Mental health overhaul draws heated discussion

Proponents favor flexibility; foes say privacy is sacrificed

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WASHINGTON -- Mental health advocates were at odds Thursday during a congressional hearing on a sweeping overhaul that would increase accessibility of care while expanding the use of involuntary treatment and allowing family members and caregivers to intervene in cases involving the severely mentally ill.

Sponsored by Rep. Tim Murphy, R-Upper St. Clair, the bill has drawn mixed reactions from lawmakers, providers, mental health researchers and patients, including some who testified Thursday at a hearing of the House Energy and Commerce Committee.

The hearing came a day after a mass shooting at Fort Hood, Texas, and two days after police said a McCandless woman killed one son and critically injured another by submerging them in the bathtub after hearing voices.

In an interview, Mr. Murphy, a child psychologist, said his bill might have prevented those incidents by increasing opportunities for the perpetrators to receive treatment.

The bill would allow providers more flexibility to communicate with family members and caregivers in certain cases, for example, those involving patients who can't make medical decisions for themselves and/or don't acknowledge they are mentally ill.

Some witnesses at the hearing testified that patient privacy laws kept them from intervening to help relatives tormented by delusions, depression, paranoia, raging anger and suicidal thoughts.

"I believe in self-determination for those who are capable, but we must recognize that there is a small group of people, like my mother, who are too ill to self-direct their own care," testified Sylvia Thompson, who now is president of the National Alliance of Mental Illness Westside Los Angeles.

Ms. Thompson also spoke in favor of provisions of Mr. Murphy's bill that would allow courts to order involuntary outpatient treatment and would allow providers more discretion to involuntarily commit to inpatient facilities.

Currently patients can be treated against their will only if they show they are an imminent danger to themselves or others. The Murphy bill would allow providers to weigh a variety of factors including whether patients are able to provide for their basic needs, whether they are able to keep themselves safe and whether their condition is likely to substantially deteriorate without treatment.

The current system doesn't help people who aren't well enough to volunteer for treatment, and police can't help until they have become dangerous, Ms. Thompson said.

"I understand patient rights. I wholeheartedly believe in them. I help fight for them. But when someone lacks the capacity we need to take care of them, and that did not happen with my mother. She fell through the cracks over and over and over again," Ms. Thompson testified.

Witness Nancy Jensen disagreed. She is the author of "The Girl Who Cried Wolf," a memoir about her abuse in a Kansas group home for people with mental illness.

"This takes away the rights of individuals, including the right to choose their treatment," Ms. Jensen testified.

"I am also concerned that this bill would decrease the privacy protections of individuals with mental illnesses ... in order to provide families more access to information when it is not needed," she said. "Families already have access to a lot of information about their loved ones."

The advocacy group Mental Health America also has concerns about the Murphy bill.

"We strongly believe that some aspects of the legislation, while well intended, will ultimately result in damage to the system," testified David L. Shern, the group's president and a research psychologist.

Mr. Murphy said his aim is to help some of the 3.6 million seriously mentally ill people who are not receiving treatment.

He said his bill would break down barriers preventing providers from talking with parents and caregivers about loved ones who are in a mental health crisis, expand access to care, ensure only evidence-based programs receive funding, and increase opportunities for early intervention.

"For far too long, those who need help have been getting it the least. And where there is no help, there is no hope," he said. "We can, must, and will take mental illness out of the shadows of ignorance, despair and neglect and into that bright light of hope."

Bureau chief Tracie Mauriello:, 1-703-996-9292 or on Twitter @pgPoliTweets.

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