Mental health bill gets a second chance

A House subcommittee plans on Tuesday to consider the 173-page plan, which Murphy has ceaselessly championed over the last year and a half. The Pennsylvania Republican, who is a psychiatrist, has emerged as Congress’ most vocal proponent of reforming the way mental healthcare is delivered.

Hoping to gather more traction for his bill, Murphy made some revisions to it. That included removing its most controversial provision: a requirement that states set up outpatient treatment programs to receive certain federal grants.

Under such programs, judges may order treatment for those with serious mental illnesses such as bipolar disorder or schizophrenia, often as an alternative to jail or as a condition to be released from jail. While the severely mentally ill are thought incapable of choosing the care they need, some fear such programs restrict civil liberties because they’re required to undergo treatment involuntarily.

Murphy has done away with that requirement in his bill, as all but five states already have such programs, he told the Washington Examiner. He has replaced it with an incentive program offering states extra money to run the programs if they choose.

“It didn’t make sense to mandate they have it on the books,” Murphy said. “Instead we’re saying, ‘How can we facilitate your financial needs.'”

The new bill also addresses another concern of some advocates, who said it threatened patient privacy by allowing caregivers of those with serious mental illness to gain access to their medical records if it’s deemed necessary for safety.

Murphy insists that the provision is a crucial reform, one that will massively help caregivers get the information they need to do their job. “Up to this point, it’s been a disaster, because we’ve left it up to a person with severe mental illness to coordinate their care,” he said.

But the new bill tightens the provision, specifying who qualifies as caregivers and clarifying what kind of information they can and cannot receive.

The changes, advocacy groups say, are good, although they don’t make a huge difference in how the bill would work. Broadly speaking, the legislation would create a new assistant secretary to oversee and coordinate the federal government’s mental health efforts, reorganize federal spending on mental health services and provide more ways to measure their success.

“There are many provisions in the bill that we really like,” said Chuck Ingoglia, vice president for public policy at the National Council for Behavioral Health. “It’s evident that in many places he made changes to try to modify concerns groups had.”

The estimated $130 billion the U.S. government spends on mental health annually is distributed through 112 federal programs, many of which don’t coordinate with each other. Just about everyone agrees the system needs reform, but it’s difficult for politicians to agree on specific changes.

Murphy started pushing for mental health reform in the wake of the 2012 shooting at Sandy Hook Elementary School in Connecticut, hoping the crimes of troubled shooter Adam Lanza would motivate lawmakers.

He has collected an array of support for his bill, including leading mental health groups such as American Psychiatric Association and the National Council for Behavioral Health. It has some Democratic cosponsors, too. But he has had trouble gaining the traction needed to propel it forward.

Republican leadership hasn’t made the bill a priority, amid the hundreds of bills they’re asked to bring to the floor every year. And many Democrats want any mental health reforms to include gun control measures.

“One of the things I realized from the time I introduced this bill is there’s a great amount of misunderstanding,” Murphy said. “And there are some groups out there very invested in not changing.”

One group particularly vocal in opposing the bill has been the National Coalition for Mental Health Recovery, a group of 35 mental health organizations. The group opposes the provision allowing for greater access to patients’ medical records and another part of the bill that would undo some grants for mental health services that don’t fit evidence-based criteria.

Murphy is not the only lawmaker working on mental health legislation. Two senators have recently teamed up, too. Sens. Chris Murphy, D-Conn., and Bill Cassidy, R-La., said earlier this year they’re working on a bill that could mirror Murphy’s measure in some ways but differ on other parts.

“Reforming our mental healthcare system is something we can all get behind,” the senators said in a joint statement. “We look forward to a continued dialogue as we work to develop meaningful and comprehensive legislation with bipartisan support in both the House and Senate.”