Is America Finally Ready for Mental-Health Reform?

A year after Sandy Hook, Congress is showing signs of action.

Christmas decorations adorn a business near the former site of Sandy Hook Elementary on December 14, 2013 in Newtown, Conn.
National Journal
Clara Ritger
Add to Briefcase
Clara Ritger
Dec. 18, 2013, midnight

The New­town school shoot­ing ig­nited a furi­ous de­bate about gun own­er­ship and gun laws. But be­neath the shout­ing, there was a quieter, less con­ten­tious con­ver­sa­tion about over­haul­ing the way the United States treats those who are men­tally ill.

Now, a year later, it ap­pears that men­tal-health meas­ures — and not gun con­trol — could be the tragedy’s le­gis­lat­ive leg­acy.

A bi­par­tis­an pair of sen­at­ors have a mod­est, in­cre­ment­al plan to ex­pand ac­cess to men­tal-health ser­vices at com­munity cen­ters, and — des­pite Con­gress’s deep le­gis­lat­ive freeze — have found a plaus­ible path to get the meas­ure to the pres­id­ent’s desk.

The men­tal-health pro­vi­sion is at­tached to per­man­ent “doc fix” le­gis­la­tion, a meas­ure that would re­place the broken for­mula used to re­im­burse phys­i­cians for Medi­care ser­vices. That bill, boast­ing sup­port in both parties and both cham­bers, ap­pears on track to be­com­ing law.

And the men­tal-health pro­vi­sion seems likely to move for­ward with it. The pro­pos­al was ad­ded by a voice vote in the Sen­ate Fin­ance Com­mit­tee, and com­mit­tee mem­bers cri­ti­cized little of the pro­pos­al sponsored by Sens. Debbie Stabenow, D-Mich., and Roy Blunt, R-Mo., in­stead of­fer­ing praise for their work to ad­dress Amer­ica’s “broken” men­tal-health care sys­tem.

Sen. Richard Burr, R-N.C., ex­pressed dis­con­tent with the meas­ure’s $1.6 bil­lion price tag, but with it at­tached to the $116 bil­lion per­man­ent doc fix, the ex­tra off­set ap­pears minute. And many Re­pub­lic­ans, no­tori­ously strin­gent about the budget, are voicing sup­port for the bill cit­ing a ser­i­ous need for re­form.

“We must take a ser­i­ous look at our na­tion’s men­tal-health sys­tem to de­term­ine how we can bet­ter sup­port and care for in­di­vidu­als and fam­il­ies af­flic­ted by ser­i­ous men­tal ill­ness, and I am en­cour­aged that we are mak­ing pro­gress,” said Sen. Susan Collins, R-Maine, a sup­port­er of the bill, in an email.

“The ser­i­ous­ness of this need is un­der­scored by the fact that men­tal ill­ness has been a sa­li­ent factor in mass shoot­ings, such as the cases at the Navy Yard in Wash­ing­ton and in Con­necti­c­ut, Col­or­ado, and Ari­zona,” she ad­ded. “Un­for­tu­nately, our cur­rent sys­tem too of­ten fails pa­tients with ser­i­ous men­tal ill­ness who may lack ac­cess to the care that they need.”

The mo­mentum be­hind re­form is fueled by a year of tra­gedies linked to men­tal ill­ness. In the wake of the mas­sacre at Sandy Hook Ele­ment­ary, in­vest­ig­at­ors re­vealed that the shoot­er, Adam Lanza, struggled with As­per­ger’s, a form of aut­ism. Closer to Con­gress, there was an at­tack at the Navy Yard by a man who heard voices but did not seek treat­ment, and a fatal Cap­it­ol Hill car chase touched off by a moth­er who was dia­gnosed with post­partum de­pres­sion with psy­chos­is, ac­cord­ing to her fam­ily.

Stabenow knows firsthand the pain of liv­ing with someone with an un­treated men­tal ill­ness. Her fath­er struggled with bi­polar dis­order. He’d stay up all night to talk about his ideas and, dur­ing the day, gave away cars at his job as an Olds­mobile deal­er. The fam­ily even­tu­ally moved in­to a smal­ler, more af­ford­able home. Stabenow’s fath­er wasn’t vi­ol­ent, but, then, most people with men­tal ill­nesses aren’t. Of the roughly 17,000 hom­icides in the U.S. an­nu­ally, less than 5 per­cent in­volve men­tal ill­ness, ac­cord­ing to the Na­tion­al In­sti­tute of Men­tal Health. And people with severe men­tal ill­nesses are 11 times more likely to be vic­tims of vi­ol­ent crime than the gen­er­al pop­u­la­tion.

