Chris Harper Mercer was not the first person alleged to have serious mental illness to go on a shooting rampage. Before Mr. Mercer killed nine people in Oregon, a review of all mass shootings since 1982 found an estimated 58 percent of the 72 were by someone with mental illness. There have been at least three since I started investigating the nation’s mental health system after the massacre at Newtown as chair of the House Oversight and Investigations Subcommittee.
But while high-profile acts of mass violence by people with untreated serious mental illness captures public attention, it was the pain and suffering of those with untreated serious mental illness and their families that stunned my committee. We found that in spite of 112 programs spending $130 billion annually on mental health, at least 164,000 of the most seriously mentally ill are homeless, 365,000 are incarcerated, 770,000 are on probation or parole and 95,000 are regularly denied a hospital bed because of the bed shortage. Of the 41,000 who die by suicide, more than 90 percent have a mentall illness. We also found people with a serious mental illness are more likely to be victimized and die earlier.
And the toll on families is heartbreaking. Subcommittee members heard a clear pattern of stories: Families with loved ones who were turned away simply because the programs limited themselves to the higher functioning; federal laws that prevent doctors from telling parents the diagnosis, treatment and pending appointments of their children, making them powerless to help prevent their deterioration; federally funded lawyers ‘freeing’ patients from care over the objection of their parents; patients waiting a week in a gurney in an emergency room because no beds were available. We heard of federally-funded conferences where people with mental illness were taught how to go off violence-preventing medicines; laws that forbid someone to get care until after they become violent and then force them into restrictive inpatient care or incarceration. We heard of people who are so ill they believe they are the Messiah, or the devil, being allowed to refuse treatment that could free them of their delusions and restore their free-will.
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When we looked at why there are so many problems, all roads led to the Substance Abuse and Mental Health Services Administration. It’s a small, relatively obscure federal agency but it develops most of the nation’s mental health policy. Rather than focusing on reducing homelessness, hospitalization, or incarceration in people with serious mental illness it focused federal and state efforts on delivering ‘behavioral wellness’ to everyone else. Parents who wanted care for loved ones and states who wanted to improve their treatment systems regularly found themselves stymied by pseudoscience and anti-treatment advocacy supported by SAMHSA.
To fix this obscenity, we proposed the Helping Families in Mental Health Crisis Act (H.R. 2646) to redeploy federal assets to where they can do the most good. The most important reform is that it replaces SAMHSA with an Assistant Secretary of Mental Health and Substance Use Disorders and focuses it on the elephant in the room: getting treatments that reduce homelessness, arrest, incarceration, hospitalization, suicide and violence to people with untreated serious mental illness. That will keep patients, the police and the public safer.
Other reforms include rewarding states that implement Assisted Outpatient Treatment. AOT is for a very tiny group of the most seriously ill who have already accumulated multiple episodes of arrest, hospitalization and homelessness due to their inability or unwillingness to stay in treatment. It allows judges to order these individuals into six months of mandated and monitored treatment while they continue to live in the community. It cuts homelessness, arrest and violence incarceration about 70 percent each.
The bill also lays the groundwork to increase the number of hospital beds to serve the seriously ill, writes a small exemption into federal privacy laws so families who provide housing, case management and financial support to seriously ill loved ones can get the same information paid providers receive if needed to protect health, safety and welfare. It returns a federal program designed to help the seriously ill to its original function of preventing abuse and neglect of the seriously ill.
In spite of having 142 bipartisan co-sponsors, the support of the House leadership, the support of families of the seriously ill, the Treatment Advocacy Center, Mental Illness Policy Org, International Association of Chiefs of Police, National Sheriff’s Association and others, the bill has not been brought up for a vote. That should offend everyone, especially as there is very little opposition to the bill. Almost the only opposition comes from those funded by SAMHSA who want to keep their SAMHSA funds while refusing to serve the most seriously ill. Their SAMHSA funds gives this small group a large megaphone that is trying to have the bill watered down, so Congress can say it ‘did something’ without actually doing anything important.
In the aftermath of the Oregon tragedy, Congress held another moment of silence. We don’t need silence. We need action. We need H.R. 2646.
Tim Murphy represents the 18th congressional district of Pennsylvania. Thinking of submitting an op-ed to the Washington Examiner? Be sure to read our guidelines on submissions.
