The last piece of legislation that President John F. Kennedy signed into law was the Community Mental Health Act on Oct. 31, 1963. In addition to being the last bill that Kennedy signed before his assassination that fateful November day in Dallas, the Community Mental Health Act was the last mental health reform bill to be signed by a president. More than a half century has gone by and nine more presidents have sat in the Oval Office and there hasn’t been a federal law passed to significantly improve our nation’s mental health system. That could change next month.
We are on the cusp of passing meaningful mental health legislation in the Senate – the Mental Health Reform Act of 2016 (S.2680) -- following passage earlier this summer of a similar bill in the House by an overwhelmingly large margin.
The need is abundantly clear. More than 68 million Americans have experienced mental illness in the past year, which is more than 20 percent of the total population in the United States. In 2013, more than 41,000 Americans died by suicide. Many people with mental illness or substance use conditions and their families are unable to access care and are constantly challenged by a mental health delivery system that is fragmented and uncoordinated. Far too many Americans with mental illness get their care not from physicians’ offices or hospitals, but rather from our nation’s jails and prisons. In most states, the largest mental health provider is a correctional facility.
The Mental Health Reform Act – a bipartisan bill introduced by Sens. Bill Cassidy (R-La.) and Chris MurphyChristopher (Chris) Scott MurphySenators slow Biden with holds at Pentagon, State Tell our troops: 'Your sacrifice wasn't in vain' Sunday shows preview: Bombing in Kabul delivers blow to evacuation effort; US orders strikes on ISIS-K MORE (D-Conn.) – proposes a number of significant changes to our mental health care system. Passage of the bill would:
- Improve coordination of federal mental health services by requiring the Substance Abuse and Mental Health Services Administration (SAMHSA) to collaborate with other agencies and create an Interagency Serious Mental Illness Coordinating Committee. Furthermore, the bill creates a Chief Medical Officer post at SAMHSA to ensure the use of evidence-based best practices.
- Address the shortage of psychiatric and mental health providers by reauthorizing education training grants. SAMHSA will be required to report frequently on the efforts to recruit the next generation of mental health providers.
- Strengthen the enforcement of the Mental Health Parity and Addiction Equity Act of 2008, which requires that insurers treat mental illness the same as physical illness. However, lax enforcement and loopholes enacted by insurance companies have undermined the law. The Senate bill will require annual reports on parity compliance investigations from federal departments and give the Government Accountability Office the authority to investigate compliance with the parity law and to issue guidance to health plans on disclosing treatment limitations to patients.
Bipartisan support for mental health reform is strong, only two representatives voted against mental health reform when it passed the House on July 6. But time is running out for this Congress to pass this important legislation. Every day, my fellow psychiatrists are witness to their patients’ experience of the frustrations, confusions and stigma brought on by a broken mental health system. The time to act is now.
Dr. Maria Oquendo is President of the American Psychiatric Association and Professor of Psychiatry and Vice Chair for Education at Columbia University Medical Center.
The views expressed by authors are their own and not the views of The Hill.