(12-7-16) Rep. Tim Murphy’s Helping Families in Mental Health Crisis Act passed 94-5 this afternoon in the U.S. Senate clearing the way for it to be signed into law by President Obama before he leaves office.

Murphy’s mental health reforms, along with Sen. John Cornyn’s (R.Tx.)  Mental Health and Safe Communities Act,  were tucked into the 21st Century Cures Act, a $6.3 billion health care bill that critics called a boondoggle for the pharmaceutical industry, which spent millions lobbying for its passage, but supporters insist will cut bureaucratic red tape that prevents life-saving medicines from reaching markets quickly. Because the Act contains two pet projects of both Obama and Vice President Joe Biden, the Cures Act is expected to be signed quickly.

Murphy, a Pennsylvania Republican who is the only practicing psychologist in Congress, was relentless in pursuing passage of his bill — a process that started nearly four years ago and often turned bitter at congressional hearings. In a release he wrote:

This historic vote is one of the rare moments in Congress where members can say with confidence their vote to pass these reforms will indeed save lives. We are ending the era of stigma surrounding mental illness and focusing on delivering treatment before tragedy. By bringing research, treatments and cures into the 21st Century, we are finally breaking down the wall between physical health and mental health. (Full text of his release can be found at bottom of this blog.)

From the start, Murphy focused on concerns raised by parents and family members about barriers they face trying to help loved ones get help, including what they consider overly restrictive civil rights protections.  Cornyn’s bill was primarily aimed at funding successful criminal justice programs, such as Crisis Intervention Team training for law enforcement, mental health courts, and jail re-entry programs. Both Murphy and Cornyn are strong advocates of increased use of Assisted Outpatient Treatment, which has been strongly opposed by many groups that represent individuals with mental illnesses and disabilities.

 One of the organizations that Murphy depended on for advice and support from the start was the Treatment Advocacy Center, founded by Dr. E. Fuller Torrey. It’s executive director, John Snook, said in an email:

“This is one of the most important moments for mental health in more than fifty years. Mental Health Reform offers real hope to families and their loved ones who have been locked out of care. It focuses squarely on treatment of severe mental illness, providing people access to a bed instead.”

Murphy’s bill met strong opposition from the start from Democrats and eventually underwent numerous revisions to make it more palatable. When the House passed Murphy’s bill last week,  I published a blog that compared some of Murphy’s initial language with what now is in the Cures Act.

In addition to posting Murphy’s release here, I am adding a review of the bill that is being circulated by a consumer group whose members  opposed Murphy’s bill. I felt it would be helpful to see how critics of the bill now see it and the revisions that they helped add to make it more acceptable to them.

Obviously I will be writing more about this bill in later blogs, but I wanted to get news of its passage out ASAP.

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(12-2-16) A 62 year-old Virginia woman arrested for trespassing, who had schizophrenia, diabetes and was incontinent, was released three weeks after she was jailed thanks to cooperation between jail officials, a judge and local mental health officials.

Her release was cited by officials at the Hampton Roads Regional jail as an example of how the jail is taking steps to improve the way it treats inmates with mental illnesses, according to a story by Virginia Pilot Reporter Gary A. Harki. Last year, Jamycheal Mitchell  suffered a fatal heart attack in that same jail after literally starving for 101 days while reportedly under constant watch by correctional officers and a nurse. He’d been arrested for stealing $5.05 worth of snack food.

Had jail officials not cooperated with a judge and mental health workers, the 62 year-old woman would have spent four months waiting for trial, Linda Bryant, the jail’s assistant superintendent, was quoted telling Harki.

Okay, now read the first paragraph of this story again, 

The jail is citing this as an example of success because it was able to get a 62 year-old incontinent, mentally ill woman charged with misdemeanor trespassing released after spending ONLY THREE WEEKS in jail!

While I applaud the jail administration’s new attitude and spirit of collaboration, this is not a case that anyone should be celebrating and using as an example of exemplary service.

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(12-1-16) Here’s what several of the key players shepherding Rep. Tim Murphy’s Helping Families in Mental Health Crisis Act through Congress had to say last night after the legislation — now part of the $6.3 billion 21st Century Cures Act — was passed in the House. The Cures Act is expected to be voted on quickly in the Senate and then sent to the president for signing into law. Murphy’s act is the first major reform of the government’s mental health programs in decades.

