Representative Tim Murphy (R., Pa.), a psychologist and chairman of a House subcommittee responsible for health issues, has done an admirable thing: He has introduced a bill to fix the federal government’s mental-health bureaucracy by refocusing it on serious mental illness, deemphasizing amorphous “mental health” issues, and supporting treatment that’s been proven to work.
His legislation has 89 co-sponsors, including 32 Democrats, but now it appears that many elements of the bill — the best parts of it, in fact — are going nowhere.
House Energy and Commerce Committee chairman Fred Upton has reportedly said that he won’t be advancing the full bill and will instead focus on passing provisions that increase funding for research and training. But the fundamental problem with the federal government’s mental-health efforts isn’t that they’re underfunded, it’s that they’re unfocused and misdirected. Upton still has an opportunity to take up Murphy’s bill and start fixing this.
Tens of millions of Americans have diagnosable mental-health issues; a significantly smaller number have serious mental illness. It’s the sufferers in the latter category who commit suicide at appallingly high rates, fill our prisons, and pose a threat to themselves and their families. Federal efforts to help them in recent decades have been ineffective and underfunded.
The provisions that Upton is leaning toward advancing ignore this problem. (The same is true of the House Democratic leadership’s bill on this issue.) In fact, they could even worsen it, by pouring more money into the current priorities of the mental-health industry — which is why that interest group favors Upton’s version.
The industry opposes Murphy’s bill because many of its members will lose out on funding. Upton shouldn’t be caving to their complaints: Most of their methods are unsupported by research and most of their work has been a failure. Murphy’s subcommittee did painstaking work to document these failures, and his bill has the support of the people who bear their cost — public-safety professionals such as sheriffs, judges, and correctional officers, as well as, most important, the families of the seriously mentally ill.
The legislation would make it easier to ensure that the mentally ill get the help they need, by reforming federal privacy laws and encouraging the kinds of comprehensive outpatient and inpatient treatment that work. It would allow Medicaid to cover long-term hospitalization of the mentally ill. It would force the federal mental-health bureaucracy, called SAMHSA, to focus on the seriously mentally ill (as it was originally designed to do). These proposals are vociferously opposed by the mental-health activists who populate SAMHSA, some of whom don’t even believe in serious mental illness at all.
So Representative Upton hasn’t supported any of these provisions, and says he wants to pass the uncontroversial parts of Murphy’s bill. But the important parts of the bill are controversial only because they would force an ineffective federal bureaucracy to do its job. If that’s too controversial for House Republican leaders, we’ve got a problem.