Patients with serious mental illness have a right to treatment and a right to get better.
That’s what Rep. Tim Murphy (R-Pa.) said in an address last month to the APA Assembly in which he discussed the bill he is sponsoring in Congress titled the Helping Families in Mental Health Crisis Act (HR 3717).
Rep. Tim Murphy (R-Pa.) received a standing ovation at the APA Assembly following an impassioned talk in which he discussed the need to fix the country’s broken mental health system.
Murphy received a standing ovation from the Assembly representatives following an impassioned talk in which he discussed the need to fix the country’s broken mental health system.
Prior to Murphy’s address, Assembly members viewed a brief video of him at a congressional hearing grilling an official with the Centers for Medicare and Medicaid Services about the administration’s proposal earlier this year to eliminate antidepressants and antipsychotics from the Medicare Part D prescription drug program’s six protected classes of clinical concern. That proposal was rescinded after vigorous protests from Murphy, APA, and other medical and mental health organizations (Psychiatric News, March 6).
A licensed clinical psychologist, Murphy described his experience working as a volunteer at Walter Reed Army Medical Center with veterans who had posttraumatic stress disorder. He also recounted several case examples from his home state of Pennsylvania of individuals with serious mental illness, who were unable to access treatment and later killed themselves or others.
In January 2013, not long after the deadly Newtown, Conn., elementary school shooting, the Energy and Commerce Subcommittee on Oversight and Investigations (of which Murphy is chair) launched a top-to-bottom review of the country’s mental health system. The investigation showed that the approach by the federal government to mental health care is a chaotic patchwork of antiquated programs and ineffective policies across numerous agencies.
“I support an integrated care model of delivering a spectrum of services to people with mental illness,” he emphasized in his speech to the Assembly. “Within that context you need medication, evidence-supported psychotherapeutic techniques, community services, employment services, and inpatient care. All of these are critically important. But it’s not something we allow in many cases because we don’t have the mechanisms working for us. . . . We have almost 10 million Americans with a serious mental illness. Tragically, they wait an average of 112 weeks before they receive care. . .over two years, even though we know that early treatment makes a huge difference in prognosis. . . . These are the cases we are dealing with when we look at the Adam Lanzas and Jared Loughners and others. The question is, are these people getting treatment, and in many cases, the answer is no.”
In response to the review’s findings, Murphy wrote the Helping Families in Mental Health Crisis Act. Among the things the legislation would accomplish are the following:
Create an office of the Assistant Secretary for Mental Health and Substance Use Disorders within the Department of Health and Human Services to coordinate federal government programs and ensure that recipients of the community mental health services block grant apply evidence-based models of care developed by the National Institute of Mental Health. The assistant secretary will ensure that federal programs are optimized for patient care and minimize bureaucracy.
Reauthorize funding for mental health courts and require the Department of Justice to collect more data on interactions between the police and people with mental illness. The bill also authorizes grants to be used for mental health training of law enforcement and corrections officers.
Apply rigorous quality standards for a new class of Federally Qualified Community Behavioral Health Clinics requiring them to provide a broad range of mental health and primary care services.
Advance telepsychiatry to link pediatricians and primary care physicians with psychiatrists and psychologists in areas where patients do not have access to mental health professionals using a model based on a successful statewide project in Massachusetts.
Promote alternatives to long-term inpatient care, including court-ordered assisted outpatient treatment (AOT). AOT allows the court to direct treatment in the community for the hardest-to-treat patients—the less than 1 percent of people with serious mental illness—who have a history of arrest, repeat hospitalizations, and violence associated with their mental illness.
“I say let’s start changing the environment to give these [patients] the tools they need to get better,” Murphy told Assembly members. “They have a right to get better!”
(A report on actions taken by the Assembly at its May meeting will appear in the next issue.) ■