[Congressional Record (Bound Edition), Volume 162 (2016), Part 10]
[House]
[Pages 13348-13350]
[From the U.S. 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,

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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 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;

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       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.

                          ____________________