Seeing eye to eye on mental health care
It seems now more than ever that Republicans and Democrats can’t agree on anything. But President Barack Obama recently signed a bill that shows bipartisanship among lawmakers isn’t totally dead.
Obama signed the Comprehensive Addiction and Recovery Act into law. Unlike recent congressional debates, the bill was passed in both the House and Senate with near-unanimous support. The bill will advance a number of treatment and prevention measures intended to reduce prescription opioid and heroin misuse, including evidencebased interventions for the treatment of opioid and heroin addiction and prevention of overdose deaths.
After the passage of that bill, attention shifted to another important behavioral health bill. On July 6, the Helping Families in Mental Health Crisis Act passed the House by a 422-2 vote and now awaits action from the Senate.
With these two bills, Congress is actually making major strides to improve access to behavioral health services and reduce the burden on the criminal justice system. Mental health advocates should be pleased, but many are not. Perhaps the critics should reconsider their position.
The current mental health system was created in the 1960s, and although the treatment philosophy has evolved, little else has changed to advance the system forward. As a result of inconsistent funding and uncoordinated efforts at the state and federal levels, most mental health services are redundant, ineffective or fail to reach their targeted populations.
Although advocates should be proud that there is finally some real movement on behavioral health reform, some critics are voicing displeasure and nonsupport of the most recent bills. Just like any comprehensive bill, what is currently in the Helping Families in Mental Health Crisis Act is the result of compromise between allied — but fundamentally incongruent — perspectives on reform. The efforts made by all sides have made a significant difference, even though no one has gotten everything they wanted.
On one side are critics of the underfunded and disjointed community that is the mental health system. Their constituents and families are being failed by the current system to ensure treatment is evidence-based and access is easier. On the other side are consumer advocates fighting to improve civil rights protections and move the recovery philosophy forward. But in order to make it easier to access care, there is a concern that there will be an increase in involuntary hospitalizations. This is a very important concern, and it is vital to have a delicate balance between both sides.
Although it is true that the federal government should play a role in ensuring civil rights protections, the current dynamic, highlighted through the recent police shootings, shows the important role of training and implementation on the front lines. No matter the policy, the only way to shift the culture, and in this case reduce an overuse of involuntary hospitalization, is through work on the front lines to change the philosophical approach to direct care.
The passage and signing into law of these bills is a fundamental first step to fixing the broken mental health system. But at the same time, real change will not truly occur unless those who need mental health services, family members, mental health professionals, law enforcement agencies and other community members come together to assess their individual community and make changes to reduce negative outcomes.
Moving forward, mental health advocates need to have an open mind about how changes to the federal structure provide an opportunity to spur better coordination across the multiple systems that touch the lives of those who are mentally ill (i.e. criminal justice, child welfare). We all should encourage the many naysayers of this most recent bill to support this momentous piece of legislation. Everyone’s efforts have had very positive results, and although there is still grand work to be done, this is a step in the right direction.