[Congressional Record (Bound Edition), Volume 160 (2014), Part 9]
[House]
[Pages 13077-13078]
[From the U.S. Government Publishing Office, www.gpo.gov]




              HELPING FAMILIES IN MENTAL HEALTH CRISIS ACT

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Pennsylvania (Mr. Murphy) for 5 minutes.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, this week, the largest ever 
study of schizophrenia reported that the condition is tied to more than 
100 genes.
  This discovery shows more evidence that schizophrenia is a clinical 
condition just like other medical conditions. Severe schizophrenia, 
therefore, must be treated with a medical approach, using evidence-
based therapies that work.
  We know 50 percent of persons with schizophrenia suffer from a 
neurological impairment that makes them incapable of understanding that 
they are ill. This lack of awareness, termed ``anosognosia,'' is the 
leading cause of noncompliance with psychiatric treatment. This 
neurological problem helps to explain why 40 percent of Americans with 
a serious mental illness do not receive treatment, and it explains how 
our system fails to help those most in need.
  Anosognosia occurs most frequently when schizophrenia or a bipolar 
disorder affects portions of the frontal lobe, resulting in impaired 
executive function. The patients are neurologically unable to 
comprehend that their delusions or hallucinations are not real. This is 
different than denial; this is a change in the wiring of the brain. 
These individuals don't recognize they are ill. When they don't meet 
the 200-year-old definition of being in imminent danger to harm 
themselves or others, their friends and families are powerless to help 
them. Uninformed observers wrongly believe that, because the patients 
can look at them and talk to them, they must be fully functional and 
aware, but they are not.
  Much like if they had Alzheimer's disease or were in a coma, these 
individuals with schizophrenia can't voluntarily request treatment on 
their own. We would never deny care to a stroke victim or to a senior 
with Alzheimer's simply because he or she couldn't articulate her need 
for treatment. Yet, in

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cases of serious brain disorders, we allow millions to suffer because 
of the chaotic patchwork of State and Federal laws that says we can't 
even act when we know we must.
  Further, when a patient is discharged from a hospital with anything 
from a minor cut to a heart transplant, there must be a written 
treatment plan, and that plan is readily shared with family members who 
will assist with followup, but not so with serious mental illness. 
Again, we would not do this to someone with Alzheimer's. We would not 
say, ``I can't treat your grandmother until she is well enough to tell 
me to treat her, but I can't tell you about her treatment until she 
gives you permission.''
  These mentally ill men and women who are in need of medical attention 
end up sitting in jails, sleeping behind dumpsters, or being sedated 
and chained to hospital gurneys in emergency rooms. They cycle in and 
out of prison, the ER, and shelters. That is a lifestyle we have 
relegated 3.6 million Americans to. We deny people the right to 
treatment. We deny them the right to get better. How cruel is that?
  As a result, 1 million Americans last year attempted suicide, and 
40,000 people died from suicide. There are 300,000 homeless, 500,000 in 
jail, and 700,000 in other prisons. The mentally ill are also more 
likely to be robbed, physically assaulted, raped, and sexually 
assaulted. So, while several States and counties have taken bold action 
to help those who have been cast aside by our current system, the 
Federal Government sits, oblivious to the problem, and, in some cases, 
actually creates barriers to treatment for those who need help the 
most.
  Serious mental illness is more detrimental to your long-term health 
than being a heavy smoker, and it increases your risk for diabetes, 
heart disease, and cancer. It reduces your life span by some 25 years. 
There is also a financial toll. A study conducted by Duke University 
determined that assisted outpatient treatment saves taxpayers $50,000 
per patient. It also increases medication compliance and decreases 
incarceration, hospitalization, and homelessness.
  The problem is that four States still prohibit the use of this 
medical model, and most county health systems haven't implemented it; 
and studies have shown that each time individuals with mental illnesses 
experience a break from reality, their brains actually suffer from 
permanent injury. All of this is happening at a time when we know more 
about the brain than we ever have.
  We tell families that Federal laws prohibit you from knowing why your 
loved one is in a mental health crisis, and doctors tell the family, 
``Your son is only a little dangerous right now, but please bring him 
back when he becomes truly violent, and then he can be treated.'' How 
absurd. Can you imagine if we told someone with diabetes, ``Your blood 
sugar is too low, but we are going to wait until you are in a diabetic 
shock before we give you insulin''? The doctor would be fired, and the 
hospital would be sued. We would ensure that it never happens again. 
Yet, for families in a mental health crisis, this scenario plays out 
every single day, and not a word is spoken about it. The reason is that 
people don't understand the neurological basis of mental illness.
  What we need to do is have a Congress that is able to confront its 
own denial and change the laws that need to be changed. We can fix the 
mental health system but not if Congress does not act. We must pass 
H.R. 3717, the Helping Families in Mental Health Crisis Act, because 
ignoring this problem will not make it go away, and where there is no 
help, there is no hope at all.

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