We believe that mental health and behavioral healthcare reforms in the United States are vital. The vision that President Kennedy had in 1963 about accessible mental health care for all Americans was never realized. While the United States has cut 90 percent of the inpatient psychiatric beds available, we never made good on the community mental health services President Kennedy thought would replace them.
Instead, the U.S. shamefully sends many people with mental illness to prison — an expensive alternative that naturally does little to treat the person’s problems.
While we’ve previously explained why Rep. Tim Murphy’s second attempt at a mental health reform bill remains a bad bill (e.g., tramples patients’ rights; guts SAMHSA in a vendetta against the federal agency; creates even more unneeded federal bureaucracy), we’ve found a ray of hope. It comes in the form of the bipartisan Senate bill, the Mental Health Reform Act of 2015 (S. 1945) by Senators Chris Murphy (D-Conn) and Bill Cassidy (R-La).
It takes a more moderate, common-sense approach to reforms in how the federal government funds mental health care in the U.S. Here’s why you should support it.
More Money, Flexibility and Parity for Treatment of Mental Illness
The most important component of the proposed bill is that it offers greater funding and flexibility for mental health services. If you’re covered by Medicaid, you can now see a doctor for a physical ailment the same day you see a therapist for a mental illness concern. It also includes money to encourage states to adopt integrated primary care models of treatment — you know, where your mental and physical health aren’t treated as two completely separate things.
It also seeks to strengthen compliance with the federal parity act, using audits and other enforcement methods to ensure that insurance plans aren’t trying to circumvent both the letter and spirit of the law.
The bill would provide new grants for early intervention programs. One of the best ways to address mental illness is long before it’s diagnosed — through comprehensive prevention and screening programs. This bill would provide such grants to states to help implement these kinds of programs. It also continues to fund existing block grants to states and research into mental illness.
Another key differentiator between the two bills is the Senate bill leaves out controversial forced (assisted) outpatient treatment (AOT) provisions. Remember, in Rep. Murphy’s original House bill, he would’ve forced all states to have adopted this controversial treatment methods or forsake their federal mental health block grants. While he’s toned it down in the latest version, AOT is still not something that should be endorsed or mandated, even indirectly, by the federal government.
Patient’s Privacy Rights Under HIPAA
Under the proposed Senate bill, patients’ privacy rights aren’t gutted as they are under Rep. Murphy’s bill. The Senate bill clarifies when providers may disclose patient information, and would work to educate professionals, patients and their families about patient privacy rights under HIPAA. There doesn’t appear to be any new exceptions to patient privacy proposed in the Mental Health Reform Act of 2015.
Elevating & Increasing Coordination of Mental Illness Policy
The Senate bill does a few important things to elevate mental illness policy in the federal government. It creates a new Assistant Secretary for Mental Health and Substance Use Disorders within the U.S. Department of Health and Human Services. This new position will elevate the importance of mental illness in the federal government. The new Assistant Secretary will be responsible for overseeing grants and promoting best practices in early diagnosis, treatment, and rehabilitation
Second, it creates a Serious Mental Illness (SMI) Coordination Committee under the Assistant Secretary to ensure documentation and promotion of research and treatment related to SMI and evaluate efficiency of government programs for individuals. Today, coordination among federal agencies tasked with helping people with mental illness is virtually nonexistent. This Committee would fix that problem, and ensure the government knows what each arm and agency is doing, sharing best practices, and correcting failures.
Third, it will create a new national mental health policy laboratory that will fund innovation grants to help identify “new and effective models of care.” I’m less sure about this — it seems like it could simply be done with a grant to the existing National Institute of Mental Health, who is already tasked with overseeing research in mental illness. The NIMH seems like the natural place to do research — not through the creation of a new federal bureaucracy.
Instead of gutting SAMHSA, as the Murphy House bill would do, the Senate’s Mental Health Reform Act takes a more moderate stance.
The bill’s reforms focus on how SAMHSA’s grant review committees and advisory councils are formed:
Not fewer than half of the members of the group shall have a medical degree, a doctoral degree in psychology, or advanced degree in nursing or social work from an accredited graduate school and shall specialize in the mental health field.
This seems like a reasonable change. The other changes in SAMHSA simply have to do with funding. The bill increases funding for children’s mental health services as well as “mental health needs of regional and national significance,” while reducing funding for jail diversion programs and assistance for homelessness transition.
Psych Central endorses and supports the Mental Health Reform Act of 2015 (S.1945). While it’s still not ideal, it’s the best bill in Congress today providing for greater help and resources for those with a mental illness, without trampling upon the rights of patients, forcing them into treatment, and dismantling one federal agency (SAMHSA) just to replace it with another one.
Read the full bill: S.1945 – Mental Health Reform Act of 2015