But for those liv­ing with ser­i­ous men­tal dis­orders who could harm them­selves and those around them, NIMH says, the risk of vi­ol­ence is 15 times high­er without treat­ment.

Data from the Na­tion­al Al­li­ance on Men­tal Ill­ness show that one in four adults in the U.S. suf­fers from a men­tal dis­order. One in 17 has a severe con­di­tion. Few­er than one-third with a dia­gnosed ill­ness re­ceive treat­ment.

Al­though the amend­ment to the doc fix is a scaled-down ver­sion of Stabenow’s ori­gin­al bill, if im­ple­men­ted in full it could ex­pand ac­cess to treat­ment for roughly 1.5 mil­lion people na­tion­wide.

“More and more people are see­ing that the fin­an­cial and hu­man costs of in­ac­tion are far too great,” Stabenow said. “Too many people are sent to emer­gency rooms or are in­car­cer­ated when what they really need is prop­er men­tal-health treat­ment. In­car­cer­at­ing people who need treat­ment alone costs the U.S. $15 bil­lion every year, and lost pro­ductiv­ity and oth­er im­pacts of un­treated men­tal ill­ness cost the coun­try a total of $100 bil­lion per year.”

One of Stabenow’s aides said they were con­fid­ent go­ing in­to the hear­ing be­cause of the bi­par­tis­an in­terest in the pro­pos­al. “At­tached to le­gis­la­tion that is guar­an­teed to get a vote cer­tainly in­creases its chance for suc­cess,” the aide ad­ded.

What We're Following See More »
ANOTHER GOP MODERATE TO HER SIDE
John Warner to Endorse Clinton
1 hours ago
THE LATEST

"Democratic presidential nominee Hillary Clinton will score another high-powered Republican endorsement on Wednesday, according to a campaign aide: retired senator John Warner of Virginia, a popular GOP maverick with renowned military credentials."

Source:
AUTHORITY OF EPA IN QUESTION
Appeals Court Hears Clean Power Plant Case
2 hours ago
THE LATEST

The U.S. Court of Appeals for the District of Columbia Circuit on Tuesday "heard several hours of oral arguments" over the Environmental Protection Agency's Clean Power Plan rules. The 10-judge panel "focused much of their questioning on whether the EPA had overstepped its legal authority by seeking to broadly compel this shift away from coal, a move the EPA calls the Best System of Emission Reduction, or BSER. The states and companies suing the EPA argue the agency doesn’t have the authority to regulate anything outside of a power plant itself."

Source:
$28 MILLION THIS WEEK
Here Come the Ad Buys
2 hours ago
THE LATEST

"Spending by super PACs tied to Donald Trump friends such as Ben Carson and banker Andy Beal will help make this week the general election's most expensive yet. Republicans and Democrats will spend almost $28 million on radio and television this week, according to advertising records, as Trump substantially increases his advertising buy for the final stretch. He's spending $6.4 million in nine states, part of what aides have said will be a $100 million television campaign through Election Day."

Source:
UNLIKELY TO GET A VOTE, LIKELY TO ANGER GOP SENATORS
Obama Nominates Ambassador to Cuba
6 hours ago
THE LATEST
GOP REFUSED VOTE ON FCC COMMISIONER
Reid Blocks Tech Bill Over “Broken Promise”
6 hours ago
THE DETAILS

Monday night's debate may have inspired some in Congress, as Senate Minority Leader has decided to take a stand of his own. Reid is declining to allow a vote on a "bipartisan bill that would bolster U.S. spectrum availability and the deployment of wireless broadband." Why? Because of a "broken promise" made a year ago by Republicans, who have refused to vote on confirmation for a Democratic commissioner on the Federal Communications Commission to a second term. Harry Reid then took it a step further, invoking another confirmation vote still outstanding, that of Supreme Court nominee Merrick Garland.

Source:
×