HELPING FAMILIES IN MENTAL HEALTH CRISIS ACT
This 2013 Helping Families in Mental Health Crisis Act (HR3717) was replaced by the 2015 Helping Families in Mental Health Crisis Act (HR2646) which can be found here.
(However background info on this page is still relevant)
COMPARISON OF BIPARTISAN HR3717 with HR4574
Testimony of Mental Illness Policy Org to Congressional Forum (5/29/14) (PDF Version with footnotes/attachments)
SENATE BILL
Background: HR 3717 Helping Families in Mental Health Crisis Act
6 MOST IMPORTANT PROVISONS of HR3717 MISSING FROM RON BARBER’S DRAFT MENTAL HEALTH BILL
HR 3713 (introduced by Rep. Tim Murphy on 12/12/13) is the first bill to (1) focus on serious mental ‘illness’ and (2) to address multiple systemic problems in federal mental health policy that favor the largest number of the highest functioning but leave the most seriously unserved.
Video Presentation by: Rep. Tim Muphy: Patrick Kennedy; Dr. Jeffrey Lieberman (President, APA); Dr. Fuller Torrey in support of Helping Families in Mental Health Crisis Act
Oral Testimony: Sylvia Thompson
Focus on treating the seriously mentally ill, not improving the mental health of all others.
HR 3717 reorients the $204 billion US Mental Health budget towards treating the 5-8% who are most seriously mentally ill and away from loosely defined, non-evidenced based programs designed to “improve the mental health” of all others.
HR 3717 attempts to end mission-creep by instilling mission control.
This is the best way to improve care, reduce violence, sucide, victimization, homelessness, hospitalization, incarceration and needless tragedies. It saves money by reducing the use of hospitals and jails to serve people who can live in less expensive community settings.
Put another way, the problem is not that we don’t spend enough, it is that we don’t spend it efficiently.
Why does HR3717, Helping Families in Mental Health Crisis Act Prioritize the Seriously Mentally Ill?
There are now two mental health systems in the United States. One is run by traditional mental health departments and serves the highest functioning. For ex. ending “bullying” is the new cause celebre of the traditional mental health system. The other mental health system is run by criminal justice and serves the most seriously ill. There are three times as many Americans incarcerated for mental illness as there are in psychiatric hospitals. The traditional mental health system largely ignores the most seriously ill causing their transfer to criminal justice. That is a ‘success’ for the mental health system: one less person they have to treat.
The US Mental Budget is largely spent to improve mental health (make people happier) not to provide treatment to the most seriously mentally ill. We send the worried-well to the front of the line for services and the seriously mentally ill to jails shelters, prisons and morgues. There has been intensive, massive, mission-creep as every life experience is medicalized. This intentional, disastrous and massive migration has caused our mental health system to be simultaneously expensive and disastrous and dangerous.
Sponsors
If your Representative isn’t on list call and ask them to co-sponsor HR 3717, Get your Congressional Representative’s phone number here.
Sponsor
Rep Tim Muprhy (PA)
ASK YOUR REPRESENTATIVE TO COSPONSOR HR 3717. Takes 30 seconds.
HR 3717 funds pilot Assisted Outpatient Treatment Programs.
HR 3717 provides pilot funds for states that want to set up AOT programs. AOT allows judges to order very narrowly defined individuals-only those who have a past histroy of arrest, violence, or needless hospitalization caused by failure to stay in treatment-to stay in mandatory and monitored treatment as a condition of living in the community. It is not an alternative to voluntary treatment, it is only used when that fails.Assisted Outpatient Treatment has dramatically reduced arrest, violence, sucide, hospitalization and homeless in every state that has used it. HR 3717 requires states to have AOT on books (although not to use it), in order to receive Community Mental Health Service Block Grant funds and allocates $15 million for pilot program funding of up to 50 AOTprograms per year. Following is more info on AOT.
AOT Reduces Violence
Meds Reduce Violence (WSJ)
Meds Reduce Violence (Study)
Learning from New York’s Kendra’s Law
Learning from California’s Laura’s Law
Learing from Florida’s Baker Act
Misleading AOT Fact Sheet from NYAPRS/NCMHR
Research on AOT
Patients support AOT
NY Kendra’s Law constitutional
AOT constitutional
NEW: AOT CUTS COSTS IN HALF
AOT Related Provisions in HR 3717
Preserve enough psychiatric hospital beds for patients with serious mental illness who need them.
