An Opportunity for Comprehensive Mental Health Reform

JUN. 17, 2015

By Mary Giliberti, J.D.

Rep. Tim Murphy
Rep. Tim Murphy introducing the "Helping Families in Mental Health Crisis Act of 2015" to members
of Congress on June 10


Representatives Tim Murphy (R-Pa.) and Eddie Bernice Johnson (D-Texas) have introduced HR 2646, the "Helping Families in Mental Health Crisis Act of 2015." This introduction begins a legislative process toward mental health reform, which is long overdue. NAMI has submitted a letter of support to Representatives Murphy and Johnson indicating our appreciation of their leadership and our commitment to work with them to pass comprehensive mental health legislation. 

HR 2646 has many positive aspects, including provisions to improve integration of mental healthcare and physical healthcare in Medicaid, spur early intervention in the treatment of psychosis, improve the use of health information technology in mental health care and provide resources for suicide prevention. HR 2646 also contains provisions designed to improve data collection and outcomes measurement and expand the availability of evidence-based services. It contains provisions to remove discriminatory barriers to acute inpatient treatment in Medicaid and Medicare and it advances enforcement of the mental health insurance parity law as well.

HR 2646 also addresses issues that have generated much discussion within NAMI and other organizations, such as the Health Insurance Portability and Accountability Act (HIPAA) and access to information for caregivers, the role of the Substance Abuse and Mental Health Services Administration (SAMHSA), the Protection and Advocacy System and Assisted Outpatient Treatment (AOT).

We have carefully reviewed the bill and believe it takes a more thoughtful approach to these complex issues. However, we have heard from many of you and are very aware that there are strong, diverse opinions about these issues and some questions about the new provisions. For example, members and leaders have asked questions about the scope of the Protection and Advocacy systems’ jurisdiction under the new "abuse and neglect" standard and whether that includes advocacy for housing and recovery supports, which is an important question that we will seek to clarify as the bill moves forward.

Some of you know the process on Capitol Hill well, but for those who do not, here are next steps. The next stage of the legislative process is a mark-up in committee where the bill gets careful consideration and sometimes amendments are offered. Then, it would go to the floor of the House for a vote.

We also understand that Senators Chris Murphy (D-Conn.) and Bill Cassidy (R-La.) are working on a Senate version of the bill. It is not likely to be identical, but it will address many of the same issues to improve the mental health system for people with serious mental illness. The Senate will also need to carefully consider their bill in committee and then it would be voted on by the Senate. Often the next step is a Conference Committee to reconcile differences between the House and Senate versions of legislation before it goes to both Houses for a final vote. Although it may seem like a long process, NAMI is very hopeful regarding legislative action given that the efforts in both Houses are bipartisan.

This year, we have an unprecedented opportunity to pass legislation to improve mental health services. It is very important that NAMI is at the table as this process ensues. We look forward to continuing our dialogue together because NAMI, more than any other organization, understands that the status quo is unacceptable and needs to change. As the bills work their way through this process, we would like to continue hearing from all of you. If you have thoughts about the bill or mental health reform in general, please email us at I can’t promise you we will have the time to respond to each email but I can promise you that we will read and consider every one carefully.

The hallmark of NAMI is an inclusive community of individuals, families and friends whose lives have been changed by the experience of mental illness. These experiences make us very passionate about these issues. Passion will be important because we will not get mental health reform without it. But passion cannot get in the way of respectful dialogue, understanding and listening to the perspectives of others. Only by talking together and reviewing information with an open mind and in recognition of the ongoing process will we achieve reform that promotes recovery and wellness for all people with mental illness, including those with the most serious conditions.

It is unlikely that all NAMI supporters will agree with all provisions or all changes that have been made to the bill already and those that may be made in the future. But hopefully, we all can get behind the need for comprehensive reform and by working and talking together, we can achieve final legislation that will significantly improve lives.

Before Congressman Murphy focused on these issues, there was little discussion in Congress. Now there is momentum and bipartisan support. NAMI will continue to listen to our members and leaders as the legislative process continues and we will tirelessly work for a better system for those affected by mental illness. We will also continue to communicate regularly with you about the bill and the issues it addresses.

Thank you for your leadership and advocacy!

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