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

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.