There is a nationwide shortage of at least 95,000 beds for people with serious mental illness. This is largely due to an obscure provision of Medicaid law called the Institutions for Mental Disease (IMD) Exclusion. It basically tells states, “if you kick someone with mental illness out of your state hospital, we (the federal government, through Medicaid) will pay half the cost of any community care you provide. So the states lock the front door and kick people out the back to make them Medicaid eligible, no matter how inappropriate the discharge is. HR 3717 makes two narrowly tailored exceptions to the IMD Exclusion, to remove the federal incentive to provide substandard care.
95,000 psychiatric beds needed
Washington Post: IMD Exclusion
Video: US House of Representatives Hearings on Psychiatric Bed Shortage
Chief Biasotti written testimony:
Chief Biasotti video testimony
Sheriff Dart written Testimony
Sheriff Dart video Testimony
Judge Liefman Written Testimony
Judge Liefman Video Testimony
Lisa Ashley (mom) Testimony
Gunther Stern (homeless) Testimony
Dr. Jon Mark Herson Testimony
Dr. Jeffrey Geller Testimony
Rep Tim Murphy Testimony
Longer psychiatric hospital stays needed
IMD Analysis (short)
Police Chief Biasotti testimony:
Sheriff Tom Dart Testimony
Judge Liefman Testimony
Lisa Ashley (mom) Testimony
Gunther Stern (homeless) Testimony
ER doctor Testimony
Dr. Jeffrey Geller Testimony
Institutes for Mental Disease Exclusion (long)
IMD legal analysis-detailed
NAMI Policy: IMD Exclusion
NASMHPD Policy: IMD Exclusion
Removes HIPAA Handcuffs and Reforms FERPA so parents can get info they need to help provide care to seriously mentally ill loved ones.
HIPAA and FERPA are patient confidentiality laws that prevent the disclosure of medical information to parents of persons with mental illenss. Hence parents are unaware of diagnosis, treatment, appointments, and oher info they need to provide care to loved ones and prevent their needless deterioration. HR 3717 carves out an exemption in HIPAA and FERPA so caregivers can receive important information about a mentally ill loved ones diagnosis, treatment and prognosis if that information is needed by the mom or dad to protect the health, safety or welfare of their family member.
Provisions of HR3717 that eliminate HIPAA Hancuffs and FERPA provisions that inhibit care
HIPAA Handcuffs
Ensure mentally ill are not denied accessed to best medications and treatment.
Current Meidicaid and Medicare policies restrict doctors to prescribing only “one drug” per therapeutic class, even when others work better. Medicaid and Medicare also retrict patients from receiving reimbursed physical health and mental illness services during a single visit. HR 3717 gives physicians the right to prescribe the right medication for those on Medicare and Medicaid. It limits the ability of Medicaid programs to turn down payment when mental health services and primary care services are received within the same day.
Jail Diversion: Train Police and Establish Mental Health Courts
Because the mental health system has largely abandoned treating the most seriously ill, police and sheriffs get called in. Unfortunately, this is often after the person becomes a ‘danger to self or others’ which can be as dangerous for the patient as it is for police and public. HR 3717 includes two provisions to prevent this from leading to injury or incarceration.
HR 3717 funds Police “Crisis Intervention Training” (CIT) on how to deescalate incidents and divert individuals to treatment prior to arrest
Results from Implementing CIT for police
HR 3717 funds Mental Health Courts
Mental Health Courts provide mandated and monitored community based treatment in lieu of conviction and sentencing after someone comes into contact with police (AOT provides it before people come into contact with police.) HR. 3717 reauthorizes and funds the Mentally Ill Offencer and Crime Treatment Reduction Act.
Mental Health Courts reduce arrest and incarceration
Results from implementing Mental Health Courts
Council of State Governments Info on Mental Health Courts
Mental Heatlh Courts and Police Training have little penetration
Mental Health Court has positive reuslts in DC
Allocates resources to suicide prevention (Garett Lee Smith Suicide Prevention Act)
Creates a Deputy Secretary for Mental Health to focus spending on serious mental illness
The new Deputy Secretary will coordinate and control mental health spending across all agencies with the purpose of eliminating duplicative and ineffective programs. It will then steer those resources to programs that help the most seriously ill the most. Importantly, the advisory board to the Asst. Sec. will include police, district attorneys, corrections and others. This is key because many policies embraced by mental health advocates (ex. closing psychiatric hospitals) increase incarceration. HR 3717 ensures the secretary can consider that.
