Diane Rehm’s National Public Radio (NPR) segment on June 2, 2014, “Forced Commitment of the Severely Mentally Ill,” featured the sponsors of two comprehensive mental health bills that have been introduced in the United States House of Representatives. The Helping Families in Mental Health Crisis Act (H.R. 3717), sponsored by Rep. Tim Murphy (R-PA), seeks to increase the number of psychiatric beds available for those in crisis, offer an alternative to hospitalization through revised outpatient laws, allocate more funds for mental health research, and to create the new post of Assistant Secretary for Mental Health. In addition, H.R. 3717 would include provisions for telepsychiatry for areas with a critical shortage of mental health practitioners, and would cease funding for anti-psychiatry legal advocates. According to Rep. Murphy, the Act “empowers parents and families to help by clarifying confidentiality laws.” Under the current Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, a patient’s parents or other family members cannot have access to that patient’s medical records unless the patient consents to release of that information. H.R. 3717 would allow mental health providers to release patients’ information to “caregivers” – that is, immediate family members – if the provider believes it is necessary to protect the safety of the patient or another person.
The Strengthening Mental Health in Our Communities Act of 2014 (H.R. 4574), sponsored by Rep. Ron Barber (D-AZ), proposes the creation of a White House Office on National Mental Health Policy to coordinate agencies across the federal government, investing in increasing the behavioral health workforce, and establishing a registry for psychiatric beds, so that existing resources may be used more effectively. Furthermore, H.R. 4574 aims to increase parity available under Medicaid, especially the portion applying to children, and supports educating first responders, school counselors, and educators about mental health symptoms and available sources of care.
Two other guests on the program were Dr. E. Fuller Torrey, the Founder of the Treatment Advocacy Center, and Curtis Decker, the Executive Director of the National Disability Rights Network. Each guest raised concerns and commendations for the two bills. Dr. Torrey lauded H.R. 3717 for its inclusion of criteria for involuntary evaluation and commitment, the proposed revisions to HIPAA, and goal of increasing available beds for inpatient treatment. He defended the use of involuntary treatment for serious mental illness on the grounds that requiring medication is practiced for patients with tuberculosis and Alzheimer’s disease. Dr. Torrey also emphasized that involuntary treatment should be limited to the small number of individuals who are unaware that they are ill and have demonstrated a risk to themselves or others. Mr. Decker countered that involuntary commitment laws alone will not produce substantial improvements in outcomes, because they “do not realize the incredible amount of funding and resources that need to be in place to build a robust community mental health system.” Regarding H.R. 3717, Mr. Decker commented that the bill may create a “coercive environment” that could drive the mentally ill, who already face stigma, away from treatment.
With the introduction of H.R. 3717 and H.R. 4574 we now have the most comprehensive mental health legislation introduced in over 50 years when Congress passed and President Kennedy signed into law the Community Mental Health Centers Act in 1963.
AFSP applauds the introduction of both bills. There are commonalities between the two bills that align with AFSP’s public policy priorities.
1) Oversight of Federal Mental Health and Substance Use Disorder Programs
2) Evaluation and Analysis of SAMHSA Programs
3) Suicide Prevention Research
4) Reauthorization of the Garrett Lee Smith Memorial Act
5) Access to mental health prescription drugs under Medicare and Medicaid
6) Mental Health Awareness Training for First Responders
7) Behavioral Health Information Technology (extension of health information technology assistance for behavioral and mental health and substance use disorders)
8) Expansion and Development of Mental Health Workforce
AFSP will be urging all members of the House to work together to find a common ground so that we can deliver mental health legislation that will improve the lives of every American.