NYAPRS Note: This has become an eventful week for Americans with mental health conditions. Earlier this week, Senators Chris Murphy and Bill Cassidy introduced the Mental Health Reform Act of 2015 (see http://www.nyaprs.org/e-news-bulletins/2015/014421.cfm and http://www.nyaprs.org/e-news-bulletins/2015/014423.cfm) and some more details below).
Yesterday, Senator John Cornyn introduced legislation that he said is “designed to enhance the ability of local communities to identify and treat potentially dangerous, mentally-ill individuals.” But the National Journal is skeptical about the prospects of passage of the Senate bills adding that “the Senate has a packed schedule after the recess, and it is hard to see where there will be room for mental-health reform—especially given how many separate bills have been introduced.”
And later today, New York City Mayor Bill de Blasio is expected to release details of a plan to increase monitoring and treatment for a “subset of homeless and severely mentally ill New Yorkers who exhibit violent behavior”.
See next 2 postings with details as we have them on the latter two proposals.
Whatever the details and despite all of the research to the contrary, there has never been a time when there has been so much public attention and characterizations of the ‘violently mentally ill” as a public threat. This is a tragic injustice that our community will pay for for some time…unless we find and take the appropriate steps to take back our dignity and rights.
What would those steps be? Please share your comments with me at harveyr@nyaprs.org and I’ll publish some excerpts in the coming days.
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Well-Received Mental-Health-Reform Bills Have an Unclear Future
Is There Such Thing As Too Many Mental-Health Bills?
by Caitlin Owens National Journal August 6, 2015
Sen. John Cornyn, the No. 2 Republican in the Senate, added to the swell of mental-health legislation growing in Congress on Wednesday by introducing a bill to identify and treat the mentally ill.
The topic of mental-health reform has surfaced recently in both chambers, framed as a response to mass violence that has much more potential for bipartisanship than gun-policy reform. While Cornyn’s bill goes the furthest into territory prone to bitter debate—and also has the name of the majority whip attached to it—the addition of yet another mental-health-reform bill raises the question of which, if any, will be able to make the long trek to actually becoming law.
“I think this is an area that is ripe for a lot of discussion,” Cornyn told reporters Wednesday, saying that he has been in conversation with colleagues on both sides of the aisle.
“What we’re trying to do is deal specifically with this problem of mass violence from mentally ill people that, if we could identify them earlier, either because the background-check system would catch them so they couldn’t buy a weapon, or else we can prevent them from becoming violent by getting them to this intermediate level of treatment before they do, then we can hopefully save some lives,” he added.
Cornyn was referencing the multipronged approach his bill takes. It seeks to strengthen the National Instant Criminal Background Check System, or NICS, to clarify the scope of mental-health records required to be uploaded and gives states financial incentive to share those records. Currently, states are not required to share this information, which sometimes allows weapons to fall into the wrong hands. He has already garnered the support of the National Rifle Association and the National Alliance on Mental Illness.
But the bill also addresses the issue of the incarcerated mentally ill by helping state and local governments identify and treat them, and then also help them transition out of custody, which NAMI cited as the more important part of the bill.
“I know violence gets a lot of headlines, but for the most part we’re talking about people who have committed crimes—a lot of times nonviolent crimes—that result from a lack of treatment for their severe mental illness,” said Ron Honberg, NAMI’s national director of policy and legal affairs. “Instead of processing them and incarcerating them, which is almost guaranteed to make their symptoms worse, this bill would concentrate some resources into jail diversion and linking people with much-needed supports.”
There are now several mental-health-reform measures vying for attention. Cornyn’s has joined a comprehensive reform bill from GOP Sen. Bill Cassidy and Democratic Sen. Chris Murphy, and a narrower Senate bill from GOP Sen. Lamar Alexander and Democratic Sen. Patty Murray, as well as Republican Rep. Tim Murphy’s reform bill in the House. The Alexander-Murray bill is scheduled for a markup on Thursday, and House Energy and Commerce Chairman Fred Upton has said mental health will come up in committee after recess.
It seems that mental-health reform is a uniting topic, one that might actually create momentum in a slow-moving Congress.
“Isn’t it great that there is shared concern regarding mental health?” Cassidy said when asked about Cornyn’s bill. “It … means there is a widespread recognition of lots of problems with how we’re currently addressing mental health. And if they’ve got great ideas, and we’ve got great ideas, let’s perhaps even combine to get a better bill.”
“If in fact we’re going to address mental health in the prison systems in a constructive way … I would love to see that,” said Democratic Sen. Jon Tester, who had not yet seen Cornyn’s legislation but responded to it based on a brief description.