How Mental Health Industry Misleads Congress
How focus on mental health kills mentally ill (Essay)
Mental Health vs. Mental Ilness (op-ed in National Review)
Mental Health vs Mental Ilness (Wall St. Journal Editorial)
Mental Health vs. Mental Illness (Policy Paper)
Puts more criminal justice representatives on federal mental health policy boards
HR3717 establishes an Advisory Board for the newly created Deputy Secretary for mental health. While new advisory boards are rarely cause for cheer, this one is different. Acknowledging that there are more than three times as many seriously ill incarcerated as hospitialized, HR 3717 ensures police, sheriffs, judges, DAs, corrections officials are on the board since they have more experience with the seriously ill than mental health departments and industry. The policies promoted by mental health experts often turn the seriously ill into prisoners. The presence of criminal justice can help stymie this.
Police and Sheriffs overwhelmed by failure of mental health departments (National Survey of Law Enforcement)
Jaila and prisons overwhelmed by failure of mental health departments (compares mentally ill in jails vs. hospitals)
Criminal Justice Costs skyrocket because of failure of mental health departments and programs (Research)
The truth about violence and untreated serious mental illness (Research)
Ensure states have good civil commitment procedures.
The law in some states requires certain mentally ill to become ‘danger to self or others’ before they can be provided care. Laws should not require dangerous behavior, they should prevent it. HR3717 facilitiates that by requirong states that do not offer treatment to people in need of treatment to change their laws in order to access mental health block grants. federal funds.
Dangerousness vs. Gravely Disabled vs. Need for Treatment
Civil Commitment Standards by State
Reform SAMHSA/CMHS
Wall St Journal Editorial: Problems at SAMHSA
SAMHSA and CMHS distribute about $450 million in discretionary Mental Health Block Grants to states. SAMHSA and CMHS have encouraged states to spend the money on non-evidenced based programs and regularly distribute funds to organizations that don’t believe mental illness exists and/or oppose treatment for the most seriously ill. HR. 3717 eliminates non-performing programs, transfers some of the savings to NIMH for research, and gives the newly created Sec. of Mental Health the power to distribute Mental Health Block Grants and other funds.
SAMHSA funds groups that dont’ believe mental illness exists, and/or oppose treatment for serious mental illness.
Encourages states to divert blockgrants
Problems at SAMHSA (Entire Web Site)
SAMHSA Response
Reform Protection and Advocacy for Individuals with Mental Illness Programs.
PAIMII was enacted by Congress for the noble purpose of protecting the rights of individuals with “serious” mental illness living in institutions. Unfortunately, the program no longer focuses on ‘serious’ mental illness. Leaders have defined ‘rights’ to mean whatever they want, and now the program focuses almost exclusively on preventing the most seriously ill from receiving the treatments. HR 3717 attempts to reign in PAIMI and return it to its original mission of helping the most seriously ill.
How PAIMII caused death of Amy Bruce
Explantation of how HR3717 fixes PAIMI
Problems with PAIMII (Law Journal Article)
Mary Zdanowicz Testimony on PAIMI
Problems with PAIMI (SAMHSA Evaluation of)
Text of HR 3717 concerning PAIMI (Title E)
Strenthens NIMH
Transfers some of the savings from counterproductive programs at SAMHSA to do valuable research at NIMH
Requires AG or FBI to collect data on serious mental illness
Many of the policies embraced by mental health advocates (closing hospitals, making civil commitment difficult, opposing AOT, etc) increase the incarceration of people with serious mental illness. HR 3717 provides funds to document the effect on the criminal justice system of these counterproductive mental health system policies.
ASK YOUR REPRESENTATIVE TO COSPONSOR HR 3717. Takes 30 seconds.
Endorsements
American Academy of Child and Adolescent Psychiatry
American Psychiatric Assoc.
American Psychological Assoc.
