By Liz Szabo
February 12, 2015
Federal health officials need to do a better job coordinating help for people with serious mental illness, according to a new report by a government watchdog agency.
At least 112 federal programs run by eight government agencies -- including the departments of Labor, Justice and Defense -- aim to help people with serious mental illnesses such as schizophrenia, bipolar disorder and major depression.
Mentally ill people often need several kinds of help, from psychiatric care to housing and employment assistance, says Richard Frank, assistant secretary for planning and evaluation at the Department of Health and Human Services. Veterans have their own special needs.
Yet no one is coordinating programs to make sure that patients are getting the help they need and to prevent agencies from duplicating efforts, according to a report from the Government Accountability Office (GAO). There are 47 programs, for example, to address homelessness.
The substance Abuse and Mental Health Services Administration, part of the Department of Health and Human Services, is legally required to coordinate those programs. But the report says "it has shown little leadership in coordinating federal efforts on behalf of those with serious mental illness."
"This GAO report is a much-needed wakeup call," says Rep. Tim Murphy, R-Pa., chairman of a subcommittee of the House Energy and Commerce Committee, which met Wednesday to ask questions about the report.
"The federal government's approach to addressing mental illness is a convoluted and disjointed mess," says Murphy, a child psychologist. "Shame on us if we don't take action and work on fixing the systemwide failures identified in this report so that we can focus resources on helping those in desperate need of medical services."
The GAO report found that 30 of the 112 programs specifically targeted people with serious mental illness, yet fewer than half of those programs have been evaluated in the past five years, leaving no way to know if they're helping people in the most efficient way.
A mental health care coordinating committee, made up of leaders from different agencies, hasn't met since 2009, the report says. Frank says the committee was formed to identify potential solutions to problems raised in a report from the George W. Bush administration. It did that and hasn't needed to meet since then, he says.
The Department of Health and Human Services does work with other government agencies to coordinate programs that combat homelessness and suicide, Frank says.
And while Frank agrees that it's important to coordinate help for people with mental illness, he says some of the programs in the GAO report are too small to merit a major evaluation.
"We are completely on board with the idea that coordination is critically important to serve the population with serious mental illness," Frank says.
Beyond coordinating federal agencies, Frank says it's crucial to coordinate the care provided to individual patients, who are sometimes too disabled to navigate a complex health system. Coordinating community care can keep patients from falling through the cracks, he says.
Murphy began his remarks by talking about the desperation felt by many people with serious mental illness and their families.
He quoted from a November USA TODAY story about Laura Pogliano, a mother from Towson, Md., whose son had schizophrenia.
USA TODAY's nine-part series,The Cost of Not Caring, focused on the financial and human costs of failing to provide for the 10 million American adults and 2.6 million children with serious mental illness.
Pogliano told USA TODAY last year that she felt "lucky," even though her son had been hospitalized 13 times in six years, because he wasn't homeless, incarcerated or addicted to drugs.
Pogliano's son was found dead in his apartment at age 23.
Murphy noted that people with mental illness die on average, more than two decades younger than others. And while deaths from cancer, heart disease and other ailments have steadily fallen over the years, the number of suicides has steadily climbed.
"Our mental health system," Murphy says, "is an abject failure."
D.J. Jaffe, founder of MentalIllnessPolicy.org, called the report disturbing.
It "showed no one is is in charge of reducing homelessness, arrest, suicide and violence by people with serious mental illness," says Jaffe, who watched the hearing. "Federal programs are run in silos, with the left hand not knowing what the right is doing. Patients and the public are suffering."