SAMHSA FAILS SERIOUSLY MENTALLY ILL

A bill in Congress (HR3717, the Helping Families in Mental Health Crisis Act) would change SAMHSA and some wonder why change is needed. SAMHSA (Substance Abuse and Mental Health Services Administration) was created by Congress to “reduce the impact of…mental illness on America’s communities” and “target … mental health services to the people most in need”. SAMHSA has failed to do either. SAMHSA refuses to require its funds reach the most seriously ill and enacts policies to see they don't.

SAMHSA largely ignores the most significant impacts of mental illness on the communities, specifically violence, incarceration, hospitalization, homlessness and suicide. Instead, SAMHSA focuses on improving metrics like 'feeling of empowerment' 'hopefullness' and other softer outcomes.

Wellness Recovery Action Plan (WRAP) Lacks Independent Verification and is not Evidence Based

WRAP labeled as 'evidence based' by SAMHSA. 

But is it?

When we ask “is a program evidence-based’, at Mental Illness Policy Org we break that question down into three components:

1.  Does it help people with serious mental illness (ex. schizophrenia, bipolar, major depressive disorders) or is it a program designed to improve the mental health of anyone who feels their mental health can be improved. 
2. Does the program improve a meaningful outcome? To be evidence based, we require it to improve a meaningful independent measure such as reducing suicide, homelessness, hospitalization, violence, substance abuse, arrest, incarceration, etc. Self reports of greatier happiness (“improved mental health”) are not sufficient or unique to WRAP
3. What is the quality and independence of the research.

WRAP (Wellness Recovery Action Plan) has been certified by SAMHSA National Registry of Evidence Based Practices and Programs (NREPP) as an evidence-based intervention. This certification encourages states to implement it. But the evidence is not clear that WRAP improves any meaningful measure like decreasing hospital days, decreasing incarceration, decreasing homelessness or that it is for people with serious mental illness. The certification of unproven programs leads states to waste money.

Rep. Tim Murphy Announces Important Mental Health Legislation

This is big news.

Rep Tim Murphy (R. PA) is a former child psychologist, and head of the Mental "Health" Caucus. In spite of that,  he totally gets serious mental "illness" in adults and what the important versus tangential issues are.  He is as good as a Wellstone or a Domenici, and better than a Kennedy (who tended to focus on mental 'health' versus mental 'illness')

Rep. Tim Murphy has held extensive hearings where he listened to others focused on the most seriously ill including Dr. E. Fuller Torrey, Sally Satel, Joe Bruce , Ed Kelly. He also received extensive input from consumers around the country who contacted him. He  announced the results of his hearings today and the legislation he intends proposing.  It includes preserving hospitals, AOT (a/k/a Kendra's Law), revising HIPPA Handcuffs ( so families can get the info they need to help mentally ill loved ones), reigning in SAMHSA's anti-treatment activities , increasing police training, increasing NIMH budget for serious mental illness, and other key issues. I am very excited. 

 I am no Washington Insider, so I have no knowledge if it will fly or not. But at least someone is focused on right issues, not just PC tangential ones. Please support these efforts. He is totally on the right track. His press release and link to the floor speech follows: (Read more)

Representative Tim Murphy Calls out SAMHSA For Failure to Help Seriously Mentally Ill

Opening Statement of the Honorable Tim Murphy Subcommittee on Oversight and Investigations Hearing on “Examining SAMHSA’s Role in Delivering Services to the Severely Mentally Ill”

May 22, 2013
(As Prepared for Delivery)

Since I became the Chairman of the Subcommittee on Oversight and Investigations, shortly after the December 14, 2012, elementary school shootings in Newtown, we began looking into the federal programs and resources devoted to mental health and mental illness. We did so to ensure federal dollars devoted to mental health are reaching those individuals with serious mental illness and helping them obtain the most effective care.

One lesson we must immediately draw from the Newtown tragedy is that we need to make it our priority to get those with serious mental illnesses, who are not presently being treated, into sound, evidence- based treatments.

