OP-ED: Time for mental health overhaul
Published in San Mateo Daily Journal 1/4/2014 - to view article click here
How many more Newtown massacres must be experienced before Congress overhauls the federal mental health policies? Pennsylvania Representative Tim Murphy, a psychologist by training, has spent the last year studying the ineffective federal mental health system that takes up to $125 billion to fund. Funds are used for “mental health” via programs ranging from Medicaid to the social security administration. Mr. Murphy’s committee, Energy and Commerce subcommittee on oversight and investigations, discovered that most of the funds goes to vague and ineffective services rarely focused on treating the most serious illnesses – schizophrenia, bipolar disorder or severe depression. The committee also discovered that there is little interagency coordination, little government data collection on treatment outcomes, and no central effort to drive evidence-based care.
Mr. Murphy’s bill will reorient all current programs and create a new HHS assistant secretary for mental health and substance-use disorders who would lead federal mental illness efforts.
The secretary would have to be a medical professional with experience in evidence-based mental health care and would be responsible for promoting the medically oriented models of care adopted by the National Institute of Mental Health. Federal dollars need to support programs which treat when first signs of psychosis appear.
All mental health grants should be based on programs meeting evidence-based practice standards. Those programs achieving treatment outcomes should be receiving the majority of federal funding.
The standard for involuntary confinement needs to be addressed since it is really impossible to meet, and even psychotics are often able to present a brief facade of normalcy. Many are unaware they’re even ill and won’t voluntarily get help.
The Murphy bill would only fund mental health centers that have state laws that support “need for treatment” standards, which gives families and physicians greater ability to get help for the mentally ill. The state of New York passed Kendra’s Law which has been a model for how outpatient treatment laws, by which courts can require the mentally ill, as a condition of remaining in the community, to receive treatment, can help the most vulnerable and save lives.
The Murphy bill also addresses one of the more destructive forces in the mental health system, the legal lobby. Tax dollars are funding a small army of self-appointed “advocates” who encourage the mentally ill to avoid treatment, and who fight parental and court attempts to get them care. The Murphy bill stops this funding. It also provides physicians legal safe harbors to volunteer at understaffed mental health centers, some thing many currently won’t do for fear of malpractice suits.
Can this bill muster bipartisan support and will the Obama administration accept a GOP initiative?
Or does our federal government continue through $100 million at a failed system as Vice President Biden has proposed. All the money in the world won’t help the mentally ill if it isn’t getting to them or is squandered on ineffective treatments. Representative Murphy’s bill is an informed attempt to overhaul a broken system. It might even prevent the next Newtown.