HR 2646 is a piece of mental health legislation currently in the House energy and commerce committee. If passed, it will promote coercion, segregation, the removal of patient’s rights and a one dimensional scope of mental health care. Thanks to efforts made by mental health advocates, disability advocates and others Tim Murphy has been forced to revise his original bill. Unfortunately, the new Murphy Bill still contains many provisions that are a detriment to Americans who are diagnosed with mental illness.
HR 2646 creates an assistant secretary that will oversee the Substance Abuse and Mental Health Service Administration (SAMHSA) who is imbued with a vast array of powers over the organization. Tim Murphy originally wanted to take most of the funding away from SAMHSA. Although the new Murphy Bill doesn’t cut funding for SAMHSA, it is likely that with the appointment of this assistant secretary the effect will be similar. This assistant secretary is unlikely to approve funding the many mental health programs that people diagnosed with mental illness find helpful.
The Murphy Bill makes it so that only “evidence based” care receives grant funding from SAMHSA. What is qualifies and “evidence based” is subject to interpretation. Certain studies indicate that medications used to treat mental illness actually do more harm than good and people who do not take medications or take them in smaller doses in conjunction with talk therapy do better. However, these studies are likely to be overlooked when determining what evidence based care is in America if the Murphy Bill passes. The pharmaceutical industry is a major financial contributor to Tim Murphy and it is likely that drug treatment will be promoted heavily in America if the Murphy bill is passed into law.
The Murphy Bill will provide a 2 percent increase in block grant funding to states that have an assisted out-patient treatment (AOT) law. AOT is a coercive practice that forces someone to take medication under court order. It is falsely believed that AOT improves public safety. Studies show that people with mental health diagnosis are not more violent than the general population. Also, Compared head to head with a program of enhanced and coordinated mental health services AOT is no more effective at preventing acts of violence and arrests in patients. Furthermore, coercive practices like AOT actually hinder a patient’s mental health care. Studies show that coercion undermines the therapeutic alliance, the relationship between psychiatrist and patient built upon the mutual goal of the patient’s recovery.
The Murphy Bill weakens the Protection and Advocacy for Individuals with Mental illness program (PAIMI). PAIMI is a national network of mental health advocates that provide legal aid for individuals diagnosed with mental illness. The Murphy Bill changes PAIMI it so that the program cannot lobby public officials and thus have a voice in issues that affect the lives of people diagnosed with mental illness. The Murphy Bill makes it so PAIMI advocates are limited to focusing exclusively on instances of abuse and neglect in patients. Because of this, if the Murphy Bill passes PAIMI advocates will not be allowed to advocate for patients when they are discriminated against because of their mental health diagnosis or minority status. Finally, the Murphy Bill restricts PAIMI advocates from counseling patients to refuse medical treatment or acting against the wishes of a patient’s caregiver. This restricts PAIMI advocates from advising patients to refuse medical treatment if it becomes harmful and even taking action in instances where doctors are abusing their patients.
The Murphy Bill erodes privacy protections for people diagnosed with mental illness. The Murphy Bill changes HIPPA so “caregivers” are allowed to access to a patient’s private medical records without the patient’s consent. This change applies specifically to people diagnosed with serious mental illness. Changing privacy protections in HIPPA in this manner is discriminatory against people with a mental health diagnosis. This change leaves patient’s with a mental health diagnosis with a lower standard of privacy compared to ordinary citizens. Furthermore, changing HIPPA like this may deter patients from seeking mental health care. Patients may no longer feel confident that their mental health records are kept private and thus avoid seeking help when they need it.
The Murphy Bill repeals the IMD exclusion, the Medicaid rule that prevents mental health institutions with 16 beds or more from receiving federal Medicaid funding. This provision will lead to states to defunding community based mental health services and directing it toward psychiatric hospitals. IMD exclusion was created to keep mental patients from being warehoused in institutions which were breading grounds for abuse and neglect. Segregating mental patients from the general population is a regressive approach to mental health care. Instead the US needs to create more effective community-based mental health services which have been underfunded ever since deinstitutionalization began in the 1960’s.
The Murphy Bill will not fix the problems with the U.S. mental health system. Access to community based mental health supports is inadequate in the U.S. People better access to housing, vocational programs and peer support, things that will allow them to live successfully in the community. The Murphy Bill does little to address these needs. Instead, the Murphy Bill promotes policies and practices that will needlessly subject millions of Americans to coercive medical care and the loss of rights. The Murphy Bill is the absolute wrong approach to mental health reform in the U.S. Stop Murphy’s Law!
Here are four quick and easy things you can do:
1) Write or call your Congressman:
https://www.usa.gov/elected-officials
Two quick ways to contact your representative: http://goo.gl/ReJ3Wi, http://goo.gl/p0KZfj
2) Sign the Oppose HR 2646 petition on Change.org: https://goo.gl/qf2GMB
3) Follow @stopmurphyslaw and @realmhchange on twitter
4) Contact the National Alliance on Mental Illness (NAMI) and demand they change their position on HR 2646
Post on NAMI’s facebook page here: https://www.facebook.com/NAMI/
Email NAMI: MHPolicy@nami.org
Contact your local chapter of NAMI: https://www.nami.org/
Stop the Murphy Bill 