Apparently May is “Mental
Health Awareness” month, so let’s get aware of what politicians
are planning in terms of mental health care policy. Both
congressional Democrats and Republicans are pushing mental health
care bills right now. But while the Republican-led legislation has
drawn widespread support, the Democrats’ version, introduced by
Rep. Ron Barber (D-Ariz.) this week, is getting a much less
enthusiastic response. Many have slammed the bill—which Rep.
Nancy Pelosi (D-Calif.) is
said to have had a large hand in crafting—as
a “stripped down, politically orchestrated” version of the
measure Republican Rep. Tim Murphy, a clinical psychologist from
Pennsylvania, introduced in December 2013.
Murphy’s multifaceted bill,
called the “Helping Families in Mental Health Crisis Act” (H.R.
3717), has the
support of the American Psychological Association, the American
Psychiatric Association, the National Alliance on Mental Illness,
and many other medical groups. The Washington Post
editorial board also supports Murphy’s measure, writing in
an April 16 editorial that it was “more comprehensive than
other recent efforts to reform the system and perhaps has the
brightest prospects in a divided Congress.” Of the bill’s 77
co-sponsors, one third are Democrats.
“The bill would reorganize the billions the federal government
pours into mental health services, prioritizing initiatives backed
by solid evidence and tracking their success,” explained the
Post. It would do so by creating an assistant secretary of
mental health and substance abuse disorders to control mental
health funding, thereby shifting power away from the Substance
Abuse and Mental Health Services Administration (SAMHSA), which
currently administers state mental health grants.
Murphy’s measure would also change Medicaid to allow psychiatric
hospitals to be reimbursed for short-term stays. It would make it
easier for families of mentally ill patients, particularly younger
patients, to obtain medical info from doctors and records. And it
pushes states to adopt policies allowing judges to compel severely
mentally-ill people into involuntary treatment.
This last bit has been the most controversial. Critics of
Murphy’s bill have focused on the way it expands the control that
families and the state have over the treatment of severely
mentally-ill individuals. They also say the bill ignores community
treatment programs aimed at reaching people with mental disorders
before things get out of control.
“We do not see those aims as mutually exclusive, and neither do
the bill’s backers,” the Post‘s editorial board wrote. One
might also point out that current-style efforts to reach people
before it’s too late haven’t been so hot.
But the Democrats’
bill, called “The Strengthening Mental Health in Our
Communities Act,” is largely focused on such efforts. It would
increase mental health funding for various groups (schools,
veterans, community organizations). It would also reauthorize
the SAMHSA, create a White House Office for Mental Health
Policy to run it, and require Medicare to cover longer hospital
stays for mental health care hospitalizations.
“It has more candy for the mental health industry than Murphy’s
bill and stripped out all the programs that help those with the
most serious mental illnesses,” said DJ
Jaffe, executive director for the New York-based Mental Illness
Policy Organization.
In a Wall Street Journal op-ed,
Kim Strassel called the Democrats introduction of the competing
bill “the basest form of politics.” Strassel suggested the
measure is not just a ploy to kill Murphy’s bill, but also to prop
up the idea of gun control as the one true solution to serious
mental illness. Mental health advocates told USA
Today they’re simply worried that the new bill will
shift enough support away from Murphy’s bill that neither will get
anywhere.
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