On December 12th, 2013, Representative Tim Murphy (R – Pa) introduced the bill “Helping Families in Mental Crises Act of 2013” that aims to decrease mental health spending and increase mental illness spending. Within the 135-page document, Congressman Murphy highlights a number of changes he believes will fix the mental health system, such as creating an Assistant Secretary for the Mental Health and Substance Abuse Disorders (in the Department of Health and Human Services), fundamentally changing organizations such as Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Mental Health Services, and focusing community mental health services grants on people with the most serious mental illnesses.
With an extreme focus on a specific group of mental health consumers, individuals with less severe mental health conditions, which makes up the largest number of individuals with mental illness, and the thought of prevention are put on the back burner. The National Coalition for Mental Health Recovery (NCMHR), the National Disability Rights Network, and the Bazelon Center for Mental Health Law jointly issued a press release pinpointing how this bill will reinforce the connection between violence and mental illness, and erase the progress made in the last 30 years.“This legislation would eliminate initiatives that promote recovery from serious mental illnesses through the use of evidence-based, voluntary, peer-run services and family supports,” said Dr. Daniel Fisher, a founder of the NCMHR. The elimination of effective initiatives that prevent individuals from returning to hospitals would increase mental health spending. Bazelon Center trustee, Harvey Rosenthal mentioned “the legislation ultimately threatens to dismantle the efforts of the SAMHSA to promote recovery and community inclusion for the broad variety of people in our community.”
Another troubling aspect about the H.R. 3717 is that only states with Involuntary Outpatient Commitment language in statute will be eligible for SAMHSA block grants. IOC allows individuals with serious mental health illness to be court-mandated to follow a specific treatment plan, that will usually include medication. According to a report by the National Coalition for Mental Health Recovery, IOC programs are not effective, costly, and not likely to reduce violent behavior. In fact, voluntary programs without coercion are more effective than IOC programs. Because the state of Maryland does not currently have IOC language it statute, Marylanders could lose roughly $8 million in grant-funding if this bill passes
Representative Murphy’s bill will also cause changes in Health Insurance Portability and Accountability Act of 1996 (HIPAA). Some of the original goals of HIPAA is to assure that individuals’ health information is properly protected and to provide and promote high quality care. The pending law rolls back some of these protections and requires covered entities to treat caregivers as “personal representatives” who are entitled to obtain the individual’s protected health information with no regard to individual consent. This intrusion of personal rights could drive people away from treatment and recovery.
The Mental Health Association of Maryland currently does not support “Helping Families in Mental Crisis Act of 2013” and have urged our federal delegation to not support the legislation but instead support other legislation introduced in 2013, such as Garrett Lee Smith Memorial Act (suicide prevention; S. 116/H.R. 2734), Mental Health First Aid (S. 153/H.R. 274), Children’s Recovery from Trauma Act (S. 380), Excellence in Mental Health Act (S. 264/H.R. 1263), Mental Health First Aid Act (S. 153/H.R. 274), Justice and Mental Health Collaboration Act of 2013 (MIOTCRA; S. 162/H.R. 401) and the Behavioral Health IT Act (S. 1517, S.1685/H.R. 2957).