Representative Tim Murphy  (R-Pa.): 

For the last four years since the time of the terrible tragedy at Sandy Hook Elementary followed by repeated other ones our nation has been awoken from a slumber of ignoring problems of mental illness in America. One that when we closed down our institutions decades ago we turned our eye to those who lie homeless in the street or we filled our prisons or our cemeteries or laid on a gurney in the emergency room or sent back to a family that felt helpless and hopeless.

We’ve changed the situation where now we are coming together on a bill that will save lives. This is a new era of healthcare, and the next generation of hope for Americans that really transcends boundaries.

To all the families who brought their stories out of the shadows that dared to share their sorrows their hopes and to share their dreams, today is a day of joy and today is only possible, I say to all those families, because they dared to step forward.

…We can look back on this moment in history and say today though we have much to do, and although we didn’t get everything we needed but we needed everything we did get. But this is a moment on this day forward to say that today we took action to save lives.

Senator John Cornyn (R-Tx.):

(Cornyn’s Mental Health and Safe Communities Act also was merged with Murphy’s bill into the 21st Century Cures Act. He has played a pivotal role as Senate Majority Whip getting the legislation voted on during the lame duck session.)

“I dare say there’s probably not a family in America that doesn’t have to deal with this in some way or another, either at work, people you go to church with, people who live next door. Some way or another, mental health problems are rampant.”

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(11-30-16) Rep. Tim Murphy’s Helping Families in Mental Health Crisis Act is poised to become a federal law.

By a 392-26 vote late Wednesday, the House passed the 21st Century Cures Act, a massive $6.3 billion health bill, that included Murphy’s legislation. The Senate is expected to approve the legislation shortly  before sending it to President Obama to sign before leaving office.

“This is a huge victory,” Andrew Sperling, NAMI’s director of advocacy, wrote in an email. “The entire enterprise could have easily collapsed given the election results.” 

D. J. Jaffe, who publishes the website Mental Illness Policy Org., and was active behind the scenes pushing the bill, called Murphy a “hero” and praised the Pittsburgh Republican and Sen. John Cornyn (R-Texas) for their tenacity. Both endorsed greater use of Assisted Outpatient Treatment, which is strongly supported by Jaffe.

“AOT was a great win in this legislation,” he said. “Now, the question is if the new assistant secretary (for mental health) will drain the swamp at SAMHSA (Substance Abuse and Mental Health Services Administration) and make that agency focus on the seriously mentally ill.” 

The Treatment Advocacy Center, which supports AOT legislation, was a vigorous champion of Murphy’s bill from its first draft.

Murphy began laying the groundwork for his bill in March 2013, three months after Adam Lanza’s 2012 attack on the Sandy Hook Elementary School that left 28 dead, including him. I was questioned at his first House session about problems my family faced trying to get help for my son. 

Murphy’s original bill faced strong opposition from Democrats and a slew of mental health organizations, including Mental Health America, who claimed it would eliminate and roll back hard-won civil rights protections. Some mental health groups scoffed at Murphy’s chances of getting any legislation passed. The  National Alliance on Mental Illness was the only major group that supported Murphy’s bill. (see correction at end of blog.) It wasn’t until after Murphy had collected more than a hundred co-sponsors that his critics became alarmed.

Supporters welcomed Murphy’s legislation, saying it was one of the first that recognized the problems that parents and families faced, rather than focusing primarily on the rights of individuals who were ill. Because much of what Murphy first proposed was nearly identical to reforms that Dr. E. Fuller Torrey had been pushing for years,  I once dubbed the bill “Torrey’s revenge” against SAMHSA and mental health lobbying groups that had widespread support in Congress.

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(11-29-16) Few topics are as hotly debated as Involuntary Commitment, which was the featured topic on the second hour of the Diane Rehm show today. The reason for the discussion was  COMMITTED: The Battle Over Involuntary Psychiatric Care, a new book by Drs. Dinah Miller and Annette Hanson. I was invited because I wrote the book’s foreword.

You can listen to the entire hour program here. 

After the program, Drs. Miller and Hanson spent a half hour answering comments on Facebook — and there were plenty of them and questions that I’ve included in this post.  You can also read more comments and an excerpt from the book here.

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