WASHINGTON, D.C.—Paul Gionfriddo, president and CEO of Mental Health America (MHA), testified today before the U.S. House of Representatives Committee on Energy and Commerce, Subcommittee on Health regarding H.R. 2646, The Helping Families in Mental Health Crisis Act of 2015.
“In our view, H.R. 2646 is an important start to making comprehensive mental health reform a reality in America,” stated Gionfriddo. “Its emphasis on moving upstream in the process – i.e., on intervening before Stage 4 – is a critical step forward toward treating mental illnesses like we treat every other chronic disease.”
While MHA did not support the previous version of the bill, the Helping Families in Mental Health Crisis Act of 2013, the organization along with its 200+ affiliates and advocates around the country have been working tirelessly to address the specific faults of the original legislation. MHA is pleased that the bill’s author, Representative Tim Murphy (R-Penn.), was open to some important suggested changes and believes this version is a vast improvement.
Quite significantly, the legislation includes funds for screening, early intervention and treatment programs. MHA believes that screening is the doorway to services and treatment, and is a key component of MHA efforts to address mental illness before Stage 4. In the spring of 2014, Mental Health America launched online screening tools through our website at www.mhascreening.org. To date, nearly one half million screens have been completed.
“H.R. 2646 makes screening – especially for children and young adults – a part of the innovation grants, the demonstration grants, the youth suicide prevention program, and the campus mental health program, among others,” testified Gionfriddo. “And in legislation that emphasizes building on evidence-based programs, we note the importance of innovation – because today’s evidence-based program is yesterday’s well-evaluated innovation.”
Speaking as a former state legislator and mayor, as well and father of a son with schizophrenia who showed signs of the disease when he was a young child, Gionfriddo urged the committee to expand on opportunities to integrate health and educational services for our children.
“Throughout [Tim’s] school years, we sought special education services for him and were frequently rebuffed,” said Gionfriddo. “This is because those of us making policy a generation ago were not thinking about children like Tim as we implemented our modern special education laws. Today only 362,000 children in the country receive special education services because of an “SED” label. That represents only one child in every 28 that NIMH says has a ‘serious’ mental health condition or concern. This represents too many tragedies still waiting to happen.”
While the legislation is a good first step, MHA also sees areas for needed improvement. Gionfriddo spoke of the organization’s interest in seeing the following adjustments made to the legislation:
- While MHA has always supported SAMHSA and endorses the empowerment and elevation of the lead federal behavioral health agency in the legislation, it believes it is time to enhance the federal agency. MHA endorses the empowerment and elevation of the lead federal behavioral health agency in this legislation, but hopes Congress will consider adding two additional responsibilities to it. The first would be to establish a common standard other than “danger to self or others” as a trigger to treatment for SMI, because this is not a clinical standard. The second would be to develop a national plan that would result in an end to the incarceration of nonviolent people with serious mental illnesses.
- MHA supports the efforts to enhance the mental health workforce and has been working for years to develop a properly-credentialed peer workforce. MHA urges lawmakers to work with the organization on the most appropriate way to develop a properly-credentialed peer workforce that could work competitively in clinical settings.
- With respect to Assisted Outpatient Treatment (AOT), MHA supports the approach this legislation takes not to mandate it nationwide. MHA encourage the committee’s review of language that may appear to be in conflict with the intent of the sponsors and revise it if need be.
- MHA supports the changes to the privacy rules, because the current rules are an impediment to integrating health and behavioral health care. One cannot fully integrate care with only half a medical record. That said, MHA is concerned that that meeting simultaneously the six conditions spelled out in the bill may be so difficult and time-consuming for providers that many will not try. Gionfriddo suggests as an alternative clarifying the relevant law to eliminate the “super authorization” needed to share behavioral health information. This will promote integration without compromising an individual’s right to manage the release of his or her protected health information.
Finally, while MHA understands the need to offset new expenditures with reductions in other areas, there is significant concern amongst advocates that the offsets might come from existing community mental health programs, resulting in the loss of services around the country that are lifelines to people with serious mental illnesses.
“If you want to find offsets, please look to our jails and prisons,” declared Gionfriddo. “By sending so many of our children like my son Tim to those 21st Century asylums, that’s where we’ve sent the funding we need for mental health services today.”
