Obama's Mental Health Conference: Irrelevant at Best and Likely Harmful

President Obama and Vice President Biden are gathering the usual suspects for a mental health conference today focused on 'stigma'. While ostensibly in reaction to tragedies like Newtown, it ignores the elephant in the room:  people with serious mental illnesses.

Obama simply does not understand the difference between poor mental health and serious mental illness and the 'experts' he is relying on are happy to keep it that way. Everyone can have their mental health improved, but only 5-9% have serious mental illnesses. Obama keeps focusing on the former and ignoring the later.  Yet it is people with serious mental illness who are responsible for headline grabbing horrific acts of psychotic-feuled violence. It is people with serious mental illnesses, not low self-esteem who have increased incidence of homelessness, suicide, arrest, incarceration, and hospitalization.  It is people with serious mental illness who as a kind and compassionate society we should be helping.

After his last mental health conference in April, mental 'health' advocates convinced Obama to spend $140 million more to identify people with mental illness. As we wrote after that conference

Jared Loughner, who shot Gabrielle Giffords; James Holmes, who shot up a movie theater in Aurora, Colo.; John Hinckley Jr., who shot President Reagan; Aaron Bassler, who shot a former mayor of Fort Bragg, Calif.; Ted Kaczynski, the Unabomber, who mailed explosive packages around the country; Ian Stawicki, who shot five others and then himself in Seattle; Eduardo Sencion, who shot five National Guardsmen at a Nevada IHOP restaurant; Russell Weston, who shot two guards at the U.S. Capitol building; and Adam Lanza, who shot his mother, 26 others, and himself in Newtown, Conn. -- all were known to be ill before they became headlines. The problem wasn't lack of identification. It was lack of treatment.

If Obama wants to get serious about serious mental illness, he should invite criminal justice experts to the White House. The mental health system 'treats' the worried well and off loads the seriously ill to shelters, jails prisons and morgues.  There are now three times as many mentally ill incarcerated as hospitalized. Police, sheriffs, district attorneys, correction officers, parole officers, and forensic hospital workers  go where the mental health system won't: to the aide of people with serious mental illness. No sane mental illness policy can be contemplated without their perspective.

There are five steps President Obama can take to help people with serious mental illness, keep patients and public safer, and save money. They will not likely be discussed at today's conference because he has only included mental 'health', not mental illness experts in the dialogue.

1. Fund Assisted Outpatient Treatment (AOT) laws so rather than requiring people with serious mental illness to become "danger to self or others" , we can prevent people from becoming danger to self or others. 
2. Change HIPPA privacy laws so parents of seriously mentally ill individuals can get the information they need to help their loved ones get care.
3. End federally sanctioned Medicaid discrimination against the seriously mentally ill incorporated in the "IMD Exclusion". It allows the federal government to refuse to reimburse for inpatient hospital care for persons with serious mental illness. While Obama is correctly adamant that private insurers end discrimination against the mentally ill, he has been silent on federal discrimination. 
4. Send those with serious mental illness to the front of the line for services rather than the back as is current practice.
5. Eliminate SAMHSA (the Substance Abuse and Mental Health Administration) which is funding nationwide activities designed to prevent the most seriously ill from receiving treatment. Any useful programs can be transferred to NIMH, CDC, and other agencies with better focus.

When I campaigned for Obama he promised to "listen to good ideas no matter where they come from." So he should listen to Representative Tim Murphy (R-PA), a former psychologist. He has done a brilliant job in Energy and Commerce subcommittee hearings of looking at what real solutions might be to prevent the arrest, incarceration, violence, suicide, homelessness, and hospitalization of the most seriously ill. As a Democrat who volunteered for Obama, I don't like admitting the best expert is a Republican, but I care about people with serious mental illness more than political persuasion.

I believe Obama wants to help. But if the definition of insanity is trying the same thing over and over and expecting different results, then Obama qualifies. He should reach out to those who want to change the status quo, not those invested in maintaining it.  

Five Point Action Plan for President Obama to Reduce Violence by Mentally Ill

President Obama said the federal government has to do something meaningful to prevent future shootings like the twenty-six in Newtown, Connecticut.  Here is what the federal and state governments can do to prevent violence related to mental illness.

What Washington can do