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Should Involuntary Mental Health Treatment be Expanded to Increase Care and Lower Crime?

Pennsylvania Republican's bill aims to change Medicaid's 16-bed rule, increase tele-psychiatry for pediatricians.

by
Rodrigo Sermeño

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April 8, 2014 - 11:48 pm
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WASHINGTON – Rep. Tim Murphy (R-Pa.) has introduced an ambitious proposal to overhaul federal mental-health policies and eliminate the ineffective ways in which the federal government spends money to tackle mental illness.

The Helping Families in Mental Health Crisis Act, which has 60 bipartisan cosponsors, is a wide-ranging reform proposal that looks at everything from mental-health research to the shortage of mental health professionals.

The bill, which was unveiled in December, is the product of a year-long examination of the nation’s mental healthcare system by Murphy and the House Energy and Commerce subcommittee on Oversight and Investigation.

The subcommittee found that the federal agencies in charge of mental health programs often fail to use the best available medical treatment and practices, rarely coordinate their actions, and barely engage in data collection to track treatment outcomes.

Murphy had promised the parents of Sandy Hook Elementary that he would introduce the bill before the anniversary of the shooting in which Adam Lanza, who suffered from mental illness, killed 20 elementary school students and six adults before killing himself in December 2012.

Speaking at the American Enterprise Institute recently, Murphy explained that while not all mentally ill individuals are violent, it is an issue of serious concern due to the number of recent tragedies that have been committed by someone with an untreated mental illness.

“Our nation has been rocked by several of these tragedies, and although those with mental illness are not of the vast majority likely to be violent, it is an area of great concern that some of these tragedies have been committed by someone who suffered from severe untreated mental illness,” Murphy said.

Murphy, a psychologist, said that individuals diagnosed with a severe and persistent mental illness are more likely to end up in jail or on the streets because they are not getting the necessary treatment.

“There are about 60 million Americans that have some degree of mental illness — from the mild, transient, acute, mental illness to severe mental illness,” he said.

More than 9 million Americans suffer from severe mental illness, and over 3 million are without treatment. Between 20 and 50 percent of all U.S. inmates have a mental illness.

The federal government spends about $125 billion on mental health illnesses, most of which goes to payment for disability and Medicaid, and very little goes to programs focused on treating the most serious illnesses – schizophrenia, bipolar disorder or severe depression.

During the 1950s and 1960s, there was a powerful movement to deinstitutionalize psychiatric patients. This was primarily a product of the overcrowding and deterioration of hospitals, and the advent of new medications that would allow people suffering from mental illness to lead relatively normal lives.

In the 1950s, there were over 500,000 inpatient psychiatric beds in the U.S., which translated to 340 beds per 100,000 Americans. Today, there are fewer than 40,000, or 17 beds per 100,000 individuals. A 2010 survey by the Treatment Advocacy Center and the National Sheriffs’ Association estimated there were three times more individuals with serious mental illness in jails than in hospitals.

“It’s not that crime is so vast and expanding in our nation. It’s that we have traded the hospital bed for the prison cell,” Murphy said. “We have also traded the hospital bed for a mattress in a flophouse and homeless shelter, or blanket over some subway grate in our cities.”

“It’s inhumane and immoral,” he added.

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All Comments   (14)
All Comments   (14)
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If the authorities want to find a place to stick you for mental health evaluation or issues badly enough, they'll find a way.

There has been a lot of bleating about the Creigh Deeds in Virginia because the system could not find a bed for his son, as the story mentions. But the Virginia state system was perfectly able to find a bed for Brandon Raub—granted, in a federal facility at the feds' behest—after Raub said some unseemly things on social media. No one looking at the Raub case now seems to think he posed any real threat to anyone. But the authorities kept him for six days until a judge ordered his release. Originally Raub was to have been held for 30 days.

By the same token, the cops, feds, and other government types will make excuses all day long about why they can't act in certain cases to stop bad actions—but will then do something when the wrong person is affected by the behavior, or when an authority figure gets torqued off. This doesn't apply only to mental health–related behaviors. Fred Phelps and the Westboro Baptist "Church" were long allowed to run amok protesting at soldiers' funerals, even as cops ran roughshod over other types of protests at other events.

Enforcement and action are selective, for mental health issues as for anything else. Do you expect anything different from government?
27 weeks ago
27 weeks ago Link To Comment
[rant on]
If I recall correctly, the psychiatric professionals are real good at explaining why someone did something -- after the fact -- than in predicting what that person will do in the future. Let's take a hypothetical example: Joe Doaks and Jim Doaks, identical twins with identical life experiences both own guns. Joe goes on a killing spree; Jim doesn't. How would this have been predicted? Answer: it can't be.

