EDITORIAL: Support U.S. House's mental health care reform

Nov. 04--There's news on the issue that the Herald flagged on our Sunday edition's front page.

The issue is the huge number of people with serious mental illnesses who wind up in jail, and usually in jails woefully ill-equipped to treat their condition ("Locked out," Page A1, Nov. 1).

And the news:

Surprisingly, it's good news. And what a welcome development that is for an issue that poses such a tough policy challenge.

The news is that reforming America's mental health system is one of those rare issues that actually has bipartisan support in Congress. As evidence, a notable reform--the House's Helping Families in Mental Health Crisis Act of 2015--has moved through the hearing stage and now has reached mark-up, the last step in the committee process before a bill reaches the House floor.

In fact, mark-up of the bill actually begins in the House today.

The Helping Families in Mental Health Crisis Act already boasts 158 co-sponsors. They include 45 Democrats and 113 Republicans, significant bipartisan support that bodes very well for the bill's prospects of becoming law.

Those co-sponsors include both Reps. Collin Peterson, D-Minn., and Kevin Cramer, R-N.D., the congressmen from both sides of the Red River in the northern Red River Valley.

Minnesotans and North Dakotans likewise should rally, while taking heart in this example of the political process at work.

The bill "is the most far-reaching and serious attempt at mental-health reform in recent memory," write Drs. Sally Satel and E. Fuller Torrey, both psychiatrists, in the current issue of National Review.

That's because the bill reins in the policy "over-reaches" that helped bring about the current problems.

For example, a big reason why there are "10 times as many mentally ill people in jails and prisons as there are in hospital beds," as the physicians acknowledge, is the deinstitutionalization of the mentally ill that began in the 1960s and 1970s.

Two movements put thousands of Americans with serious mental illnesses in homeless shelters and in jails, rather than in long-term treatment. The first was the closure of most of the nation's mental hospitals.

The second was the civil-rights effort that now prevents the involuntary commitment of any but the most threatening people with serious mental illnesses.

The House bill, like its companion bill in the Senate, tackles both of those changes. For example, the bill supports assisted outpatient treatment, "a cost-saving and effective form of civil-court-ordered community treatment," Satel and Torrey describe.

AOT is "aimed at individuals who have an established pattern of falling into a spiral of self-neglect, self-harm or dangerousness when off medication. ... Data from multiple AOT programs indicate they reduce crime, violence (including suicide attempts) and victimization of the mentally ill when diligently enforced."

Likewise, a 1965 law blocks Medicaid from paying for the treatment of most adults in mental hospitals. As a result, "from a nationwide peak of around 560,000 psychiatric beds in 1955, the total has been whittled down to about 35,000 today, half the number experts estimate is needed," the authors write.

The House bill corrects this Medicaid disincentive. The change should ease the shortage of both beds and money for the treatment of patients with serious mental illness.

The bill has the support of the American Jail Association, the National Alliance on Mental Illness, the American Academy of Child and Adolescent Psychiatry, the American Psychological Association and the American Psychiatric Association, among other groups. It stands a good chance of becoming law, and that would be a welcome development in an area in which such milestones are too few.

-- Tom Dennis for the Herald

___

(c)2015 the Grand Forks Herald (Grand Forks, N.D.)

Visit the Grand Forks Herald (Grand Forks, N.D.) at www.grandforksherald.com

Distributed by Tribune Content Agency, LLC.