Bipartisanship Could Still Push Mental Health Reform Through Congress

Lawmakers in the Senate Committee on Health, Education, Labor and Pensions have just released the draft text of a bill that, they hope, could bring about a much needed update and reform of mental health care in the United States. It also shows that bipartisanship is not dead, and that when lawmakers work together the potential for serious legislative change is still possible.

The bill is being worked on by Senator Lamar Alexander (R-TN), leader of the Senate Health Committee, with Democrat Senator Patty Murray (WA) and Senators Chris Murphy (D-CT) and Bill Cassidy (R-LA).

The legislation is known as the Mental Health Reform Act of 2016, and it aims to achieve what could end up being the biggest overhaul in mental health care in decades by dramatically cutting the federal bureaucracy around mental health programs. It would increase state funds for certain mental health services and increase treatment options and availability for at risk groups such as children, people with no fixed address, and people who are already at risk of suicide.

In terms of specifics, the legislation makes changes to the Substance Abuse and Mental Health Services Administration (SAMHSA) policy–and so will need the Obama administration’s backing–and will provide stronger language to help tackle opiod addiction. It will also include language to lift restrictions on Medicaid being able to pay for mental health facility care (thereby nixing what’s known as the “IMD exclusion”) which is seen as a vital step towards ensuring mental health care is available to everyone no matter their current economic status. 

The legislation is more narrowly tailored than other proposed reforms have been, but the lawmakers behind this effort say this is meant as a starting point and that they want to work with other committees to add to the legislation and, by bringing together lawmakers of both political parties, move this legislation as soon as possible to beat the inevitable slow-down that will come as a result of the presidential election.

“Our mental health care system is failing those who need it most. Individuals struggling with mental illness may go years without receiving treatment, ultimately suffering in isolation, or being cast aside and abandoned by the very system they should be relying on. Too many Americans with serious mental illness slip through the cracks, and Congress must act to stop it,” co-sponsor Senator Chris Murphy is quoted as saying.  

“I’m grateful that Senators Alexander and Murray worked shoulder-to-shoulder with Senator Cassidy and me to craft this bipartisan compromise. This bill already represents the biggest reforms that Congress has seen in decades, and I’ll keep working with both Republicans and Democrats on the HELP Committee to make it even stronger.”

We’ve previously discussed why the other main mental health reform bill in Congress, known as the “Helping Families in Mental Health Crisis Act” (H.R. 2646), has angered mental health care advocates. As introduced in the House, it conflates mental illness with violent crime and its provisions stem from that basis. It robs people with mental health care of vital decision making, would expand powers to forcibly detain people with a history of poor mental health and, critics say, would not create the reform in mental health services that we need because it is too occupied with diverting attention away from what the bill is really trying to answer: calls for better gun control.

The key question is, is this bill any better? It certainly has had its detractors and there are key omissions that have disappointed mental health care advocates. For example, there are few provisions that specifically tackle criminalization of people with mental health issues (more on that below). There’s also little in the way of tackling outpatient treatment and how that should be supported (without court mandates).

However, compared to the House mental health reform bill, this gets some key things right. Firstly, it doesn’t treat mental illness of itself as a factor for violent crime and there is no gun control language in or around this bill. It also does not use the assisted-outpatient treatment framework which has been heavily criticized by mental health care advocates because it funnels mentally ill people into situations where their civil liberties are taken away, oftentimes without justification.

The National Alliance on Mental Illness has said that it welcomes this bill as “a positive start“ but has several key recommendations. The NAMI has been particularly concerned with the increasing criminalization of people with a mental illness and previously encouraged the Senate to take up the Mental Health and Safe Communities Act, introduced by Senator John Cornyn of Texas.

That legislation, among several important provisions, would create specialized training for law enforcement, crisis intervention teams (given the number of mentally ill people being shot by police, this is vital), and specialized mental health courts to prevent offenders from getting stuck in the federal system when what they need is treatment. These are just a few of the provisions, but NAMI’s response to the Mental Health Reform Act calls for many of those same and important safeguards to be added.

This legislative effort is, on the whole, a far more positive one than the Republican measure proposed in the House, and for several reasons.

Firstly, it actually tackles mental health care in a way that could help patients and doesn’t treat the mentally ill as people who should simply be restrained because they are dangerous.

Secondly, and perhaps just as importantly, it reminds both conservatives and liberals that there are issues greater than party politics and that, when lawmakers from both sides of the aisle come together and commit to tackling an issue, they can produce meaningful results.

This bill might not be perfect, but bipartisanship can move us forwards. For people suffering under the current state of mental health care, that forward momentum is crucial.

The bill is slated for further discussion on Wednesday, March 16, and lawmakers are hoping to move it swiftly through the Senate.

Photo credit: Thinkstock.

29 comments

Siyus Copetallus
Siyus Copetallus2 years ago

Thank you for sharing.

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Sarah Hill
Sarah Hill2 years ago

Until they let doctors dictate medical health rules our healthcare system will remain out of whack!

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Veronica Danie
.2 years ago

Thanks!

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Kathryn Irby
Past Member 3 years ago

As long as "people" like Old Man McConnell are in Washington, D.C., seriously doubt it.

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Ricky T.
Ricky T3 years ago

Reform is imperative.

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Lindell Lovelace
Lindell Lovelace3 years ago

As nuts as the Right is, this is WAAAY overdue!

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Anne Moran
Anne Moran3 years ago

Pass/push it,, and quickly !! -- Mental illness is more prevalent than you think... - We must do all we can,, to help these poor souls...

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Debra G.
Debra G3 years ago

This could be a huge improvement, but sufficient funding is required.

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Sherri S.
Sherri S3 years ago

Those with mental illness definitely need better help than what they are getting now. Let's hope both sides can find a middle ground and help those in need.

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Grace Adams
Grace Adams3 years ago

I personally was railroaded into a mental hospital in 1961. I was stuck there for two and a half years.

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