Fervent gun-controllers and cynical political observers sometimes deride efforts to reform America’s mental-health system as a distracting, even unhelpful, answer to the problem of mass shootings. This is unfair, as no small number of young men who commit unspeakable acts of violence do indeed have diagnosable serious mental illnesses. But it is also ignorant, because fixing our mental-health system is also a response to everyday mass suffering — to the burden that serious mental illness presents for the 7 million or so Americans, many of them on the streets or in prison, who have serious illnesses, and the families and communities that want to help them.
Thankfully, Congress seems to be coming around. There is not just one bill currently floating around that would improve the mental-health system, but several, all of which would move public dollars toward treating serious mental illness (schizophrenia, bipolar disorder, etc.) and away from trying to diagnose and treat mental-health problems across the whole population.
The best bill is the one that Republican representative Tim Murphy, a psychologist from Pennsylvania, has been pushing for a couple of years now. Murphy’s bill, which has substantial bipartisan support, attacks some of the most perverse aspects of our laws regarding mental illness. It will finally change the Health Insurance Portability and Accountability Act so that family members of people with serious mental illness can know what medications they have been prescribed, when they are scheduled to see their doctors, and other crucial information. Murphy’s bill will also use federal mental-health grants to encourage the use of assisted outpatient treatment, which, unlike most of the work the federal mental-health bureaucracy supports, has been proven to be effective. The bill will require the Centers for Medicare and Medicaid Services to reconsider whether Medicaid should be paying for long-term hospitalization for the mentally ill. More broadly, the bill would reform the federal mental-health bureaucracy, pushing it toward supporting the seriously mentally ill and reducing support for “patient advocates” efforts that actually hamper effective treatment.
A companion bill in the Senate, introduced by Senators Chris Murphy (D., Conn.) and Bill Cassidy (R., La.) includes many of the same reforms Tim Murphy’s bill does, though they are generally weakened. Another bill, by Senator Lamar Alexander (R., Tenn.) and Patty Murray (D., Wash.) is a much narrower effort, though still an improvement; Senator John Cornyn (R., Texas) also has a sound bill that would boost evidence-based treatment and improve the coverage of mental-health history in the national background-check system.
There is one powerful interest group in the way, the mental-health industry, which prefers treating mild problems across wide swaths of the population rather than focusing on the toughest cases, which directly affect many fewer Americans. Partly because of the industry’s efforts, mental-health policy has been well-funded but woefully ineffective for decades.
#related#Finally, the dam seems to be breaking — decades of leaving the seriously mentally ill in our prisons and on the streets, it seems, have finally pricked the conscience of Congress. This is an issue conservatives should enthusiastically take up: It is in large part a matter of spending right, not spending more, and while it may not look like mental illness should be the concern of the federal government, federal funding for this issue is here to stay, and the current policies are unhelpful or counterproductive.
Some states have done admirable work improving their mental-health laws; it’s time Washington did, too. We would rather the bill be even more sweeping, but for now, Energy and Commerce Committee chairman Fred Upton ought to bring Tim Murphy’s bill to a vote as soon as Congress returns from recess, and fight any attempts to weaken it.