Serious attention is finally being paid to the crisis in mental health facing the United States. Many of the worst problems affecting communities across America, including mass shootings, violence on the streets, and homelessness, are attributable to a change in the manner in which mental illness was handled by government.
Rep. Tim Murphy (R-Pennsylvania), a psychologist and Co-chair of the Mental Health Caucus and a founding member of the GOP Doctors Caucus, has introduced the Helping Families In Mental Health Crisis Act, H.R. 2646.
According to Murphy, “More than 11 million Americans have severe schizophrenia, bipolar disorder, and major depression yet millions are going without treatment and families struggle to find care for loved ones. The federal government’s approach to mental health has been a chaotic patchwork of antiquated programs and ineffective policies across numerous agencies. Sadly, patients end up in the criminal justice system or on the streets because services are not available.”
The problem is an example of a situation made worse by federal intervention. The Heritage Foundation notes that “Fifty years ago, America began a grand experiment by transferring to the federal government the fiscal responsibility for individuals with mental illnesses. During that half-century, it has become increasingly clear that the experiment has been a costly failure, both in terms of human lives and in terms of dollars. The outcome was, in fact, clear as early as 1984, when the chief architect of the federal community mental health centers program proclaimed it to be a failure: ‘The result is not what we intended, and perhaps we didn’t ask the questions that should have been asked when developing a new concept….’ Bringing sanity to our present mental health system is dependent on one essential change: Return the primary responsibility for such services to the states…. Rarely in the history of American government has a program conceived with such good intentions produced such bad results. The patients were deinstitutionalized from the state hospitals, but most of the 763 federally funded CMHCs failed to provide services for them. The majority of the discharged patients, and those who became mentally ill after the hospitals closed, ended up homeless, incarcerated in jails and prisons, or living in board-and-care homes and nursing homes that were often worse than the hospitals that had been closed.”
Journalistsresource reports that “According to some estimates, as much as 50% of the U.S. prison population suffers from some form of mental illness. As a consequence, each year thousands of mentally ill offenders are sent to prisons that — because of overcrowding and limited resources — are poorly equipped to treat them. They are placed in solitary confinement, subjected to punishments inappropriate for their conditions and end up serving longer sentences than the general inmate population.”
According to a Substance Abuse and Mental Health Services Administration statistic reported by the National Homeless organization, “20 to 25% of the homeless population in the United States suffers from some form of severe mental illness. In comparison, only 6% of Americans are severely mentally ill …In a 2008 survey performed by the U.S. Conference of Mayors, 25 cities were asked for the three largest causes of homelessness in their communities. Mental illness was the third largest cause of homelessness for single adults (mentioned by 48% of cities). For homeless families, mental illness was mentioned by 12% of cities as one of the top 3 causes of homelessness.”
The proposed legislation would address the nation’s broken mental health system by focusing programs and resources on psychiatric care for patients & families most in need of services.
Rep. Murphy stresses that “Nearly 10 million Americans have serious mental illness (schizophrenia, bipolar disorder, and major depression); but, millions are going without treatment as families struggle to find care for loved ones. To understand why so many in need of care go without treatment, the Energy and Commerce Subcommittee on Oversight and Investigations launched a top-to-bottom review of the country’s mental health system beginning in January 2013. The investigation, which included public forums, hearings with expert witnesses and document and budget reviews, revealed the federal government’s approach to mental health is a chaotic patchwork of antiquated programs and ineffective policies spread across numerous agencies with little to no coordination. As documented in a recent Government Accountability Office (GAO) report, 112 federal programs intended to address mental illness aren’t connecting for effective service delivery and ‘interagency coordination for programs supporting individuals with serious mental illness is lacking.’”
“While the federal government dedicates $130 billion towards mental health each year, the so-called “mental health system” is best described by its deficits. To name just a few:
- There is a nationwide shortage of nearly 100,000 needed psychiatric beds.
- Three of the largest mental health “hospitals” are in fact criminal incarceration facilities (LA County, Cook County, and Rikers Island jails).
- Privacy rules that frustrate both physicians and family members generate nearly 8,000 official complaints yearly.
- For every 2,000 children with a mental health disorder, only one child psychiatrist is available.
- The leading federal mental health agency does not employ a psychiatrist.
- Supporters of the bill state that it “fixes the nation’s broken mental health system by refocusing programs, reforming grants, and removing federal barriers to care.”
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Among the key provisions:
- It Empowers Parents and Caregivers by Breaking down barriers for families to work with doctors and mental health professionals and be meaningful partners in the front-line care delivery team.
- Drives Evidence-Based Care,
- Creates an Assistant Secretary for Mental Health and Substance Use Disorders with mental health credentials within the Department of Health & Human Services to elevate the importance of mental health in the nation’s leading health agency,
- coordinates programs across different agencies, and promote effective evidence-based programs.
- Further Refines Mental Health & Substance Abuse Parity.
- Requires the Assistant Secretary for Mental Health and Substance Use Disorders to make public all federal investigations into compliance with the parity law so families and consumers know what treatment they have rights to access.
- Establishes a National Mental Health Policy Laboratory to drive innovative models of care,i
- Improves Transition from One Level of Care to Another
- Requires psychiatric hospitals to establish clear and effective discharge planning to ensure a timely and smooth transition from the hospital to appropriate post-hospital care and services.
- Fixes Shortage of Crisis Mental Health Beds Provides additional psychiatric hospital beds for those experiencing an acute mental health crisis and in need of short term (less than 30 days) immediate inpatient care for patient stabilization.”