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Another Big Step in the Journey to Mental Health Reform

By Paul Gionfriddo, president and CEO, MHA

Senators Chris Murphy (D-CT) and Bill Cassidy (R-LA) have now introduced the Mental Health Reform Act of 2015. While Mental Health America has not yet formally endorsed it or its House counterpart, we consider it another important step toward making comprehensive mental health reform a reality in America.

It builds on H.R. 2646, the Murphy-Johnson proposal introduced two months ago in the House, incorporating many of the provisions that Mental Health America has made a priority in our advocacy for many years.

The most important is in its emphasis on screening and early intervention, with substantive language identical to that in the House bill.  I cannot underscore how important this is to our cause.  If these proposals move forward and are reconciled someday soon, the fact that those provisions are identical will mean they won’t get lost.

The same is true of other provisions common to both proposals. These include an emphasis on:

  • building community-based systems of care;

  • enhancing the behavioral health workforce;

  • innovation to develop new evidence-based programs;

  • integration of health and behavioral health care, including measures to facilitate the sharing of health data needed for care integration;

  • enforcement of parity in coverage between health and behavioral health services; and

  • the elevation of behavioral health in the federal government, including increased coordination of services. 

As we have argued, these are all essential components of a sound care delivery system.  MHA was credited by Rep. Murphy in helping get them into HR 2646 earlier.  We now thank Sen. Murphy and Sen. Cassidy for including them in the Senate bill, too.

These legislative proposals and others, including an anticipated mark-up as early as this week in the Senate HELP Committee of mental health legislation sponsored by Senators Lamar Alexander (R-TN) and Patty Murray (D-WA), reflect a growing bipartisan energy in Washington around mental health that we have not seen in years.  This energy, infused into the legislative process by MHA and so many of our supporters, is moving policymakers upstream in addressing mental health issues – and not waiting for crises to occur first. 

We are happy to see some new things in this Senate proposal – most notably funding levels attached to the new grant programs.  And we’re happy to see something missing, too – any restriction on Protection and Advocacy services for people with mental illness.

But there are also some things in the House version that are not in this one – the reauthorization of Garrett Lee Smith Act for suicide prevention, for example (but to be fair, this could be in the Alexander-Murray mark-up).

And there’s a difference in how mental health lead agency at the federal level will be structured.  Both create a new Assistant Secretary for Mental Health.  The Senate version makes the SAMHSA Director report to the Assistant Secretary – a structure we opposed last year – while the House version essentially makes SAMHSA a part of the Assistant Secretary’s office.

What else is missing from our perspective?

We would still like to see more to support children with mental illness, including integrating special education and clinical services; more choice of services and supports for adults in recovery, including housing and employment support; and a commitment to end the incarceration of nonviolent offenders with mental illness within ten years.

But like their counterparts in the House – Representatives Murphy and Johnson - Senators Cassidy and Murphy have taken another step in the right direction to address the failures that so obviously exist in our mental health system.  They are to be commended for their effort and applauded for their willingness to stand up and be counted.

We urge mental health supporters to work with us to ask Congress to pass comprehensive mental health reform legislation this year. The framework is now there and while it may be imperfect it is an opportunity to do some good.  Let’s not let the opportunity pass.

Based on what we’ve now seen and heard, we hope and expect that the differences and details can be ironed out in language we all can ultimately endorse. 

But this is MHA’s bottom line.  Now is the time to erase the discrimination and stigma surrounding mental illness, to address mental health before Stage 4, and to intervene effectively to save lives and change the trajectories of people living with mental illnesses.

Comments

This sounds hopeful, but is there any attention in the language of the bills to ensure reducing disparities among many underserved groups in order to break the barriers of stigma and gain access to both prevention and treatment?

While there is little in the proposals that address disparities reduction in particular, this has become a priority for SAMHSA and will remain so in the coming years. In addition, our thinking in working so hard for the innovation grants is that a good deal of these dollars could find their way to the populations with the greatest unserved needs. Finally, if screening becomes ubiquitous - and it is favored in both proposals - this will help level the playing field over time.

Thank you for all you do to improve the system. One small step leads to another.
We have suffered with a 47 year old son,diagnosed with Schizophrenia for the past 30 Years.
Thanks to clozapine he is highly functional but is barely making a decent living delivering pizza for Dominos in Smithfield, N.C. Minimum wage $7.25 .. Only part-time-no health benefits- BC/BS
Under "affordable Health Care Act is a sham.

At one point in time I was scared of the implementation of AOTs in our mental health community, but as I have been getting to know some fellow peers wuho've been incarcerated & unmedicated in our local jail I see a great need here in Cortland, NY. A friend of mine has schizophrenia & a history of substance abuse. He keeps getting put into jail, because there isn't anything in place here to court order him to take meds. We do have what they call EDPRT through local law enforcement (Emotionally Disturbed Person's Response Team) The officers are really making improvements, but they can only do so much! I fear for the safety of my friend & others. Thank you.

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