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Government NewsFull Access

Mental Health Reform Bill Reintroduced Into House

Published Online:https://doi.org/10.1176/appi.pn.2015.7a23

Abstract

The bill would strengthen enforcement of the federal mental health parity law, advance early intervention and prevention programs, and create a national strategy for increasing the mental health workforce.

Reps. Tim Murphy (R-Pa.) and Eddie Bernice Johnson (D-Texas) have reintroduced their bipartisan legislation promising comprehensive reforms to the U.S. mental health care system. The bill, the Helping Families in Mental Health Crisis Act (HR 2646), was first introduced in 2013 in response to the tragic shootings in Newtown, Conn.

A major focus of the bill is on eliminating the fragmentation of mental health resources across federal departments through the establishment of a new position, the assistant secretary for mental health and substance use disorders within the Department of Health and Human Services. The position’s duties would emphasize the coordination of those services and the promotion of science-driven and evidence-based approaches to care.

The bill would also substantially improve the enforcement of the Mental Health Parity and Addiction Equity Act by requiring annual reports to Congress on parity compliance investigations from federal departments, tasking the proposed assistant secretary with coordinating all programs and activities related to parity in health insurance benefits, and requiring the Government Accountability Office to investigate compliance with the parity law.

“It’s not just a new bill, but marks a new dawn for mental health care in America,” Murphy said in a statement. “We are moving mental health care from crisis response to recovery, and from tragedy to triumph. I am tremendously proud of the work we’ve accomplished and so encouraged about our nationwide grassroots support involved in advancing our legislative vision to help families in mental health crisis.”

APA leaders hailed the bill as a critical step toward mental health reform. “The nation’s mental health system needs reform and investment—especially on behalf of patients and families living with serious mental illness. We applaud Reps. Murphy and Johnson,” said APA President Renȳe Binder, M.D. In addition to strengthening enforcement of the parity law, she noted that other important provisions of the bill include “enhancing the psychiatric workforce, ensuring better coordination of federal resources, and improving research and treatment for persons with mental illness, including substance use disorders.”

Added APA CEO and Medical Director Saul Levin, M.D., M.P.A., “We look forward to working with Congress to pass this bill this year.”

According to a summary of the bill prepared by Murphy’s office, the bill seeks to address, among other issues, the following:

  • Innovation: Establishes the National Mental Health Policy Laboratory to drive innovative models of care and develop evidence-based and peer-review standards for grant programs and dedicates funding for the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative.

  • Improving transition from one level of care to another: Requires psychiatric hospitals to establish clear and effective discharge planning to ensure a timely and smooth transition from the hospital to appropriate post-hospital care and services.

  • Shortage of crisis mental health beds: Provides additional psychiatric hospital beds for those experiencing an acute mental health crisis and in need of short-term (fewer than 30 days) immediate inpatient care for patient stabilization.

  • Mental health workforce: Requires the assistant secretary for mental health and substance use disorders to study and recommend a national strategy for increasing the number of psychiatrists, child and adolescent psychiatrists, and other mental health professionals; includes child and adolescent psychiatrists in the National Health Service Corps; and authorizes the Minority Fellowship Program.

  • Early intervention and prevention programs: Authorizes, for the first time in federal law, the Recovery After Initial Schizophrenia Episode (RAISE), an evidence-based early intervention program, and launches a new early childhood grant program to provide intensive services for children with serious emotional disturbances in an educational setting.

  • Alternatives to institutionalization: Incentivizes states to provide community-based alternatives to institutionalization for those with serious mental illness, such as assisted outpatient treatment (AOT) and other assertive community treatment approaches.

In a letter to the authors of the bill, Binder and Levin wrote, “Every day throughout our country, individuals and their families are struggling with mental health crises, many of which could be prevented if our nation enacted comprehensive mental health reform. The statistics are startling: 14 million Americans suffer from serious mental illness, yet almost 40 percent of these individuals receive no treatment at all. The epidemic of preventable hospitalizations and incarceration costs our nation billions and displays widespread systemic failure. Moreover, despite recent progress, pervasive discrimination and stigma continue to harm our patients and impede efforts of the treatment community.

“Your bipartisan Helping Families in Mental Health Crisis Act will address these challenges by promoting evidence-based psychiatric care and research activities, ensuring better coordination of federal mental health resources, addressing the critical psychiatric workforce shortage, and improving enforcement of mental health parity, among other notable provisions,” Binder and Levin continued. “This bipartisan legislation is a much-needed remedy for our nation’s broken mental health system.”

At least one important modification over the previous version of the bill is that HR 2646 provides more flexible requirements for proposed state AOT requirements, a 2 percent block grant bonus for states that have an AOT law, and an additional 2 percent block grant bonus if a state amends its inpatient commitment provision to a “need for treatment” standard. ■

APA’s letter to Reps. Murphy and Johnson can be accessed here. A summary of the bill is available here.