By Kimberly Leonard
January 27, 2015
Rep. Tim Murphy, R-Pa., said Tuesday that he has not stepped onto the House floor without a member of Congress asking him what will happen to mental health legislation – raising the hopes of many that 2015 might be the year for substantial change in the field.
In a lunch hosted on Capitol Hill by the Treatment Advocacy Center, Murthy elaborated on the Helping Families with Mental Health Crisis Act, which he plans to reintroduce in a few weeks after “polishing and tinkering.” The bill would increase access to psychiatric beds, allow patients to get medications they need more easily, and create accountability services to make sure care is delivered as it should be, among other measures.
“This bill is the most comprehensive federal mental health legislation in more than half a century,” Doris A. Fuller, executive director of the Treatment Advocacy Center, said in a statement. “It would improve the lives of at-risk individuals with untreated mental illness dramatically.”
Murphy, a trained psychologist, was honored at the lunch for his activism in mental health.
The prevalence of mental issues and how it affects the U.S. population is not rare. One in four Americans suffers from a mental health issue such as anxiety or depression, and one in 18 suffers from more serious mental illness such as bipolar disorder or schizophrenia, according to the National Institute of Mental Health.
Often, calls for reform in mental health legislation surface only during extreme events, such as mass shootings in schools. A recent report from the National Alliance on Mental Illness found that states and the District of Columbia increased funding for mental illness after the shooting at Sandy Hook Elementary School, but many decreased it the following year. In 2014 Congress did not pass any bills related to mental illness.
In part because of this pattern, the public often associates mental illness with violence, but the perception is false, advocates say. Instead, people with a mental illness are more likely to harm themselves, or to be victims of abuse.
It’s difficult to get people’s attention about the issue, Murphy admitted at the event.
Still, the damage to the lives of families and individuals is evident. Murphy points out that people with mental illness are often homeless or in the criminal justice system. “The stories go on and on with this,” he said. “Unfortunately the solutions aren’t there yet.”
Kathy Bruno, a mother whose son has a severe mental illness, spoke at the lunch about her experiences. After reacting to voices, her son was arrested and put into solitary confinement in prison. Only then did he receive the health services she previously had sought for him.
“What does he need to do to me in order to get treatment?” she asked at the time, referring to laws that obligate a person to demonstrate they are a danger to themselves or others in order to receive treatment.
A portion of Murthy’s bill likely will aim to fix this portion of mental health policy.
People with mental issues not only face difficulties with their particular illness, but also are more likely to have co-occurring chronic physical diseases, such as cardiovascular disease and arthritis, showdata from the Centers for Disease Control and Prevention. They also are likely to smoke or to abuse drugs or alcohol to aid in self-medicating difficult symptoms.
Mental health advocates say they have been waiting decades for treatment and laws to improve. They point to the Community Mental Health Act as the last piece of legislation that upended the system. It dismantled mental asylums in favor of community mental health centers.
The problem with the law was that not only was it signed in 1963, but it never truly panned out.
“The programs were put together with the best of intentions,” Dr. E. Fuller Torrey, founder of the Treatment Advocacy Center and executive director of the Stanley Medical Research Institute, said at the event. “They were good ideas, just not carried out very well. All we did was empty the hospitals.”
Mental health experts accept that a person with mental illness who has adequate medications, services and support, including therapy, can recover – a term that is understood to mean the treatment and management of lifelong struggles, and is not defined as a cure.
But not everyone supports all parts of the soon-to-be proposed legislation. Curt Decker, executive director for the National Disability Rights Network, said in an email that the bill as a whole would do more harm than good. As examples he cited the elimination of initiatives such as evidence-based, peer-run services and family supports; the reorganization of the Substance Abuse and Mental Health Services Administration; changes in privacy laws related to mental illness; and the requirement for states to enact involuntary commitment.
Mental health historically has been the red-headed stepchild of the medical field. The most recent change came with the Affordable Care Act, President Barack Obama’s signature health care legislation. It mandates that mental health services be comparable to surgical and medical services. Substance abuse and mental health also are now among essential health care services that insurance companies must provide.
But advocates say much more still needs to be done. “The Mental Parity Act has been a help, but really not for people with great mental illness,” Fuller said.
For instance, a House Energy and Commerce Committee investigation last year found that the delay between a first episode of psychosis and the onset of treatment averages 110 weeks.
“Every day I see patients backed up, waiting for a medical bed,” Dr. Paul Summergrad, president of the American Psychiatric Association, said at the event. “We would not tolerate this for any other medical condition.”
Mental illness received a quick mention in Obama’s State of the Union address last week, but there was little elaboration on whether any substantial change was in the works.
The issue does appear to be on the administration’s radar for action. In a call with reporters Tuesday that was aimed at enrolling more Americans in health insurance, Dr. Vivek Murthy, newly appointed surgeon general, said he has been doing a listening tour with Americans that includes mental health issues.
Murphy is adamant that Congress must respond to the mental health crisis soon, and believes it can happen. “I will not turn my back until we help fix this problem of severe mental illness in America,” he said.