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From the PresidentFull Access

The Time for Mental Health Reform Is Now!

Published Online:https://doi.org/10.1176/appi.pn.2015.9b10

Photo: Renée Binder, M.D.

During my career, I have frequently been contacted by family members who are trying to obtain care for their loved ones. I have heard stories of patients locking themselves in their rooms, or threatening suicide, or becoming agitated and threatening. Even with all of our treatment advances and our legislative successes such as the parity law, it is difficult to obtain mental health care that is accessible and affordable and has a continuum of services. Unfortunately, our mental health care system is still broken. Insurers are not giving our patients the care they deserve despite a federal law mandating equal coverage of mental health care. In addition, our jails and prisons have evolved into de facto mental health treatment facilities, and 22 veterans every day are dying by suicide.

Mental health reform is desperately needed. Fourteen million Americans suffer from serious mental illness, but 40 percent of them receive no treatment. Exacerbating the problem is that a number of those who do seek treatment encounter obstacles by their insurers, despite the mental health “parity” law that has been on the books since 2008. Research shows that 1 out of 5 adults experiences a mental health problem in a given year, which can be triggered by an unexpected job loss, a divorce, a physical illness, or any other major life event. Our health care system is not able to treat people when they most need it.

Finally, hope for a better day is emerging on Capitol Hill. There is bicameral and bipartisan support to fix some of the problems. Politicians are beginning to understand that mental health is of concern to all Americans.

In August, Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.) introduced the Mental Health Reform Act of 2015. The Senate legislation echoes the Helping Families in Mental Health Crisis Act (HR 2646), a comprehensive mental health bill reintroduced weeks earlier by U.S. Reps. Tim Murphy (R-Pa.) and Eddie Bernice Johnson (D-Texas). Both bills call for better coordination of federal mental health resources, stringent monitoring and enforcement of the existing mental health parity law, establishing a national plan to boost the mental health workforce, and increased research funding for the National Institute of Mental Health. If enacted, these provisions and others in the two bills will help patients and families struggling with serious mental illness (Psychiatric News, July 3 and September 4).

In February, Congress overwhelmingly passed the Clay Hunt Suicide Prevention for American Veterans (SAV) Act, which is intended to improve mental health care for veterans. The bill is named after Marine veteran Clay Hunt, who took his own life after serving in Iraq and Afghanistan. Hunt, a Purple Heart recipient, became an advocate for veterans on Capitol Hill after his service. Tragically, he shot himself in 2011 as he struggled with depression and posttraumatic stress disorder.

Under the legislation, a third party would conduct an annual evaluation of the VA’s mental health and suicide prevention programs. The measure would further establish a three-year pilot program to pay for the education loans of psychiatrists who work at the VA for at least two years. It would also allow the VA to jointly carry out its suicide-prevention programs with nonprofits dedicated to promoting mental health.

The passage of the Clay Hunt legislation and the introduction of comprehensive mental health care reform in both the Senate and the House demonstrates that lawmakers on both sides of the aisle are coming together because they recognize it’s time for a fundamental change. The treatment of mental illness is everyone’s concern, and we need better systems to do so.

As these new bills move through Congress, we need to show our support. You will receive requests from APA to contact your members of Congress and urge them to vote for the bills. They want to know what their constituents want when determining how they will vote. Our nation’s last big effort at comprehensive mental health reform was over 50 years ago, with President Kennedy’s Community Mental Health Act in 1963. It’s a new century, and it’s vital that our political leaders seize this rare opportunity. Patients, families, and communities can’t afford to wait any longer. ■