Now, who is proposing to expand the reach of "mental health" services? I'd never have guessed: a psychiatrist! Think there might be "gold in them thar ills," doc?

Last part of rant: who's to determine who gets the "preventive" care? The feddle gummint? The "caring, nurturing, therapeutic" community? Why should I believe a word either says, or trust either farther than I can see 'em?
[rant off]

Ben Hartley
(I write it, I sighn it)
27 weeks ago
27 weeks ago Link To Comment
Stop. Stop. Stop.
The Constitution does not give the federal government authority or responsibility for mental health care, nor for the standards of judging the requirement for forced mental health care. In cases involving federal crime or military members, there may be an appropriate role. But there is no broad role for the federal government in this area.
Compulsory mental health care is a dilemma-strewn landscape. It's very hard to predict who will do dangerous things or who will allow themselves to fall into squalor and want. I sure as the dickens want this worked out at the lowest level of government possible and with strict care -- if it happens at government level at all, and perhaps it does have to.
27 weeks ago
27 weeks ago Link To Comment
I actually think we could do better with Scientology.

Scientology's auditing works. It should work when you think about it. they stole it from WW2 medical practice of group therapy. The rest of scientology is just made up mumbo jumbo created by a scrounging sci-fi writer. It would much cheaper than all these beds that they want.

I would rather decriminalize marijuana and have treatment programs and go from there instead of saying 50% of people in prison need to be in a hospital. Do that & see where we are after a while for a course correction.

Beside 50% of the time pills do not work or do harm. See the latest issue of Discover Magazine April Issue on the 2nd coming of Freud.

28 weeks ago
28 weeks ago Link To Comment
All this sounds like a great idea until you realize that liberals will declare that wanting to own a gun, or opposing government control of everything, are signs of mental illness.

The Soviet Union was expert at declaring its enemies to be insane, and we're already too much like the old USSR.

Mental-health reform may be a good idea, but putting it in the hands of the Feds is really crazy.
28 weeks ago
28 weeks ago Link To Comment
Yes. How many of the recent attacks could have been due to parental refusal to admit the mental illness. As a teacher, I have seen many exanples od this.
28 weeks ago
28 weeks ago Link To Comment
From what I've seen, Nancy Lanza and her former husband knew Adam had problems, but the doctors didn't know what to do with him. However, once he turned 18, she had very little power to intervene. Peter Lanza just disappeared from his life. (I still cannot for the life of me understand why she allowed him access to guns.)

I wonder if mental illness played a role in today's mass stabbing in Murrysville.
28 weeks ago
28 weeks ago Link To Comment
Gun control would not have stopped the attack near Pittsburg. The focus should be on mental illness and community interactions.

Psychiatrists will say that sometimes the people in treatment should not be there so much as people that they interacted with.
28 weeks ago
28 weeks ago Link To Comment
I never said gun control would've stopped that sophomore from hacking at people. It would have worked in Lanza's case if his MOTHER had controlled her guns.
28 weeks ago
28 weeks ago Link To Comment
I did not accuse you of writing or thinking that. I have read too much of your writing to make such a mistake. I will apologize for not making my point clearly. The fault is mine.

I was was pointing out a fact. I am sure that many on the Left are heart broken that he did not use a gun so they could have gone on the warpath.
28 weeks ago
28 weeks ago Link To Comment
"tele psychiatry" - another "money pit"
28 weeks ago
28 weeks ago Link To Comment
Why are there "federal agencies in charge of mental health programs"?
Who could possibly believe this is not a very, very dangerous idea? And unconstitutional. (Lord, those Founders were smart.)
28 weeks ago
28 weeks ago Link To Comment
Perhaps that's because the federal government pays for the programs.

I wish Murphy a lot of luck in this because mistreatment of the mentally ill is one of this nation's most hiideous aspects.

However, notice how the homeless disaappear when Democrats are in control? But, let the GOP have power, and the media find them everywhere. Too bad the media are ignorant of the root of the problem: de-institutionalization by short-sighted civil libertarians and Progressives.
28 weeks ago
28 weeks ago Link To Comment
"Perhaps that's because the federal government pays for the programs." You're correct, but the federal government isn't supposed to be doing that either, except in limited cases like federal employees (through insurance), military members, and federal prisoners.
Mistreatment of the mentally ill is an abiding heartache in every society I know about. Mental illnesses are poorly understood and their treatments are wildly variable because no plans are consistently successful.
27 weeks ago
27 weeks ago Link To Comment
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