I have received a slew of emails about the Democrats’ decision last week to introduce a mental health bill challenging the legislation that Rep. Tim Murphy (R-Pa.) is fighting to get passed in the House. The Wall Street Journal also offered its opinion, after citing one of my earlier blogs. Here is a sampling, beginning with readers who are wary of Rep. Murphy’s legislation, including Virgil Stucker, Executive Director and President, CooperRiss Healing Community.
Dear Pete
Good to see that you entering more deeply into the dialogue about HR3717 (Rep. Murphy’s bill.) I have read the bill twice. Mostly I am concerned by its pessimistic tone which seems to scapegoat those of us who focus on ‘recovery’, on efforts to help vulnerable individuals with mental health issues to achieve and sustain their highest levels of functioning and fulfillment. I enter this arena with deep respect for these individuals and only rarely need to help cause involuntary treatment to occur for them. Day by day, I walk with, dine with, work with, live with these individuals on their journey. I feel honored to be in their presence and to try to help provide some of the essential conditions of recovery within our program. I am sustained personally by vicariously participating in the recovery stories I see unfolding before my eyes.
As I write I am at the American Psychiatric Association conference in NYC where I have been invited as a non-psychiatrist to participate in a new Caucus that is wrestling with the concepts and practicalities, as its leader put it, of trying to move from “bio-bio-bio psychiatry” to “bio-psycho-social psychiatry”. I was glad to be amongst about 40 psychiatrists who seem to harbor some optimism for accomplishing this.
Although, I am sure that Rep. Murphy is someone of goodwill and knowledge, as I read his bill, I wonder if he has actually had the opportunity to stand with, be with, work with someone with serious mental illness and feel the joy of helping to move them toward recovery. Unfortunately, too many clinical psychologists have not really had this chance. If he has not, then I am uncertain about why he is so pessimistic about the ‘recovery model’.
My concerns about his bill are basically twofold: First, I fear that it will inadvertently lead us toward deeper entrenchment into bio-bio-bio psychiatry. Secondly, Rep. Murphy’s many new criteria that would allow for forced treatment are broad and open to interpretation by mental health court judges who are not trained to make good judgments in these areas. I am concerned that the number who will be forced simply to take medications will greatly increase and opportunities for recovery will be lost.
There are certainly many good features of the bill as well. I fear these features will not be funded and the new practices will focus on forced medication usage.
Virgil Stucker , Executive Director and President, CooperRiss Healing Community at www.CooperRiis.org
This email was less kind.
Dear Pete
Had great hopes for what you could do for those locked and/or shunted out of the mental health industry(ies). You showed your hand a long time ago in your support for the Republican ideologies. Once getting on to this, made me suspicious of your motives all together. Big Pharma loves ya though. You’ll get richer and richer.
–J.L.
Here’s a comment from a friend of mine who is a judge who hears involuntary commitment cases.
The next time you and I meet I will fill your ears with the progress of people on outpatient treatment who really are not interested in receiving it. Think of it like this: you know how you sometimes have to hold onto your dog forcefully (occasionally takes two people) when you are stuffing a large pill down his/her gullet? It’s a lot like that, only it results in less success. You and Dr. Murphy may soon learn.
Continuing, I got this missive:
The notion that family members are “always right” is a dogma only for (Pete) and people who think like him. They prefer to ignore data of abusive families using psychiatry to control children (or parents).
And finally, as promised, here is a different view from The Wall Street Journal.
By Kimberley A. Strassel
May 8, 2014 6:56 p.m. ET
Were this a case study in a mental-health journal, it might be characterized as Midterm Derangement Syndrome. As there is no such category, call it what it is: the basest form of Washington politics.
Arizona Rep. Ron Barber, a former aide to Gabby Giffords, led four House Democrats on Tuesday in unveiling The Strengthening Mental Health in Our Communities Act. Mr. Barber insisted his bill is a “comprehensive approach to long-ignored mental health issues” and a completely “nonpartisan” exercise. Which he would say, since this is in reality a Nancy Pelosi special: a raw partisan exercise in killing mental-health reform, shoring up midterm election prospects and protecting Democratic constituencies—all at the expense of the most seriously ill.
