The Mental Health Crisis Act May Be Bringing The Mental Health Conversation Back

The opportunity for Congress to consider a piece of mental health legislation is expected to return sometime early in 2015. According to Dr. Jeffrey Lieberman of Columbia University, in a video and article posted on Medscape, that opportunity will take the form of the Helping Families In Mental Health Crisis Act. The legislation, created and sponsored by Tim Murphy (R-Pa), is designed to address the federal government’s current and—for some— inadequate approach to mental health, which Murphy calls a “chaotic patchwork of antiquated programs and ineffective policies.” Murphy’s concerns are echoed in the Energy and Commerce Committee report on federal program handling of serious mental illness. According to a January 27, 2015, U.S. News article, Murphy plans to reintroduce the bill within a few weeks, following some “polishing and tinkering.”

Goals

According to Lieberman and Medscape, the goals of the legislation (H.R. 3717) include:

  • “Providing care to underserved populations such as rural populations;
  • Providing ways to prevent individuals with mental illness from needing institutionalization, or if they have committed a criminal act, from being prosecuted as criminals, instead of being treated as people with mental illness;
  • Promoting the integration of primary care and mental health care in the collaborative care model;
  • Addressing the shortage of inpatient psychiatric beds in the United States;
  • Supporting the integration of evidence-based methods of treatment rather than treatments that are favored or preferred by individual providers;
  • Requiring that services provided in mental health care facilities, that are reimbursed by funding from the government through Medicaid and Medicare or any other sources, have been proven effective through rigorous research.”

Structure

To effectuate the broad goals of the legislation, the law would require the creation of a new position within HHS—Assistant Secretary of Mental Health. The Assistant Secretary would be charged with identifying mental health policies that would be most effective for the federal government to support.  The bill would also provide additional funding to allow National Institutes of Health to conduct research on disorders of the brain that affect mental function and behavior.  The bill also includes added support for veteran mental health programs and expands treatment for those in prison.

Need

The discussion about a reintroduced Mental Health bill comes on the heels of a December 18, 2014 Government Accountability Office (GAO) Report, which revealed that despite a GAO finding that there are 112 federal programs across eight government agencies that generally support individuals with mental illness, there is a significant lack of coordination  among those programs. Despite the fact that the GAO identified the lack of coordination as a potential cause of gaps in mental health support, HHS pushed back on the GAO recommendation to lead other agencies in coordinating mental health care.

Opposition

Not everyone is supportive of the bill. For example, some critics, like John M. Grohl  Psy.D of psychcentral.com, indicate that it is important to remember the focus and name of the bill—helping families—which means the aim is not necessarily to assist patients.  Grohl also critiques the funding structure of the bill and its method of adding layers of bureaucracy. Regardless of the best approach to address the mental health crisis, it is significant that the bill reminds Congress and the U.S. that there is a crisis. If no other advancement comes from either the Bill’s proponents or opponents, at least the conflict may produce more of a discussion about that fact that for almost 20 percent of the adult population, mental illness is the norm.