[Congressional Record Volume 162, Number 144 (Thursday, September 22, 2016)]
[House]
[Pages H5810-H5811]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
ADDRESSING THE MENTAL HEALTH CRISIS IN AMERICA
The SPEAKER pro tempore. The Chair recognizes the gentleman from
Pennsylvania (Mr. Murphy) for 5 minutes.
Mr. MURPHY of Pennsylvania. Mr. Speaker, I include in the Record a
letter from which I am going to read some excerpts. This includes a
letter that we are sending to Majority Leader McConnell and Minority
Leader Reid in the Senate. Let me read a few excerpts from this.
We are asking the Senate to pass the Helping Families in Mental
Health Crisis Act before the district work period break. Delays in
enacting this into law will contribute to more crime, violence,
homelessness, and the daily deaths of 959 Americans as a result of
mental illness.
We know that there is a critical shortage of qualified providers.
There are only 9,000 child and adolescent psychiatrists for 17 million
children, and we need 30,000. African Americans are half as likely to
receive psychiatric care, and for Hispanics with a mental disorder,
fewer than 1 in 11 sees a mental health specialist. Fifty-five percent
of counties in America do not have a practicing psychiatrist,
psychologist, or social worker.
The average time between the onset of the first symptoms of psychosis
and the first treatment is 80 weeks. There is a nationwide shortage of
100,000 psychiatric beds, which means people are often diverted to
jails, are boarded in emergency rooms, or are released without
treatment. There is no oversight, monitoring, or enforcement of the 10-
year-old parity law, and persons with eating disorders still cannot get
coverage for their treatment.
The Federal Government spends about $130 billion annually by 112
agencies across eight separate departments, but the GAO exposed that
these have nearly no coordination and do not require evidence-based
practices.
In terms of violence, those with untreated psychosis are 15 times
more likely to be violent or not in treatment. With regard to jail,
over 50 percent of those in jail have a mental illness. Mentally ill
inmates cost taxpayers three times more than those without a mental
illness, and individuals with a mental illness are four to six times
more likely to be victims of sexual violence.
With regard to homelessness, over one-third of homeless Americans
have a serious mental illness, and people with serious mental illness
are three times more likely to be in poverty.
Having a serious mental illness is worse for someone's health than is
chronic heavy smoking, and those with serious mental illness tend to
die 10 to 25 years prematurely, meaning over 350,000 Americans will die
this year as a direct or indirect result of mental illness. So far this
year, over 255,000 have died.
H.R. 2646, the Helping Families in Mental Health Crisis Act, is the
most transformational crisis mental health reform bill in 50 years. It
passed the House with near unanimous support on July 16, 2016, with a
vote of 422-2.
It reforms the Federal Government approach to mental health by
establishing the critically important leadership position of Assistant
Secretary for Mental Health and Substance Use Disorders, who must be a
doctor and who will bring accountability, effectiveness, and
coordination to the Federal Government's programs and will develop a
national strategy to increase the mental health workforce.
It increases the number of psychiatrists, psychologists, and
psychiatric nurses to treat serious mental illness. It provides funding
for tele-mental health to increase access in underserved areas. It
provides additional
[[Page H5811]]
psychiatric beds. It requires the oversight and enforcement of parity
laws and extends coverage to people with eating disorders.
The Helping Families in Mental Health Crisis Act has been endorsed by
more than 40 professional organizations, by 77 newspapers, and has 207
bipartisan cosponsors.
We write with the vital request that the Senate take up and pass the
Helping Families in Mental Health Crisis Act in order to fix our
Nation's mental health system. It must take priority over any partisan
divide. We, respectfully, ask that the Senate advance this bill to
provide treatment before tragedy and to provide desperately needed and
fully deserved help.
Along these lines, Mr. Speaker, I ask my colleagues to also contact
my office to cosign this letter that pleads with the Senate to please
move this bill quickly so that we don't have to see more tragedy, so
that we can provide treatment, so that we can relieve Americans of this
terrible scourge of mental illness without treatment, and so that we
may provide quick and lifesaving action because, where there is no
help, there is no hope.
Congress of the United States,
Washington, DC, September 22, 2016.
Hon. Mitch McConnell,
Majority Leader, U.S. Senate,
Washington, DC.
Hon. Harry Reid,
Minority Leader, U.S. Senate,
Washington, DC.
Dear Majority Leader McConnell and Minority Leader Reid: We
are in the midst of a mental health crisis in America. One in
five Americans will experience mental illness this year.
There are 10 million adults with a serious mental illness
(SMI), but nearly 40% do not receive treatment. The reasons
for this are a critical shortage of qualified providers, a
dearth of crisis psychiatric beds, failed mental health
parity implementation, and most importantly the absence of
strong federal leadership. We are asking the Senate to pass
the Helping Families in Mental Health Crisis Act before their
district work period break. Delays in enacting this into law
will contribute to more crime, violence, homelessness, and
the daily deaths of 959 Americans as a result of a mental
illness. The level of this crisis was learned during the 4
year long House investigation, the major findings of which
are listed below.
