interventions and supports, reauthorize legislation for the development of suicide prevention and intervention programs, and reauthorize National Child Traumatic Stress Initiative to help children and adolescents exposed to traumatic events, says Johnson.

“By helping the public better identify and understand the signs of mental health crisis situations, the legislation I co-authored with Senator Begich – included in the Mental Health Awareness and Improvement Act – represents an important first step toward strengthening our mental health system,” says Ayotte by email. “This legislation, which has broad bipartisan support, also aims to help connect individuals with mental health issues to health professionals and available services in the community – with the goal of facilitating timely and necessary treatment.”

Paula J. Caplan, Ph.D., a clinical and research psychologist who is an associate at Harvard University’s DuBois Institute, says she has some concerns about the bill, which sounds good on paper but is not very specific about what mental health services psychologists and other therapists would be expected to implement.

“The danger is that psychologists would be expected to follow a standard of care that requires them to focus on psychiatrically labeling and possibly drugging and involuntarily committing people for whom that is unwarranted, who would likely be helped by low-risk and non-pathologizing approaches that have been shown to be effective in decreasing isolation and despair and who are at great risk for being harmed by the labeling, commitment, and drugging,” she says.

Caplan adds that “People in crisis of course need to be supported and cared for and listened to, because we don’t want them hurting themselves or someone else, but that is very different from forced commitment to a medical institution and forced medicalized treatment.”

Senate bill 689 has been placed on the legislative calendar.

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