In 2009, the Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that about 11 million U.S. adults had serious mental illness, and 40 percent of these individuals did not receive treatment. While the vast majority of individuals with a mental health condition are nonviolent, Director of the National Institute for Mental Health, Dr. Thomas Insel, told this subcommittee at our March 5 public forum that effective treatments, which include medication adherence and evidence-based psychosocial therapy, can reduce the risk of violent behavior fifteen-fold in persons with serious mental illness.

Getting these individuals into treatment is a crucial first task and SAMHSA, as the federal agency whose mission includes reducing the impact of mental illness on America’s communities, should be playing a central role in this effort. But based on our work to date, SAMHSA has not made the treatment of the seriously mentally ill a priority. In fact, I’m afraid serious mental illness such as schizophrenia and bipolar disorder may not be a concern at all to SAMHSA.

Testimony: SAMHSA FAILS TO HELP SERIOUSLY MENTALLY ILL

Mental Illness Policy Org has written on problems at the Substance Abuse and Mental Health Services Agency (SAMHSA).  The Energy and Commerce Subcommittee on Oversight and Investigations held hearings 5/23/13 at which Dr. Fuller Torrey and Sally Satel testified. Their testimony is below.  Joe Bruce's testimony is in a separate blog. Torrey and Satel highlighted how SAMHSA fails to serve the most seriously mentally ill; how many of their programs actually harm people with serious mental illness and suggested SAMHSA make greater use of Assisted Outpatient Treatment. Joe Bruce described how SAMHSA funded lawyers 'freed' his son from a psychiatric hospital after which he killed his mother with a hatchet.

Joe Bruce Testimony to Congress: My Mentally Ill Son Killed my Wife:

Late one afternoon in June 2006, Joe Bruce of Caratunk, Maine, came home from work to find his wife dead. He called 911 and told the dispatcher that his 24-year-old schizophrenic son, William, had killed her, that he couldn't find the son, and that he was arming himself for self-defense. Below are excerpts from the transcript of that call made available to The Wall Street Journal.  Following that is Joe's 5/23/13 testimony to the House Energy and Commerce Committee subcommittee on Oversight and Investigations. They were holding hearings and Joe testified that SAMHSA funded the lawyers who 'freed' his son from the hospital, resulting in the killing of his wife.

'My Son Has Killed My Wife'

Caratunk, Maine, June 20, 2006, at 4:49 p.m.

Dispatcher: 911. What is the address of the emergency?

Mr. Bruce: My name is […] I live at […] in Caratunk. Um, my son has killed my wife, he is schizo -- completely out of his mind.

Dispatcher: Where is your wife now?

Mr. Bruce: She is in the bathtub, she is dead. I just came home from work, her car is gone. […] I don't believe anyone

has been here, there is no sign the neighbors are aware of anything going on. His name […]. He is 24 years old.

* * *

Dispatcher: How old is she?

Mr. Bruce: She's 48 years old. Please, please don't put this out over the scanner. Just send someone up somehow. Would you please just do me that favor?

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

SAMHSA Ignores 500,000 Seriously Mentally Ill

The Substance Abuse and Mental Health Agency's most recent and widely-quoted report on the prevalence of 'any' mental illness and 'serious' mental illness in America failed to count the 300,000 individuals with serious mental illness in jails and prisons, the 200,00 who are homeless and the 51,000 mentally ill who are in hospitals. Excluding these individuals led SAMHSA to understate the incidence of serious mental illness and overstate the percentage who receive treatment.

The new report acknowledges in the introduction and methodology sections that they ignored the incarcerated, institutionalized and homeless, but did not do so in their press release which is what most media apparently worked off of. Excluding these populations led to understating the number with serious mental illness, and since the chances of homeless or incarcerated receiving good treatment is next to nil, also understating the percentage who receive treatment.

SAMHSA has come under increasing criticism for their failure to focus on serious mental illness. A recent article by leading researcher Dr. E. Fuller Torrey in National Review, is but the latest example. I have written on SAMHSA waste of taxpayer dollars for DC Insider, a whistleblower group and Washington Times. Those articles highlight the mission-creep, waste, and counterproductivities at SAMHSA and suggest eliminating it would save money for taxpayers and improve care for people with serious mental illness. Worthwhile programs within SAMHSA (and they do exist) could be transferred to the Center for Disease Control (CDC), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA) and other organizations that are much more effective, efficient, and focused than SAMHSA.