But there will almost certainly be debate over whether Cornyn’s bill—or any other for that matter—goes far enough. Sen. Chuck Schumer plans to introduce legislation allowing the Justice Department to create rewards and penalties for states that submit or don’t submit records into NICS, whereas the Cornyn bill addresses only mental-health records.
And then there’s also the question of funding. The budget resolution currently does not appropriate all funds authorized for mental health—something both Cornyn and Schumer take issue with. Cornyn’s bill keeps all funding at existing levels.
“The authorization that I mentioned earlier for $195 million a year is not appropriated at the authorized levels. I think that’s a conversation that we need to have,” Cornyn said. “But we need to make sure the money, whatever money is spent, is spent in a effective and targeted sort of way, and that’s what we’re trying to do here. So that’s a conversation we should perhaps have about what is the appropriate level of funding.”
“I believe we should improve mental-health funding,” Schumer said in an interview, “but why are our Republican colleagues supporting a budget that cuts mental-health funding by $129 million?”
There’s also the issue of timing. Cornyn did not give a timeline for his legislation, which currently does not have any cosponsors. But the Senate has a packed schedule after the recess, and it is hard to see where there will be room for mental-health reform—especially given how many separate bills have been introduced. Cornyn’s will likely be referred to the Judiciary Committee, whereas the Alexander-Murray and Cassidy-Murphy bills will be considered in Health, Education, Labor, and Pensions.
“The key around here is capacity. When we come back in September, we’re going to be dealing with Iran, with funding the government, and that’s going to consume a lot of capacity. I’m new here, but I’m just trying to figure out how all that fits in,” said Sen. Thom Tillis on Cornyn’s bill. “I think it’s something good to get out there and get moving, though.”
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Murphy, Cassidy Highlight New Bipartisan Overhaul Of America’s Mental Health System
MSNBC August 5, 2015
WASHINGTON – Today, in an appearance on MSNBC’s Morning Joe, U.S. Senator Chris Murphy (D-Conn.) and U.S. Senator Bill Cassidy (R-La.), both members of the U.S. Senate Health, Education, Labor, and Pensions Committee, highlighted their new bipartisan legislation – the Mental Health Reform Act of 2015 – that will comprehensively overhaul and strengthen America’s mental health care system. The Mental Health Reform Act will make critical reforms to address a lack of resources, enhance coordination, and develop meaningful solutions to improve outcomes for families dealing with mental illness.
The full text of the senators’ remarks on Morning Joe is below:
Willie Geist: Joining us now from Washington, Democratic senator from Connecticut, Chris Murphy….and Republican senator from Louisiana Bill Cassidy. They’re the co-authors of a new bipartisan push for mental health reform. Gentlemen, thank you so much for joining us. You couldn’t be more different on the issue of guns – you’ve said as much there is not a lot you agree on, but you have found some common ground here. What it is?
Senator Murphy: Well, we both unfortunately come from states where we’ve had just enormous horrific tragedies with respect to gun violence. I don’t think it’s any secret that we’re going to likely have trouble finding common ground in Congress on gun laws over the course of the next couple years. But we absolutely can find common ground on fixing a very broken mental health system. So Bill and I have been working for the last six months – a conservative republican and a progressive democrat – to try to put together the first comprehensive reform of the nation’s mental health laws that’s been introduced in the Senate at least during the time that we’ve been there. We’re focused on building capacity for inpatient care, for outpatient care, trying to bring together the physical health and mental health system and continuing to reduce discrimination. You know, hopefully we’ll be able to breakthrough some of the inaction around these issues that affect families and individuals suffering mental illness.
Joe Scarborough: Chris, why has mental health been ignored for so long?
Senator Murphy: It’s hard to understand why Congress has taken a pass on this for so long. Part of it is that we do need some more resources and it’s hard to come up with those resources. But this is an issue that really should unite both of our parties. Every single member of the Senate has a family member or a close friend who has been touched by mental illness. We’re spending and wasting a lot of money by warehousing people in prisons, by leaving people lingering in hospitals. We can save a lot of money if we fix this system.
Mike Barnicle: Senator Cassidy, what does this bill do, if anything, about access to mental health care? I understand the greater goal of providing mental health care, but access to mental health care for people?