The timing, method and content of the Barber bill say it all. Ever since the Sandy Hook shooting, Pennsylvania Republican Rep. Tim Murphy, a psychologist, has pushed a mental-health reform designed to find and treat the Jared Loughners before they strike. Mr. Murphy’s subcommittee spent a year investigating every failed corner of the federal mental-health system and months more working with professionals, advocacy groups and families.
What has most characterized the Murphy effort has been his bipartisanship. His bill doesn’t shy away from necessary reforms: fixing broken privacy laws, revamping commitment standards, increasing assisted outpatient treatment, overhauling that broken federal agency, the Substance Abuse and Mental Health Services Administration (Samhsa). Yet rather than point fingers for past failures, Mr. Murphy has presented the bill as an opportunity for all of Congress to finally tackle a serious national problem. His office has engaged in extensive outreach, and since his bill’s December debut has collected 77 co-sponsors—a third of them Democrats.
Mr. Murphy also had solicited Mr. Barber’s thoughts and was even working recently with his committee counterpart, Colorado’s Diana DeGette, in the expectation that she would come on board. All that ended when Ms. Pelosi decided that Republicans couldn’t be allowed any victory that might present them as bipartisan, compassionate and leaders on health issues. Mr. Barber and Ms. DeGette received new marching orders.
While Mr. Barber presented the bill (Ms. DeGette is a co-sponsor), the Hill reported late last week that Ms. Pelosi and Rep. Henry Waxman (D., Calif.) were “deeply involved in crafting” it. A lobbyist told the paper that “Pelosi and Waxman hope this legislation will blow up any kind of continuing dialogue with Murphy.”
That serves another Pelosi priority: keeping alive the dream of gun control. Liberals have been unhappy that Mr. Murphy has so successfully focused attention on mental illness, since it messes with their story line that the only issue is guns. In this warped universe, a bipartisan vote for a Murphy bill —an acknowledgment that mental illness plays a primary role in shooting tragedies—is a surrender on gun control, and potentially an excuse for some Democrats to drop that politically dangerous issue.
The Barber bill is no threat to these liberals, since it won’t be heard, and is simply another Democratic spending blowout. Pelosi-Barber strips out every consequential reform from the Murphy bill—outpatient treatment, privacy rules, commitment standards, Samhsa reforms—and settles for throwing yet more federal dollars at “mental health awareness.”
As such, Pelosi-Barber also protects Democratic lobbies that are currently feeding from the federal trough and want to continue doing so. That includes federally funded lawyers who fight to keep the seriously mental ill out of treatment, as well as to a huge array of Samhsa-funded anti-psychiatry groups, such as the National Coalition for Mental Health Recovery, that oppose treatment for those most sick. Pete Earley, an author and mental-health reform advocate, noted on his well-read blog this week that “all I heard yesterday in the halls of Congress were laments by different interest groups scrambling to protect SAMHSA and their favorite programs from being cut.”
And then there’s Mr. Barber, one of the most vulnerable House Democrats in the country. He was injured in the Loughner shooting and then won a special election to finish Ms. Giffords’s term. Yet he was barely re-elected in November 2012, is in a GOP-leaning district, under fire for ObamaCare, a target of outside conservative groups, and is facing a rematch with his (now better known) 2012 opponent, Martha McSally. Ms. Pelosi gets to undercut Republicans, and Mr. Barber gets to put his name at the top of a mental-health “reform” that he hopes will help him in his particular district this fall.
The risk to Democrats is that this is all so blindingly obvious. Mr. Murphy’s outreach and educational efforts have helped mobilize reform advocates, and they know what is going on. Democrats are already getting pushback from mental-health grass-roots organizations across the country and from family and support groups. Even the press is describing the bill as a political stunt.
Yet the damage is done. Up to now, the Murphy bill remained a rare cause for bipartisan optimism. Ms. Pelosi has now issued a rival bill that all but forbids Democrats from working with Republicans on one of most pressing issues of the day. When the next tragedy comes, remember this week.
Write to kim@wsj.com
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