American Academy of Forensic Sciences
American Academy of Emergency Medicine
National Assoc. for the Advancement of Psychoanalysis
Mental Health Assoc of Essex County
Mental Illness FACTS
Michigan State Legislature
Louisiana State Legislature
Mental Illness Policy Org
National Alliance on Mental Illness
NAMI Ohio
NAMI New York State
NAMI Los Angeles
NAMI San Francisco
National Council for Behavioral Health
National Assoc. of Psychiatric Health Systems
National Sheriffs’ Association
New York Assoc. of Chiefs of Police
Treatment Advocacy Center
Letter from mom to Rep. Murphy
Media Support
Editorial Endorsement
Washington Post (4/16/14) (PDF)
Wall St. Journal (3/4/14)
Washington Times
Wall Street Journal
National Review
Observer Reporter (PA)
Brandenton FL, Herald Tribune
Ocala FL Star Banner
Sarasota Herald Tribune
Observer-Reporter (PA)
Op-eds
Bloomberg News – Satel
National Review – Jaffe
Daily Journal (CA) – Chip Higgins
Union Trbune (CA) – Jaffe
Arizona Republic -Zoellner
Articles
Psychology Today
San Francisco Chronicle (A. Yanello)
WHY (Maiken Scott)
Huffington Post
National Review
Law Enforcement Today
Letters to Editors
New York Times
Lancaster Intellengencer
Baltimore Sun
Arizona Republic
Sacramento Bee
LA Times
Favorable Mentions
Blog of “I am Adam Lanza’s Mom”
President. Am. Psych. Assoc on PBS
Pete Ealey Blog
Links to key source documents HR 3717 Helping Families in Mental Health Crisis Act
Text of HR3717 (as introduced-PDF)
Most recent version of Text
Current Sponsors
Legislative Action
Sponsors’ Explanation
Mental Ilness Policy Org-Explanation
Key Oversight & Investigations Subcommitee documents
On 5/22/13 the Subcommittee on Oversight and Investigations of the House Energy and Commerce Committee heard about problems within SAMHSA. Following is some of the testimony presented.
Oversight Committee
US. Rep. Tim Murphy (video)
Transcript of Murphy Bill introduction
US Rep. Tim Murphy (opening statement: problems in SAMHSA)
Dr. Fuller Torrey (SAMHSA fails to focus on science or serious mental illness)
Dr. Sally Satel (SAMHSA Fails to Focus on Serious Mental Illness)
Joe Bruce (SAMHSA PAIMI Program led to wife’s death by own son)
Issues HR 3717 attempts to address that are largely ignored by mental ‘health’ advocates
2 million untreated mentally ill
5000 mentally ill suicide
1000 Homicides by mentally ill
175000 homeless mentally ill
Cost of homeless mentally ill
25% of homeless seriously ill
Criminalizing mentally ill
Increased criminal justice costs
Mentally ill victimized
Mental health systems overwhelmed
Poorer prognosis for mentally ill
Violence and mental illness
Mental Illness Tragedies in PA
Mental Illness Tragedies in MA
Mental Illness Tragedies in OH
Mental Illness Tragedies in NY
Mental illness Tragedies in MD
Mental Illness Tragedies in WV
National Plan to reduce violence by mentally ill
63% of mass shootings by mentally ill
Increased violence by mentally ill
5000 mentally ill suicide
Do Antipsychotics cause suicide
Myths, Opposition, and Impediments to Reform
Myths about AOT
Psychiatry vs. antipsychiatry
Myths about consumers
Myths about medicines
Myths about stigma
Stigma not important
Coercion is Patient Centered
Opposition: NYAPRS
Opposition: We the people
Mental Illness Awareness Week
Big pharma buys psychiatrists
P&A (PAMII/PAIMI) lawyers
National Law Journal
Scientology/CCHR
Misinformed advocates
ACLU
Not everyone recovers
Review: Mad in America
Mindfreedom, Scientology, CCHR
Family Tragedies HR 3717 may have prevented if enacted
Aaron Bassler (shot/was shot)
Jenna Ward (sibling)
Peter Earley (parent)
Pat Webdale (daughter murdered)
Morgan Claire (wife)
Karen and James Logan (son shot cops)
Michael Biasotti (police chief)
Brother deinstitutionalization
(AOT)
California Laura’s Law Home Page