Senator Cassidy: It attempts to expand access. It asks states to report their outcomes. Now if the state is doing a really good job, the hope is that other states will imitate what the one is doing which looks so good. There are also grants in which we expand the number of mental health providers. Right now, there is an incredible shortage of mental health providers, so there will be an attempt to increase that number. That’s a good start. We have more to do, but we also are going to increase the number of, as Chris mentioned, capacity for inpatient beds. There is, right now, an incredible shortage of inpatient beds. So that’s another thing we’re doing to expand access.
Joe Scarborough: You know, Chris, you and I are both residents of Connecticut, and obviously both touched in different ways about it horrors of Newtown. I remember after Newtown, we all talked about the things that we needed to discuss – gun laws, mental health, other issues – but it devolved into an ugly gun debate immediately, and mental health got brushed aside. Do you think Congress is ready—do you think America is ready to have this discussion now?
Senator Murphy: I wish that we weren’t having this debate over fixing our mental health system because of these gun tragedies because frankly, Bill and I have been working on fixing our mental health system for a long time. And it should be fixed because it’s broken, period, stop. But we do have this political moment where people are paying attention, and we’d be fools not to take advantage of it. The fact is that people who are mentally ill are much more likely to be the victims of gun violence rather than the perpetrators of it, but there’s no doubt that by increasing capacity, you’re going to make it less likely that somebody is going to walk into a school or a movie theater who is very sick and cause this kind of damage.
Joe Scarborough: And Senator, are Republicans in our party that you work with, do they understand the need to expand mental health?
Senator Cassidy: Absolutely. If you speak to a sheriff, a sheriff will say that he is the largest provider of mental health in his county or in his parish – in Louisiana, we have parishes. And, he’ll also say that oftentimes the person they have most trouble with within that system, is he or she who is mentally ill. So this is neither a right nor left issue. It is an American issue. And we think we can find rationale for it both from the patient’s perspective, the family’s perspective, but also the societal perspective. We would rather have somebody who’s first episode at 15 is recognized, who is then redirected to a path of wholeness and wellness, who does not enter the criminal justice system, who gets a good job and pays taxes as opposed to becoming eventually something less than they could be. This is going to be an issue good for all Americans.
Joe Scarborough: All right guys, thank you so much. Greatly appreciate you focusing on this serious, serious topic. We appreciate it. Thank you so much, Chris Murphy and Bill Cassidy.
https://www.youtube.com/watch?v=Cw2pFSNce-s
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Senators Announce Mental Health Reform Bill, Pledge To Enforce Parity
By Shannon Muchmore Modern Healthcare August 4, 2015
Lawmakers introducing a new mental health reform bill Tuesday said it would increase access to mental health services and help enforce insurance coverage parity.
Sens. Bill Cassidy (R-La.) and Chris Murphy (D-Conn.) said the Mental Health Reform Act of 2015 is a companion bill to a revised House bill brought forth last month by Reps. Tim Murphy (R-Pa.) and Eddie Bernice Johnson (D-Texas).
Cassidy said he and Chris Murphy, both members of the Senate Committee on Health, Education, Labor and Pensions, have received assurances from committee leadership that the bill would move forward.
The bill, which has yet to invoke early criticism, creates an assistant secretary for mental health and substance abuse disorders within HHS who would oversee mental health services across the federal system. That person would be appointed by the president and approved by the Senate.
The bill would award grants to encourage states to integrate physical and mental health services and grants to help states focus on early intervention of children as young as 3. It would also clarify regulations under the Health Insurance Portability and Accountability Act regarding mental health patients and help educate family, patients and doctors on what the regulations mean.
Cassidy said the bill does not yet have a score from the Congressional Budget Office but it doesn’t need a lot of funding.
Chris Murphy said the previous efforts show the bill could actually ease costs.
“We’ll have to address the cost issue but we can certainly say this bill will likely save a lot more money than it costs,” he said.
Mary Giliberti, executive director of the National Alliance on Mental Illness, said her organization is supporting the bill because she gets calls and e-mails daily from people who are desperate for access to care for themselves or a family member.
“We need a national solution to what is a national problem,” she said.
Giliberti, who worked as a section chief within HHS’ Office for Civil Rights, said having an assistant secretary help coordinate mental health services at the federal level will make a positive difference because it will add weight to the relevant policies and programs.
Dr. Saul Levin, CEO and Medical Director of the American Psychiatric Association, said the bill would help the millions of Americans who suffer from mental illness as well as their families.
“This legislation I think really helps us step up,” he said.
Murphy said improved access to mental health care would come from more psychiatric beds because of some changes to how hospitals are reimbursed for them and by creating different pathways for doctors to specialize in mental health care,” Levin added.
http://www.modernhealthcare.com/article/20150804/NEWS/150809966