By Daniel Fisher, President, National Coalition for Mental Health Recovery
Wake up, advocates, before it is too late. Representatives Murphy and Johnson’s bill, the Helping Families in Mental Health Crisis Act (H.R. 2646) is a much greater threat than you realize. This bill is a direct attack on the core values of our mental health recovery movement of empowerment and community integration by its emphasis on coercion and institutionalization. It is an attack on all the work we advocates have done over 40 years as far as recovery, deinstitutionalization, and rights for persons labeled with mental illness. Its intent is to extinguish our vision of recovery.
This proposed legislation robs people of hope because it is based on a false belief that people never recover, and must be controlled and maintained in the same psychiatric institutions from which people have gradually been freed. This is not evidence-based legislation. It is a denial of the evidence that when provided voluntary community supports, people recover from even the most severe conditions. Every element of the legislation is disempowering and attacks our values of recovery by: its intent to expand outpatient and inpatient commitment, its loosening of confidentiality, its expansion of payments for institutional care at the expense of community care, its call to dismantle SAMHSA, the agency that has carried out the New Freedom Commission (NFC) for Mental Health’s call for recovery-oriented systems, and its curtailing of the capacity of the Protection and Advocacy organizations’ to promote system change, while providing no new money for mental health services.
Some supporters of the bill are saying we have to rebuild asylums to prevent incarceration in jails and prisons. But we cannot financially, legally, or morally afford to rebuild asylums. The Supreme Court’s Olmstead Decision and the ADA upon which it is based have stated that people should not be institutionalized if they are capable of living in the community. But we need legislation that creatively expands opportunities and funding for voluntary, community-based alternatives to coercive institutions such as:
- Reforming of Medicaid and Medicare, so they can fund recovery and community integration rather than simply medication & symptom reduction
- Enabling Medicaid funding of economical peer-run respite care, crisis stabilization, and cooperative apartments rather than nursing homes and hospitals
- Expanding of housing first programs and new housing subsidies to alleviate the dead end of homelessness.
- Expanding of cost-effective, consumer-run recovery centers and technical assistance centers to support them
- Expanding training and hiring of peers into all organizational levels of the system
- Expanding training and support for persons with lived experience to be meaningfully involved in policy and evaluation
- Developing promising clinical approaches, such as Open Dialogue, that reduce over dependence on medication
- Strengthening the P&As so they can ensure that the potential of the Olmstead Decision is fulfilled
The most ominous aspect of this Murphy legislation is its intent to silence the voice of persons with lived experience in the formation of its provisions and in future policy development. The disability world in general and mental health world in particular has had a long history of highlighting the centrality of the voice of consumers in policy formation. This principle is formalized in the regulations concerning the expenditure of Mental Health Block grant funds. In addition, the NFC report concluded that the transformation of the mental health system should be consumer- and family-driven. In contrast, the Murphy bill calls for the new advisory body to the Assistant Secretary of MH and SUD to consist of mainly of clinicians with a lone spot for a person with lived experience, but he/she had to have received mental health services in the last two years.
Rather than further amending this fatally flawed proposed legislation, I recommend it be stopped and the drafting begin anew with the 115th Congress. Congress could use the example of the disability community in its drafting of the ADA. There was true involvement of leaders with disabilities and it was bipartisan. We need to pressure Congress to accept the theme of our movement and every civil rights movement: “Nothing about us without us.” Congress needs to realize that the only truly evidence-based system is one that is based on our voice and experience, because “We are the evidence that people recover.”
Wake up and contact your Congressperson, and let them know that Rep. Tim Murphy’s Bill, HR 2646, is dangerous to recovery and should not progress any further. As Justin Dart said, “Fight as if your life depends upon it because it does.”
Contact info – National Coalition for Mental Health Recovery (NCMHR): 877-246-9058; www.ncmhr.org; [email protected].
