Deliver mental health before tragedy

Each day, sensationalized headlines about violent episodes grab our attention and boggle the mind. 

In Florida, a 23-year-old man decapitated his mother with an ax, because she had badgered him about his daily chores. Missing from the article, however, was that the man had been diagnosed with schizophrenia and involuntarily (yet temporarily) held under the state’s civil commitment law. Despite his illness and past run-ins with mental health authorities, the man was no longer receiving care for his psychiatric condition because Florida, like most states, required him to be imminently homicidal or suicidal to get treatment.

{mosads}At the trial of the former Marine who killed Iraq War veteran Chris Kyle, the mother of the defendant testified she had begged VA doctors to keep her son in psychiatric treatment just days before he murdered the decorated sharpshooter.

These tragic episodes are difficult to comprehend because they were so seemingly preventable. The families knew there was something wrong with their mentally ill loved one. But they were ignored, frustrated or turned away by state and federal laws that put up barriers instead of facilitating access to treatment.

Can you imagine if we told someone with diabetes, “Your blood sugar is too low, but we are going to wait until you are in diabetic shock before we give you insulin.” Or what if we told those with heart disease to come to the doctor only after they had a heart attack?

We never deny care to those with chronic illness because their condition isn’t sufficiently severe, nor do we walk away from an Alzheimer’s patient simply because he or she cannot articulate their need for treatment. 

Yet for families in a mental health crisis, this scenario plays out every single day. Those with deteriorating brain disease, incapable of making informed choices as a result of their illness, are told they will not receive help or treatment until the patient attempts suicide or homicide.

To help these people and families who are trapped in a system that is misguided and in denial, we must approach serious mental illness (SMI) as a medical emergency that engages the community.

First, we must accept that mental illness is a brain disease. It is not an attitude or a lifestyle choice. Psychosis, schizophrenia and other SMIs disrupt typical brain functioning and result in disturbing behaviors. That is not a condemnation or criticism of those with severe brain disorders. Hallucinations, voices and paranoia prompt actions that aren’t grounded in reasoned choices. When we accept that behaviors are symptomatic of what is occurring in the brain, we can address them without judgment, just like other medical diseases, and offer life-saving treatment before tragedy strikes.

That’s the goal of my bipartisan Helping Families in Mental Health Crisis Act. This legislation removes the barriers that prevent well-meaning families from helping loved ones in crisis. The bill also fixes the shortage of psychiatric hospital beds, clarifies and simplifies HIPAA privacy laws so well-meaning families can be part of the care delivery team, and makes major reforms to federal efforts so programs adopt treatment models for individuals with SMI that research shows work.

As a Government Accountability Office (GAO) report requested by my Energy and Commerce Subcommittee on Oversight and Investigations revealed, our federal mental health system is dysfunctional, disjointed and without leadership. Following a survey of eight federal agencies, the GAO identified at least 112 separate federal programs supporting individuals with severe mental illness. Most damning in the GAO report were these two principle findings: Interagency coordination for programs supporting individuals with SMI, a key legal responsibility of the Substance Abuse and Mental Health Services Administration (SAMHSA), is “lacking,” and less than one-third of SMI programs were evaluated for effectiveness.

Sadly, SAMHSA and the Health and Human Services Department told the GAO and my committee there was no need to adopt the GAO’s recommendation for better leadership. This is a clear example of unaccountable government — one that refuses to recognize its failings, even when it is presented with constructive recommendations for improvement. We are not talking simply about wasted dollars or program inefficiencies. We are talking about lives ruined, dreams shattered and preventable tragedies.

The Helping Families in Mental Health Crisis Act would fill this leadership void by creating an assistant secretary for mental health and substance use disorders, an idea that has been promoted by both Republicans and Democrats. This individual, who would have clinical and research experience as a psychiatrist or psychologist, would be responsible for coordinating these disjointed programs, as well as evaluating and monitoring programs to ensure they work.

The GAO report was a much-needed wake-up call. I hope now is the moment when Congress and the Obama administration join together to pass the Helping Families in Mental Health Crisis Act for the sake of the thousands of Americans who’ve written, emailed and called my office about how the broken mental health system has torn their family apart. Together, we can take mental illness out of the shadows and place it in the bright light of hope.

Murphy has represented Pennsylvania’s 18th Congressional District since 2003. He sits on the Energy and Commerce Committee. Murphy also serves as a lieutenant commander in the Navy Reserve Medical Service Corps as a psychologist treating wounded warriors with post-traumatic stress and traumatic brain injuries. Prior to serving in Congress, he was a practicing psychologist specializing in child and family treatment. For more information on the Helping Families in Mental Health Crisis Act, visit http://murphy.house.gov/helpingfamiliesinmental​healthcrisisact.