Addressing the Mental Health Crisis in America
Floor Speech
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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, 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;
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.
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