GOP has strong mental-illness reform
Here’s an acknowledgment from a two-time Obama doorknocker: The Republicans have a much better plan on the table than the Democrats for fixing our ruinous mental-health system.
U.S. Rep. Timothy Murphy, R-Pa., a licensed psychologist, has introduced a sweeping reform measure that would devote more attention to immediate, and even compulsory, treatment to the “seriously mentally ill” — those in the grips of wretched diseases that can make them an immediate threat.
Murphy’s bill would also force doctors to relax some of the harmful privacy restrictions that now keep them from disclosing crucial information to the families of those most affected by mental illness.
These reforms are a long time coming. But a competing bill introduced by U.S. Rep. Ron Barber, D-Ariz., does more to protect the entrenched interests of the community health partnerships that offer a broad range of services — some of them notoriously ineffective — to a wider clientele. Such initiatives include marriage counseling and substance-abuse education, which are frequently duplicated by other agencies.
Barber’s measure throws more money at a broken system without demanding real reforms. Most strikingly, it does little to address the pressing needs of the serious- ly mentally ill — one of whom, it must be said, was Jared Loughner, a paranoid schizophrenic who picked up a discount-store handgun and shot then-U.S. Rep. Gabrielle Giffords in the head at a supermarket in 2011. Barber himself took two bullets and nearly died. Six others lost their lives. (Disclosure: I worked with Barber on one of Giffords’ election campaigns).
As with any congressional attempt to shake up an industry, the loudest hollering is often in service of the economic interests of the status quo. Mental health has been a lucrative business since the days when Gothic-looking sanitariums were the primary places of residence for anyone judged to be too incapable to live on their own. The asylums pioneered some humane ad- vances in treatment but were sometimes used as dumping grounds for eccentric relatives and as havens for greedy doctors all too happy to collect payments for a lifetime.
That era came to close in 1963 when John F. Kennedy signed a law to deinstitutionalize the mentally ill, setting them free to live independent lives and receive counseling and drugs from outpatient clinics. The approach worked in some cases but failed miserably in others and created a persistent culture of homeless mentally ill that persists today.
When you look at Los Angeles’ Skid Row, the beating deaths of the mentally ill at the hands of police or the stunning level of psychotic suffering in any jail cellblock in America, you’re seeing the poisonous effects of wellintentioned social policy gone bad. Unless they come from privileged families, the seriously mentally ill — SMI in industry parlance — are frequently bounced between jail and the streets in a miserable cycle that ends in death.
Critics of Murphy’s plan, many of whom make their livings from Big Mental Health and profit the most from the current misallocation of resources, complain that it will return us to an era of “One Flew Over the Cuckoo’s Nest” asylums and rubber rooms. This is nonsense.
It only increases Medicaid reimbursements for psychiatric bed space and asks state legislatures to make it easier for judges to require involuntary treatment for SMI patients. This is where the suffering is greatest and where the real threat to public safety resides.
Had Loughner been ordered into a facility, it is probable that the Safeway shooting that killed six people would never have happened. While the Barber bill mandates programs to counter school bullying that leads to mental illness, it fails to offer tougher protections against preventable mass shootings. Not every state, for example, yet has a version of California’s neces- sary “5150” provision, which permits police to ask for the confinement of an SMI person who poses an imminent threat. Had the Santa Barbara County Sheriff’s Office checked California’s gun-purchase list when they paid a call on a future killer last month, six college students might not have died.
This must be said: Violent behavior is quite rare among the mentally ill, and the gunrampage worries are centered among a small fragment of the SMI. Should the Barber bill prevail, citizens would be right to wonder if the next public slaughter (and another is surely coming) might have been stopped while mentalhealth funding was being squandered on redundant programs and vacuous studies.
The grease in the gearbox of our two-party system has always been a willingness among politicians to acknowledge that the other side occasionally had good ideas and more-sensible priorities and to have the courage to vote their dissent. This is a case where Democrats in Congress need to stop coddling a powerful corporate interest and start using taxpayer resources for the highest and greatest good. It will be a disgrace — and a public-health risk — if the curious sickness of blind partisanship gets in the way.