Earlier this month, the Health Subcommittee of the House Energy and Commerce Committee marked up H.R. 2646, the “Murphy Bill” on Mental Health. This weekend, Paul Ryan, newly elected Speaker of the House, commented that passing the bill is a priority in order to address mass shootings.
This is simply promoting prejudice against people with disabilities. There is no evidence that any of the policy changes under the Murphy Bill could have an effect on violence. Many studies confirm that people diagnosed with “mental illness” are no more likely to commit violence than similarly situated individuals not diagnosed. Factors such as age, sex, where a person lives, and use of alcohol or other drugs have the strongest correlation with violence.
H.R. 2646 includes several provisions harmful to people with disabilities:
- People with psychiatric disability will have a lower level of protection under federal health and education privacy rules;
- It promotes institutional services by modifying the Institutions for Mental Diseases (IMD) rule to allow Medicaid payments for hospitals and nursing facilities for people with psychiatric disability;
- It promotes involuntary treatment (euphemistically called “Assisted Outpatient Treatment”), limiting federal aid for community mental health services to states that fail to have laws conforming to the new standards; and
- It restricts protection and advocacy services for people with psychiatric and other disabilities under the federal P&A program.
The bill also dismantles the federal Substance Abuse and Mental Health Services Administration, replacing it with a new bureaucracy under a new Assistant Secretary for Health and Human Services. The new Assistant Secretary would have to be a Medical Doctor or Ph.D. Psychologist. These provisions include restrictions on peer-to-peer services and a decreased role in policy for stakeholders other than doctors and psychologists.
Some national mental health organizations have supported the bill because it reauthorizes a number of federal mental health programs, including the Garrett Lee Smith suicide prevention program. It also authorizes new programs. However, these are not likely to come with any new funding. Other than the Medicaid changes (estimated to cost $3 billion or more), there is no anticipated increase in funding for services.
The bill has passed through the Health Subcommittee and is expected to have a markup in the full Energy and Commerce Committee within the next few weeks.
Take Action
- Writing the House Energy and Commerce Chair and Ranking Member is the highest priority. Please contact Representative Fred Upton (Chairperson) and Representative Frank Pallone (Ranking Member).
- The bill may also require action by the House Education and the Workforce Committee (because of the Educational Privacy provisions) and the Ways and Means Committee (because of the Medicaid / Medicare provisions). Please contact your Representatives, especially those on the House:
Tell them to oppose H.R. 2646 because we cannot tolerate discrimination against people with disabilities.
It would also help to work with other local and state disability advocates to get their help to stop this bill. The NCIL Mental Health Subcommittee can use help in its work to protect the civil rights of people with psychiatric disabilities.