Critical Shortage of Qualified Providers
There are 9,000 Child and Adolescent Psychiatrists for 17
million children with a mental health condition, but there is
a need for 30,000;
African Americans are half as likely to receive psychiatric
treatment;
For Hispanics with a mental disorder, fewer than 1 in 11
see a mental health specialist;
55% of counties do not have a practicing psychiatrist,
psychologist, or social worker;
72% of states have a shortage of psychiatric nurses;
Over the last decade the total number of physicians has
increased by 45% but the number of psychiatrists has only
increased 12%;
The average time between onset of first symptoms of
psychosis and first treatment is 80 weeks.
Dearth of Psychiatric Crisis Beds
There is a nation-wide shortage of 100,000 crisis
psychiatric beds;
In 1955 there were 550,000 psychiatric beds, but today
there are only 40,000;
Only one state (Mississippi) has enough beds to meet the
minimum standard;
When patients are in crisis they are often diverted to
jails, boarded in Emergency Rooms, or released without
treatment.
Parity
It has been nearly a decade since parity became law, yet
there is no oversight, monitoring or enforcement;
Americans with eating disorders still cannot get coverage
of their treatment.
Failed Federal Leadership
In the area of mental health, the federal government spends
$130 billion annually by 112 agencies across 8 separate
departments;
In a stunning and groundbreaking report the GAO exposed
that federal mental health programs have nearly no
coordination, few evaluations, and four out of five do not
require evidence-based practices;
55% of Medicaid funding goes to 5% of the Medicaid
population and nearly all of those patients have a mental
health condition.
Violence
While individuals with a mental health condition are NOT
more violent than the general public, those with untreated
psychosis are 15 times more likely to be violent when not in
treatment;
80 percent of violent acts committed by those with
untreated psychosis are attributable directly to their
illness.
Criminal Justice
Of those Americans in local jails 64% have mental illness,
56% in state prison, and 45% in federal prison;
Mentally ill inmates cost taxpayers three times more than
those without a mental illness;
Incarcerating someone with a mental illness is 20 times
more expensive than community treatment;
Over 70% of people in jails with serious mental illness
also have a substance use disorder;
Individuals with a mental illness are 4 to 6 times more
likely to be the victim of sexual violence.
Homelessness and Poverty
Over one-third of Americans experiencing homelessness have
a serious mental illness.
People with serious mental illness are three times more
likely to be in poverty.
Preventable Deaths
Having a serious mental illness is worse for someone's
health than chronic heavy smoking;
Those with a serious mental illness die 10-25 years
prematurely;
There are 43,000 suicides, and 90% of those suicides have
mental illness as a contributing factor;
350,000 Americans die each year as a direct or indirect
result of a mental illness.
H.R. 2646
The Helping Families in Mental Health Crisis Act, the most
transformational crisis mental health reform bill in 50
years, passed the House with near unanimous support on July
16, 2016 by a vote of 422-2. Our legislation delivers
treatment before tragedy and fixes the problems above
identified by the House investigations. The legislation:
Reforms the federal government approach to mental health by
establishing the critically important leadership position of
Assistant Secretary for Mental Health and Substance Use
Disorders (who must be a doctor) to replace the Administrator
of the Substance Abuse and Mental Health Services
Administration;
The Assistant Secretary will bring accountability,
effectiveness, and coordination to the federal government's
112 mental health programs, and develop a national strategy
for increasing the mental health workforce;
Increases the number of providers for SMI by supporting
postdoctoral psychologists, authorizing minority fellowships,
allowing doctors to volunteer at federally qualified
community health centers, and provides funding for tele-
mental health to increase access in underserved areas;
Provides additional psychiatric hospital beds for those
experiencing an acute mental health crisis and in need of
short term immediate inpatient care for stabilization;
Requires oversight and enforcement of parity and extends
parity coverage to eating disorders;
Establishes a National Mental Health Policy Laboratory to
set objective and scientific outcome measures for mental
health spending;
Authorizes the Suicide Prevention Hotline;
Incentivizes states to provide community-based alternatives
to jails, prisons, and institutionalization.
The Helping Families in Mental Health Crisis Act is the
product of years of collaboration between dedicated members
of Congress, as well as numerous organizations, who came
together to offer feedback and suggestions. The bill has also
been endorsed by more than 40 professional organizations, 77
editorial boards and newspapers, 207 bipartisan Members of
Congress, and hundreds of individual physicians, patients,
and families.
Given the urgency of the mental health crisis in America,
we write with the vital request that the Senate take up and
pass the Helping Families in Mental Health Crisis Act before
you break for district work period. We understand the nature
of the short schedule during the month of September, but we
maintain that fixing our nation's mental health system must
take priority over scheduling or any partisan divide. We know
that every day more than 900 lives are lost in our nation
due--directly or indirectly--to mental health. That
translates to over 70,000 preventable deaths since the House
passed H.R. 2646 in July.
At a time when thousands of lives are on the line, delays
and politics cannot overrule compassion and common sense. We
respectfully ask you to advance this bill to provide
treatment before tragedy, and H.R. 2646 will provide
desperately needed, and fully deserved, help. We call on you
to pass H.R. 2646 because where there is help, there is hope.
Sincerely,
Tim Murphy,
PhD.
Eddie Bernice Johnson,
RN.
____________________