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Why the New Mental Health Reform Law Passed, and What It Means to Me

By: Paul Gionfriddo, MHA president and CEO

It is fair to say that a year ago, few people thought we’d be celebrating mental health reform as part of the last major legislation signed by President Obama. There were so many outstanding issues to resolve, and many on both sides appeared to have dug in their heels.

But Congress did come through, due both to the dogged determination of a few key legislators, like Tim Murphy in the House and Chris Murphy in the Senate, and to the willingness of members of both parties and both chambers to find common ground.

What changed the equation for us was that when the House and Senate proposals were offered in mid-2015 they were not only similar in their approach, but they were comprehensive as well. For the first time in a long time, we weren’t just talking about deep-end, post-crisis services and how we could educate sheriffs, judges, and correctional officers to divert people with late-stage mental illnesses from the criminal justice system. We were also talking about prevention, early intervention, and integrated health and behavioral health services. For the first time in many years, we were treating mental illnesses as public health – not public safety – matters.

This gave advocates something around which we could come together. Whether we represented people with lived experience, family members, professionals, or providers, and whether we took a more clinical institution-based approach, or a community services-based approach, we could all agree that addressing mental health concerns before Stage 4 made a whole lot of sense.

At Mental Health America, we offered scores of recommendations on both bills. At the same time, we major advocacy groups delivered a common message to Congress. We said that it was so important to pass legislation now that if members of Congress could find pathways to compromise, we could too.

I met personally over the course of months with many members – Tim Murphy, Chris Murphy, Bill Cassidy, Fred Upton, Frank Pallone, Diana DeGette, Patty Murray, Chuck Schumer, and John Cornyn, to name a few. I even grabbed Paul Ryan one day in the airport to give a brief pitch, and asked an ever-gracious Todd Young to listen to a more extended one on a flight we shared to Florida.

What impressed me about every member was that while they individually might have a special priority or differ in their approach, they were all committed to trying to get something done and all open to compromise.

When the compromise legislation finally did emerge, the members of Congress overwhelming got behind it and showed us what that body is at its best. The President stepped up, too, adding mental health reform to his priorities, and making increasingly strong and positive statements about it as the year wore on.

That’s why this legislation passed. And here’s what it means to me.

My son Tim has lived with a serious mental illness for almost all his life. It wasn’t diagnosed early when it emerged during childhood. Even after it was, it was still treated as a behavioral, not a medical, problem.  As a result, as a matter of public policy we sent Tim along a pathway to chronic homelessness, frequent incarceration, and occasional hospitalization. He’s been doing better the past year – a tribute to his resiliency more than anything else.

I’ve seen first-hand, up close, and very personally what serious mental illnesses can do to individuals, their families, their friends, their educators, their employers, and their social support systems. I’ve seen how ill-prepared sheriffs, judges, lawyers, courts, and jails are to address mental health concerns.

I’ve seen this as a parent and as a policymaker.  And the conclusion to which I’ve come is that the problems we’ve created through the policy choices we’ve made laid foundations that severely limited the choices and pathways to recovery that people like Tim could make.

We have needed a different approach.  That’s what this new law gives us.

It lays a foundation for a better system of care, services, and supports.  It will open new doors for children and adults who live with mental health challenges. Over time, it will give people like Tim and the people who love them more pathways to recovery, and more choices along those pathways.

There is a whole lot more we all need to do.

But anyone who thinks this law – which strengthens SAMHSA, better coordinates our federal agencies, promotes innovation and evidence-based practice, establishes programs to help kids, promotes earlier intervention and better integration of health and behavioral health, gives more teeth to parity, supports suicide prevention, expands the mental health workforce, and demands a reduction in imprisonment of people with mental illnesses – isn’t the right approach either hasn’t read it, doesn’t care, or will never be satisfied by any law that could pass.

It won’t happen overnight, but this law will help change the trajectories of lives like Tim’s. And for that, I am grateful to my Congress and my President, and feeling hopeful about the uncertain future.

Comments

Thank you for this post. The 21st Century Cures Act is certainly a great achievement for our field, but I worry that many of its provisions become hollow if lose ground in a full ACA repeal. I'm a medical student at UNC Chapel Hill going into psychiatry, and I am working on a grassroots advocacy project to save the ACA's mental health provisions which my team thinks could be bipartisan targets. You can learn about our efforts at www.SaveMentalHealthReform.org. Would MHA like to partner with us on this project? You can reach me at samuel_dotson@med.unc.edu.

As a parent who has struggled with paying for medication and hospitalization for my adult child, I am deeply concerned about the effects the Republican monopoly on government will have in 2017 and thereafter. I am retired and the Affordable Care Act allowed me to support myself instead of only buying medication for my affected off-springs with my small pension. Will the new president and congress take back the help that we finally won for children and families who live daily in the shadow of mental health challenges?

Caregivers of mental health adults are discriminated against due to the lack of understanding how stressful this role is. After 4 years burn out and anxiety haunt you day and night. We need to be heard..we are the only thing keeping our loved ones safe.

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