Senators tackle ‘crushing burden’ of mental illness in America

WASHINGTON (MEDIA GENERAL) – Twenty percent of American adults battle mental illness every year, and now Congress is taking ownership of the devastating, often deadly, issue.

“We can do much, much better than we’re doing currently,” says Dr. Tom Insel, director of the National Institute of Mental Health.

Sen. Bill Cassidy, M.D. (R-Louis.) questions mental health witness on patient privacy in HELP committee. (Photo credit: Chance Seales)
Sen. Bill Cassidy, M.D. (R-Louis.) questions mental health witness on patient privacy in HELP committee. (Photo credit: Chance Seales)

On Thursday, Insel told the Senate’s Health, Education, Labor and Pension Committee (HELP) that there is “an unconscionable gap” in what we know about mental illness and what’s being done to treat it.

The health committee is grappling with strategies to fund viable research, create effective treatments and eliminate red tape.

On Thursday, HELP Chairman Sen. Lamar Alexander (R-Tenn.) invited some of the nation’s leading mental health experts to help them move the ball forward.

The bipartisan effort delved into the staggering rates of mental illness in military veterans, adolescents,  prisoners, Native Americans and LGBT youth.

The committee’s top Democrat, Sen. Patty Murray (D-Wash.),  highlighted, “Suicide is the second highest cause of death for those ages 15 through 34” and impacts LGBT adolescents at twice the national rate.

Guns and Mental Illness

Sen. Elizabeth Warren (D-Mass.) laid into gun advocates for “banning” National Institutes of Health (NIH) and research on firearms and denying the link between mental health and gun violence.

Dr. Insel called Warren’s inquiry “timely,” clarifying that NIH does, in fact, study the mental health-firearm relationship, determining that the issue falls within the health agency’s “sweet spot.”

Treatment Access

Access poses an unwieldy problem for legislators.

“Half of all U.S counties don’t have a single psychiatrist, psychologist, or social worker,” stated Sen. Murray.

Dr. Insel pointed out that psychosis goes untreated an average of 74 weeks, routinely missing a crucial window for detection and treatment.

Sen. Tim Scott (R-S.C.) derided the current system, saying it makes jails and prisons “de facto” treatment facilities, depriving patients of appropriate care and costing taxpayers exorbitant sums of money.

Breakthroughs

Senators mulled the hard budgetary numbers of funding mental health efforts, ticking through billions of dollars awarded to agencies and research projects.

The question now: Where to send the next round of federal money, and why?

There was talk of brain scans, genetic markers, smoking rates, tracking initiatives and HIPAA pitfalls.

Sen. Chris Murphy of Connecticut (left) greets witness after HELP mental health hearing (Photo credit: Chance Seales)
Sen. Chris Murphy of Connecticut (left) greets witness after HELP mental health hearing (Photo credit: Chance Seales

Patient Privacy

In the push to overhaul federal privacy laws, considered a central issue on Capitol Hill, committee members like Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-Louis.) showed up early to ensure their opportunity to ask questions of the experts about their joint legislation.

Sens. Cassidy and Murphy crafted a measure that, among other things, gives parents of patients battling serious mental illnesses more access to their treatment programs.

Cassidy, a medical doctor, grilled expert witness Kana Enomoto of the Substance Abuse and Mental Health Services Administration about the prospect of increasing treatment transparency when it comes to families. After three rounds of questioning, Cassidy ran out of time and Enomoto ran out the clock, without providing a direct answer.

The privacy-access balance presented a speed bump for a similar House bill this week.  But in the upper chamber, Sen. Murphy suggests there is widespread consensus that HIPAA privacy clarifications, not a total rewrite, are necessary when it comes to cases of serious mental illness.

Sen. Susan Collins (R-Maine) appeared to side with Cassidy and Murphy in committee, illustrating the need for reform by recounting the story of William Bruce, a young man with schizophrenia released from a Maine treatment facility who successfully limited his parents’ access to his treatment files before ultimately killing his mother in a 2006 psychotic episode.

Sen. Collins underscored the grim irony that the couple’s son only got full treatment once his mother was dead and his case became a criminal one.

Collins also noted that most people experiencing mental illness are not violent.

Next Steps

The Cassidy-Murphy bill still awaits a full committee hearing, which will likely occur in early 2016 according to Alexander. HELP’s bipartisan leadership is publicly committed to passing reforms. The final legislative vehicle remains to be seen.

Once the final Senate bill is crafted and votes come due, Sen. Murphy says he will not settle for his signature issue to be watered down to legislative “window dressing.”

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