Wednesday, April 2, 2014

One Week in Washington: Mental Health Care Debate Continues

By Bob Carolla, NAMI Director of Media Relations

In the course of week, mental health care has had a high profile in the nation’s capital, including legislative action.

Congress has passed two mental health measures, contained in broader legislation setting Medicare reimbursement fees for doctors. The House of Representatives passed the bill on Thursday, March 27, followed by the Senate on Monday, March 31. It now moves to the White House for the President’s signature.

One provision in the bill establishes an eight-state “pilot program” to modernize services provided by community mental health clinics. The other authorizes “demonstration program” of federal grants for outpatient treatment for individuals living with mental illness who are not participating in treatment and have experienced adverse consequences such as homelessness, repeated hospitalizations or incarceration.

As the Senate prepared to vote on the Medicare bill on March 31, Virginia State Senator Creigh Deeds, whose son died from suicide late last year, spoke separately at the National Press Club across town indicating that broad, sustained reform is needed in the mental health care system.

Deeds, who ran for Virginia governor in 2009, declared: “The issue is much bigger than any one person’s experience.” In the wake of his family’s tragedy, NAMI has thanked him for his courage in helping to raise national attention to the cause.

Deeds’ broad perspective echoed voices from a March 26 House hearing that initially focused on the national shortage of psychiatric hospital beds.

NAMI Executive Director Mary Giliberti observed in a press statement about then hearing that people living with mental illness are being hit by a “double whammy.” There are not enough hospital beds to meet existing needs, while other mental services also are being starved.  Those services include:

  • Mental health screening and early intervention.
  • Crisis response and stabilization programs.
  • Discharge planning.
  • Outpatient services.
  • Peer support.
  • Assertive community treatment (ACT).
  • Supportive housing.
  • Jail diversion.

On March 28, following the House hearing and House vote, the conservative American Enterprise Institute (AEI) convened a panel discussion on mental health care and what Congress can do. It included liberal perspective from U.S. Rep Patrick Kennedy (D-RI), who noted that mental illness is not a partisan issue. It can strike anyone at any time, including both Democrats and Republicans.

One witness at the March 26 House hearing was Hakeem Rahim, a mental health educator, who shared his personal story of recovery. Rahim first began speaking publicly about his experience through NAMI’s In Our Own Voice program. He is active with New York’s NAMI Queens/Nassau Affiliate.

Another House hearing focusing on the Helping Families in Mental Health Crisis Act is scheduled for April 3. Like the previous events, it will be both streamed live and posted online.


Anonymous said...

Do we know what 8 states will be the pilot states?

Syster Haa said...

How 'bout stronger Guidance to get 2nd & 3rd opinions?

Anonymous said...

Why do you always talk about mental health recovery? There is no fucking recovery for those of us with a little too much money to qualify for the paltry public benefits that are provided and not nearly enough money to pay for services on our own. For us, there is not even survival.

Anonymous said...

Thank you for posting this! From Mother with a daughter that has a serious mental illness since she was 19 years old, & is now 34 years old.

Martina Nicholson said...

Please help us know who to write to for advocacy, and when something critical comes up for review!

Anonymous said...

Does NAMI have a position on assisted outpatient treatment?

Linda Ford said...

Thank God for people who understand this issue. And I appreciate NAMI so much for their work.

Mary Seguin said...

Have to say Anonymous has it spot on. There is no recovery for those who have just a little too much to qualify for any of these programs. The rest of the family is at a very high risk of suffering from mental illness.

Anonymous said...

Recovery may be too much to hope for, but better functioning, maintaining a healthier body in less crisis is also worth trying for-- and that is where assisted living, supportive housing, and adjunctive health programs come in...
We need to realize that we want everyone to be at their personal best, not neglected, or in jail because there IS No mental health care!

Anonymous said...

I want to see NAMI completely support HR 3717, in its entirety, and push a grassroots campaign to get all NAMI members calling their representatives about it. This is the Helping Families in Mental Health Crisis Act which you barely even mention in this blog post.

You are failing us by not leading the charge for this legislation which could do so much to improve the system and get people treatment. Education and support groups are great, fighting stigma is great, walks are great, but they won't provide treatment, hospital beds, housing, or jobs. It's time to put 100% of our energy into reforming the system so that all can get treatment -- both those who can self-direct their care, and those that don't have the capacity to do so. When are you going to do something about the system? When are you going to utilize families to help press legislation to reform the system?

HR 3717 will do give more access to AOT which will only be used in extreme circumstances -- like where someone is gravely ill and one step away from going to jail, or has been hospitalized many times and isn't able to self direct their care on an outpatient basis. It will fix HIPPA problems which tie families' hands, and many other issues that we deal with everyday.

It's unconscionable to me how you are failing to take the lead to get this legislation passed. We need you to lead a grassroots campaign, along with other organizations like APA, law enforcement organizations, etc., to build a coalition of support. You need to send emails asking NAMI members need to call their reps to cosponsor this legislation. It would make a world of difference for so many of the seriously mentally ill.

Anonymous said...

Congress needs to do away with the Institution for Mental Disease (IMD) Exclusion. If you don't know what the IMD is, please research it on the web. You need to know.

When that is done (and when there are new complementary laws requiring that 100% of the reimbursement to the States for adult inpatient care be spent on new hospital and community behavioral health programs)we will see the change that is needed.

It would seem to be a viable plan since the Senators and Congressman in all 50 states would benefit. It is always a case of "Show me the money!" And it always will be.

Anonymous said...

Anonymous, based on your letter, I will ask my congressman to support HR 3717. Please give us more, and perhaps we can get a floor vote on helping it, through the California NAMI meeting in August. When is it coming up? Who is on the committee? Is there a "legislative watch group" to help spread advocacy? Is it time to send out soundbites on Facebook?? Please advise!

Bob Smith said...

The proposed bill in Washington makes it easier to force additional people into the mental health system without providing any additional funding. How do you care for more patients without more money? The answer is even shorter hospital stays in order to free up money for the additional drug prescriptions. It's a win for the drug companies not for American families. It's a trend that has been going on for decades as shown in this graph: