What to Do About Our Mental Health Problems

Some have said there are no Democrats, Republicans or Independents when it comes to mental health. Mental health reform should know no partisanship whether it is treatment for the invisible wounds of soldiers returning from duty overseas or a young child experiencing a psychiatric break due to genetics, trauma or abuse.

Today, we need the vision and courage to turn the corner and improve the delivery of mental health and developmental disability services both at home and across the United States. Locally, law enforcement is serving as the provider of last resort. Admittedly, there are no deductibles or co-pays when receiving mental health counseling at a jail or prison at the local or state level. Law enforcement at the local level explain that more placement options are needed than simply in-patient hospitalization and the jail for those who are not receiving proper treatment for their mental illness or developmental disabilities. In short, law enforcement is overwhelmed with the unmet needs and an acute shortage of psychiatric beds, counseling, access to and oversight of medications, and enhanced out-patient mental health treatment.

Psychiatrist and United States Congressman, Tim Murphy, Ph.D., from suburban Philadelphia and Gettysburg, launched oversight investigations into the problems with America’s mental health system last year. Congressman Murphy speaks to a patchwork of laws that are antiquated and uncoordinated. H.R. 3717 seeks to resolve many systemic problems and ensure psychiatric care for those most in need. I encourage you to examine this legislation and contact your federal representatives to support and pass the bill from committee for consideration in both the United States House of Representatives and United States Senate.

Did you know the U.S.A. had 600,000 in-patient psychiatric beds in the 1960s? Today, only 40,000 inpatient psychiatric beds exist for a population over two times the size of 50 years ago.

Congressman Murphy’s legislation assists the most critically mentally ill by creating 2 new exemptions to the mental disease exclusion under Medicaid. Just like cancer treatment should not begin after an individual has stage 4 cancer, or diabetes treatment should not begin after an individual has serious ailments, changes in coding/reimbursement rates would work to remedy the shortage of psychiatric beds for locally qualified community mental health centers. Additionally, higher reimbursement rates would work to place mental health treatments on par with other services provided by medical and counseling providers. As is the case with other diseases, early diagnosis and treatment of psychosis improves outcomes dramatically. Prevention does save money and human life, in some cases.

Did you know that only one child psychiatrist exists for every 7,000 children with mental illness or behavior disorders? The reforms in Congressman Murphy’s legislation increases loan repayments and incentives for pediatricians, primary care physicians, psychologists, and psychiatrists to work in underserved areas where patients lack access to mental health professionals. More reforms are needed for incentives to nurse practitioners.

H.R. 3717 promotes alternatives to institutionalization such as assisted outpatient treatment, amends HIPPA regulations so physicians and mental health professionals can share information with parents and caregivers of loved ones (especially in times of an acute mental health crisis); advances medical research of the brain at the National Institutes of Health, re-authorizes and expands mental health courts and evidence based practices for police officers, advances tele-psychiatry by linking pediatricians, psychiatrists, psychologists and primary care clinicians via coordinated care and electronic medical records systems, and strengthens Congressional oversight for review of programs that are not working.

Under H.R. 3717, physicians are granted authority to use a broad array of formularies for Medicaid and Medicare patients. The prescribing of medications would be in line with protected classes of medications for patients with epilepsy and cancer. This is an effort to avoid crisis situations and stabilize patients beyond the emergency room.

In sum, we must deal with reality; this is not an issue of the left or right but rather, an issue of whether our local communities move backward or forward. That is why our community is exploring the idea of community based initiatives for mental health reform such as mental health courts in Indiana, improvements to Medicaid eligibility procedures and coding/reimbursement for providers and crisis intervention training for law enforcement officers and those serving the mentally ill.