By Congressman Tim Murphy
Washington, DC, USA
More than half a century has passed since Congress last addressed comprehensive mental health reform, but the stage is now set for Congress to overhaul the outdated and failed system. For the first time since the Kennedy Administration, the Energy and Commerce Committee took the historic step this year by passing extensive mental health reform I introduced more than 3 years ago. The Helping Families in Mental Health Crisis Act (H.R. 2646) passed the committee on June 15, 2016 unanimously by a vote of 53-0.
The next step for the legislation is a vote on the House floor, which will be the culmination of a 4-year effort which dates back to 2012, when as Chairman of the Subcommittee on Oversight and Investigations I launched an investigation into our nation's fractured mental health care system following the devastating tragedy at Sandy Hook Elementary School in Newtown, Connecticut. What my investigation uncovered was shocking and disgraceful: a wasteful federal bureaucracy that is anti-patient, anti-family and anti-medical care.
This year alone, nearly 350,000 people suffering from mental illness will die. These deaths are tragically unique in our public health system for two reasons: they are continually increasing in number, yet fully preventable. Over the last decade, mortality rates for heart disease, stroke, HIV/AIDS and cancer have all significantly decreased, however, during that same time period the rate for suicide and drug overdose have sky rocketed, despite the federal government spending upwards of $130 billion on mental health. As a psychologist with more than forty years' experience, I have witnessed firsthand these failures of our fractured mental health system which has abandoned those most in need of help: the vulnerable, the poor and the disadvantaged.
This is why I introduced the Helping Families in Mental Health Crisis Act, landmark legislation to focus resources and reform where they are most needed: to foster evidence-based care, fix the shortage of psychiatric hospital beds, empower patients and caregivers under HIPAA privacy laws and help patients get treatment well before their illness spirals into crisis.
A cornerstone principle of my bill is to enhance the involvement of families into the frontline care delivery team. Too often, family members who have a loved one with a serious mental illness are unable to know any critical healthcare information because federal law prohibits it. My bill will allow for compassionate communication between a doctor and a known family member or caregiver, allowing families to join the frontline of care.
Increasing access to care is critical to improving the mental health system, yet the number of inpatient psychiatric beds in the U.S. has decreased by more than 90% since the 1950s as a result of the decades-long deinstitutionalization movement that began in the civil-rights era. This movement has been fueled by federal laws which prohibit funding for inpatient care at psychiatric hospitals with more than 16 beds. My bill reforms these laws and moves away from arbitrary caps to establish clinically based treatment standard for patients with serious mental illness.
My bill promotes alternatives to long-term inpatient care by helping states fund these innovative approaches to community-based treatment like Assisted Outpatient Treatment (AOT). States across the country are adopting court-supervised treatment programs for patients who are unable to voluntarily comply with necessary medical and psychiatric care because of their serious mental illness. This model of treatment known as AOT, reduces rates of imprisonment, homelessness, substance abuse and costly emergency-room treatment for chronically mentally ill participants by upward of 70%. It also saves the government money. A recent Duke University study found that AOT reduced annual Medicaid costs by more than 40% for each participant.
Delivering evidence-based treatment is how we will finally conquer stigma surrounding mental illness, and this bipartisan bill transforms the federal government's approach to mental health. This bill calls for a complete overhaul of the current federal system, refocusing resources on helping those with the most serious mental illnesses by getting them treatment before, during and after a psychiatric crisis.
With this bill, we can jointly proclaim that the diagnosis and treatment of mental illness must come out of the shadows, we declare a new dawn of hope for the care of those with mental illness and we pledge our unwavering commitment to continued work to bring help and hope in the future. And, while the fate of the bill in the Senate remains uncertain, I promise I will continue my steadfast commitment to see crisis mental health reforms signed into law to help those with the most serious illness.