Capitol Hill and Mental Health Crisis Act


I made my way to the Rayburn House Building on Capitol Hill yesterday to attend the markup session for Helping Families in Mental Health Crisis Act (H.R. 2646) sponsored by representatives Tim Murphy (R-Pa) and Eddie Bernice Johnson (D-Tex). It made for a very interesting and long morning.

As a lifelong Democrat, it was hard to see “my” party miss the boat on so many of the issues.  The bill redoes the Substance Abuse and Mental Health Services Administration (SAMHSA) in a big way with focus on psychiatry and serious mental illness; takes a more informed view of the federal Health Insurance Portability and Accountability Act (HIPPA) regarding our patients, and supports Assisted Outpatient Treatment (AOT), which exists already in all but 4 states.  None of this was popular with Democrats, and the Democrat leader, Rep Pallone (D-NJ) repeatedly indicated that the President would never sign such legislation.  With the exception of Rep Kennedy’s (D-Mass) good amendment regarding Community Outreach Treatment Team (COTT), which added to AOT, the Democrats overall came across whiny and partisan, despite their clear compassion for the mentally ill.

I first learned about Rep Murphy’s bill during the course of making the documentary “The Realities of Serious Mental Illness” ( ). The intent of the film was to provide the arc of serious mental illness to educate and inform. Never far from my mind was the epidemic of violence related to serious mental illness, which became through the media, a primary interface between the public and the seriously mentally ill.

Having returned to the clinical care of patients in recent years after National Institute of Mental Health (NIMH) Intramural Research and biotech company work, I have been taken back by how bad things have become for seriously ill patients in terms of resources, understanding of illness and treatment. Gun control is one strategy to decrease violence. Recognition and treatment (compassionately enforced if necessary) of seriously ill patients are complementary others.

The response to our film has been interesting. There have been many viewers who appreciate the “learning experience” and families and others who thank us for presenting the realities of the illness. On the other side, the film was not uplifting enough for the National Alliance on Mental Illness (NAMI), the organization whose support meant so much to me during my entry into schizophrenia research. The National Institute of Mental Health (NIMH) found it too political because it highlighted Rep Murphy’s Bill.

I had mixed feelings when I listened to the Democrats in the House markup session, similar to those I had about some of the responses to our film. As long as I have been in psychiatry, I have encountered the inclination to avoid the reality of the seriously mentally ill patient; focus on de-stigmatization at the expense of treatment; hostility to medication and ambivalence to psychiatry. I think I was hearing it again in markup, but maybe that was just a flashback. As Helping Families in Mental Health Crisis Act (H.R. 2646) progresses to law, as it will, I smile to myself that things do change.