The Mental Health Care Overhaul Bill: What You Need to Know

House Speaker Paul Ryan has declared his support for a Republican-led effort to overhaul mental health care in the United States. Some advocates have praised the initiative, but there are campaign groups that have serious concerns–and namely that this is so Republicans can side-step gun control reform. Here’s what you need to know.

What Is the Bill Called and Who Proposed It?

The legislation is called the Helping Families in Mental Health Crisis Act (HR 2646) and it was proposed in the House by Rep. Tim Murphy [R-PA-18].

This version of the legislation was introduced back in June, but it is a repeat introduction of a similar text that was introduced shortly after the Sandy Hook shootings in 2012.

The legislation failed to pass in 2013, however House Speaker Paul Ryan last week came out in favor of the bill, responding to a question about gun control and saying that he wasn’t pursuing reform but was instead interested in Murphy’s mental health bill:

“The other issue that I think we need to take a look at, and I’m pushing this in the Commerce committee, is Congressman Murphy’s legislation on mental health,” Ryan is quoted as saying in an un-aired segment of a recent CNN 60 Minutes interview. “I think we need to improve our mental health laws so we can address these problems before they get out of control, because mental health is a component to a lot of these shootings that, I think, we have not looked at seriously enough.”

What Would the Legislation Do?

The stated purpose of the bill is:

To make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes.

The legislation contains a number of provisions. Among them, the text claims to:

  • Focus on preventative care through initiatives like the Recovery After Initial Schizophrenia Episode (RAISE), an evidence-based early intervention program.
  • Reduce institutionalization by using Assisted Outpatient Treatment.
  • Improve care transition when patients are going either up or down the scale of treatment involvement.
  • Cut red-tape and create better coordination across federal agencies.
  • Focus on a patients’ rights to be free from abuse and to receive timely and appropriate treatment.

You can read a full summary of the legislation here.

Supporters of the bill say that it constitutes a massive step forward in patient-centered care. However, not everyone is convinced.

Why Has the Bill Met With Significant Opposition?

There are a number of reasons for opposition to the bill, however the primary one is that it is grounded in the notion that by being able to force people into treatment we can lower the overall number of people with mental health problems who will go on to commit violent crimes–except, research shows that violent gun crimes and mental health problems don’t actually tally.

Statements from the National Coalition for Mental Health Recovery claim that Murphy’s legislation “is based on a false connection between mental illness and violence,” and points out that “study after study shows that no such connection exists. In fact, individuals with mental illnesses are actually 11 times more likely to be victims of violence than is the general public.”

Terming the Assisted Outpatient Treatment (AOT) clauses a smokescreen for involuntary and court-mandated treatment programs which, if a patient refuses, could mean institutionalization, the coalition of mental health professionals also point out that this kind of approach has proven ineffective. In fact, the data suggests that positive outcomes from similar versions of AOT actually appear to come from access to costly services–such as one-to-one therapy and medication access–that often isn’t available to the general public and not from the treatment approach itself.

Other issues of concern are that the bill appears to alter a health privacy law known as the Health Insurance Portability and Accountability Act to allow family members and carers of mentally ill people to have greater access to records on their loved one’s care, even down to accessing information on their treatment program. This, critics say, is a step too far and strips people with mental illnesses of the right to privacy that is offered mentally well people.

A couple of legislative issues have also been raised: firstly that the money isn’t there to implement many of these changes, and secondly that the bill requires all grants and contracts for mental health services controlled by this legislation to go through the Energy and Commerce Subcommittee on Health, which is the committee on which Rep. Murphy currently holds a position. Opponents have called this overreach that, rather than limiting red-tape as the legislation was supposed to do, would actually allow more meddling if the committee was so inclined.

What Is the Reform’s Chances of Passing?

Despite the above concerns, some Democratic lawmakers who have long supported mental health care reform may still be open to voting for this bill. There appears to be an appetite to work with Republicans to make this a meaningful bipartisan effort, though it’s unclear whether the bill could be amended enough to remove many of the significant issues that mental health awareness groups have raised.

The primary issue however remains that this bill is being used as the Republican answer to gun violence. Seen through that lens it lets down the victims of gun violence, and by virtue of linking gun violence and mental health problems the Republican effort stigmatizes the very people they are purporting to help.

Photo credit: Thinkstock.


Siyus Copetallus
Siyus Copetallus3 years ago

Thank you for sharing.

Sarah Hill
Sarah Hill3 years ago

This is what is needed, not gun control. If you pass laws against guns, only the law abiding will obey them. The definition of a criminal is that they do not obey laws. All gun control laws do is make the innocent more vulnerable.

Ricky T.
Ricky T3 years ago

Same here in the UK. The parity of the MH healthcare initiative #equality4mentalhealth they signed up to a fortnight or so ago, is gonna prove to be a PR sham…never bought it! The same people who signed up to it, are warmongers & apologists for war, and refuse to link suicides to benefit sanctions, and their contempt for vulnerable, disabled & poor people.

Kathryn Irby
Past Member 3 years ago

Just more Republican incompetence; it will never work for the betterment of the patients; Republicans haven't a single clue of how to govern. Thanks for posting.

Victoria Vaughan
Victoria Vaughan3 years ago

Please read the bill before you pass judgment. I am a democrat but I back this bill. As someone who witnessed the brutality of the treatment of my own brother for 40 years with the so called mental health system that we have I can tell you we need this bill. We currently use prison as our main "plan" for those with mental illness. Families are helpless to assist their loved ones because of current laws in most states. Please do some research if you do not believe this is the case. Thank you.

Karl S.
Karl S3 years ago

Anything actually good in this legislation will not be funded, thus giving the pukes the chance to say, "see we are in favor of health care" while not actually doing anything of worth.

Tanya W.
Tanya W3 years ago

My comment disappeared - gun control is needed yesterday...

Tanya W.
Tanya W3 years ago

As is the old format for Care2 - I agree... A submit button, desktop version instead of this new mobile crap, NOT having to have a bloody contract muster to find click to donate and being able to access causes/ petitions without going into a old message from friends to take you to the causes page!!! This new system does not work!!!! Care2 is hard enough on a good day without this crap!!! Not happy Jan!!!

Tanya W.
Tanya W3 years ago


Debbi -.
Debbi -3 years ago

Ryan is another snake oil salesman. I agree with Marianne C.