New Democrat Mental Health Bill Needs to do more for Seriously Mentally Ill

Quick Rough Instant Analysis of Comprehensive Behavioral Health Reform and Recovery Act of 2016’ an alternative to HR 2646.

MentalIllness Policy Org. will be studying the bill in detail over the next day or two. In the interim, here is our instant analysis.

Statement by DJ Jaffe, Executive Director of Mental Illness Policy Org. We thank the Democrats for introducing this bill, but note that it largely ignores reforms that could help the most seriously mentally ill. It is the seriously mentally ill, not the worried-well who cause added expense and are responsible for tragedies. Congress must focus on the elephant in the room: getting treatment to the most seriously mentally ill and this bill does not.

Summary.  This bill does a better job at ‘poor mental health’ than delivering treatment to people known to have the most serious mental illnesses. It maintains most of the failures of the existing system and layers more programs on top. Some are good programs, others not.  It fails to include the most important provisions of Helping Families in Mental Health Crisis Act (HR 2646) that help people with the most serious mental illness:

• Assisted Outpatient Treatment (AOT): HR2646 bill provided $15 million for Assisted Outpatient Treatment which has been extensively independently researched and proven to reduce homelessness, arrest, incarceration in the seriously mentally ill, in 70% range[1]. This bill instead allocates $20 million to Mental Health First Aid (MHFA) which has been researched and not shown to help the mentally ill.[2] It is candy for the mental health industry.
• SAMHSA: The failure of SAMHSA to focus on serious mental illness, it’s waste, have been well-documented by Mental Illness Policy Org and the E&C, O&I Committee. HR2646 largely disbands SAMHSA. This bill calls for yet another “study”. In the interim, it empowers SAMHSA even more. While HR2646 would require the head to be an MD, this bill creates a new bureaucracy within SAMHSA “Office of Chief Medical Officer”. It seems to make SAMHSA Administrator an Asst. Sec of Mental Health.
• Hospital Care: Like, HR 2646, the bill codifies that managed care plans can pay for 15 days of hospital care for individuals in capitated payment plans. But it largely maintains the discriminatory provisions in Medicaid (IMD Exclusion), that prevent people in ‘fee for service plans’ (50% of those on Medicaid) with serious mental illness from getting hospital care when needed.[3]
• Protection and Advocacy. The bill does not reform the Protection and Advocacy Program which funds federally funded lawyers in states who work to prevent care for the most seriously ill.[4]
• HIPAA: The bill leaves HIPAA as is, but sets up procedure to create new regulations. Since the regs must work within existing legislation, they are not likely to have an effect. Families who provide care out of love to mentally ill will continue to be prevented from receiving the same info paid providers receive.

Congress can not be claiming to do mental health reform when it  ignores the most seriously mentally ill. We urge Congress to stop shunning the most seriously mentally ill.  Here are our ideas.

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[1] http://mentalillnesspolicy.org/national-studies/aotworks.pdf

[2]  http://mentalillnesspolicy.org/samhsa/mental-health-first-aid-fails.html

[3] http://mentalillnesspolicy.org/media/bestmedia/imd-exclusion-washington-post.html

[4] http://mentalillnesspolicy.org/myths/mental-health-bar.pdf