How Should We Help the Seriously Mentally Ill?
Two mental-health bills. Two different parties.



This week, President Barack Obama and Representative Tim Murphy (R., Pa.) used the anniversary of the shootings at Sandy Hook to unveil two very different views of how to serve the mental-health needs of Americans. President Obama announced $100 million in incremental spending in the usual way: more mental-health facilities and programs. The mental-health industry cheered.

Representative Murphy, a psychologist who knows what he’s talking about, announced something different and more exciting. He used the Energy and Commerce Subcommittee on Oversight and Investigations to find out where spending money would do the most good. The result is a bill that would restructure certain parts of the federal mental-health system so it focuses on serious mental illness rather than mental “health.”

He came to that conclusion because, unlike President Obama, he listened to people from outside the mental-health industry, like Joe Bruce. Mr. Bruce tried to get hospital care for his mentally ill son, William, but the federal government gave William a lawyer who “freed” him from care. Shortly thereafter, while psychotic, William killed his mother, Joe’s wife. That program continues to receive federal funding. Representative Murphy listened to leading mental-health-industry critics such as Dr. Sally Satel and Dr. E. Fuller Torrey.

In 2014 U.S. spending, public and private, on mental health will total $203 billion. Because of mission creep and lack of coordination among agencies, the funds are now spent by the unregulated mental-health industry on “improving the mental health” of all Americans rather than focusing on the 5 to 8 percent with serious mental illness. Throwing money at mental health, as Obama proposes, will not result in more funds’ being spent to treat those with serious mental illness, because the mental-health industry disguises worthy social-service programs, like helping people get better grades, find better jobs, and feel more empowered, as mental-health programs to gain access to the mental-health budget. Rather than concentrating on delivering treatment to those with serious mental illnesses, such as schizophrenia and bipolar disorder, they deliver improved happiness to the 25 to 40 percent they claim have “mental health” issues.

The industry now routinely, regularly, unabashedly classifies ordinary life experiences like being unhappy, having an unsatisfactory marriage, experiencing the death of a loved one, or this year’s favorite, bullying, as major unmet mental-health challenges that the federal government should fund. Meanwhile those who have serious brain disorders are left to sleep on street grates and forage in trash bins for food. Some 200,000 are homeless, 300,000 are incarcerated, and many are living hellish lives locked inside hallucinations, delusions, and paranoia, contemplating how to take their own lives.

President Obama would never let the banks write his tax policy, but he has no problem letting the mental-health industry write his mental-health policy. Rather than funding mission creep, Representative Murphy focuses on mission control. When President Obama took office, he said he would listen to good ideas wherever they came from. Representative Murphy has good ideas. The two of them should talk.

Following are some of the proposals Representative Murphy has included in his Helping Families in Mental Health Crisis Act.

Restructuring government agencies

Create within the Department of Health and Human Services an assistant secretary for mental health and substance-abuse disorders. This official’s job would be to coordinate services and reduce duplication and mission creep across the innumerable government agencies that have an interest in the issue. The assistant secretary will ensure that resources go to the most effective treatments, programs, and research — specifically, those that improve outcomes for people with serious mental illness. The administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA) will report to the new assistant secretary.

Increase the role of criminal-justice personnel in developing mental-health policy. Representative Murphy proposed creating an advisory board to the new assistant secretary. Admittedly, a new federal advisory board is rarely something to cheer, and when such boards are populated by the mental-health industry, the “solutions” focus on improving mental health, not treating serious mental illness. This “eyes-off-the-prize” strategy has led to three times as many Americans’ being incarcerated with mental illness as hospitalized. As a result, police, sheriffs, district attorneys, and corrections officials, rather than mental-health officials, have become the strongest advocates for improved treatment for the seriously mentally ill.