TOM ZOELLNER

Mental health reform done right

Rep. Tim Murphy’s bill would address the most serious problems

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Here’s an acknowledgement from a two-time Obama doorknocker: The Republicans have a much better plan on the table than the Democrats for fixing our ruinous mental-health system.

U.S. Rep. Timothy Murphy, R-Upper St. Clair, a licensed psychologist, has introduced a sweeping reform measure that would devote more attention to immediate, and even compulsory, treatment for the “seriously mentally ill” — those in the grips of wretched diseases that can make them an immediate threat. Mr. Murphy’s bill would also force doctors to relax some of the harmful privacy restrictions that now keep them from disclosing crucial information to the families of those most affected by mental illness.

These reforms are a long time coming. But a competing bill introduced by Rep. Ron Barber, D-Ariz., does more to protect the entrenched interests of the community health partnerships that offer a broad range of services — some of them notoriously ineffective — to a wider clientele. Such initiatives include marriage counseling and substance-abuse education, which are frequently duplicated by other agencies.

Mr. Barber’s measure throws more money at a broken system without demanding real reforms. Most strikingly, it does little to address the pressing needs of the seriously mentally ill — one of whom was Jared Lee Loughner, a paranoid schizophrenic who picked up a discount-store handgun and shot then-Rep. Gabrielle Giffords in the head at a supermarket in 2011. Mr. Barber himself took two bullets and nearly died. Six others lost their lives.

(Disclosure: I worked with Mr. Barber on one of Ms. Giffords’ election campaigns).

As with any congressional attempt to shake up an industry, the loudest hollering is often in service of the economic interests of the status quo.

Mental health has been a lucrative business since the days when Gothic-looking sanitariums were the primary places of residence for anyone judged to be too incapable to live on their own. The asylums pioneered some humane advances in treatment but were sometimes used as dumping grounds for eccentric relatives and as havens for greedy doctors all too happy to collect payments for a lifetime.

That era came to close in 1963 when John F. Kennedy signed a law to begin deinstitutionalizing the mentally ill, setting them free to live independent lives and receive counseling and drugs from outpatient clinics. The approach worked in some cases but failed miserably in others and created a persistent culture of homeless mentally ill that persists today.

When you look at skid rows, the beating deaths of the mentally ill on the streets or the stunning level of psychological suffering in any jail cellblock in America, you’re seeing the poisonous effects of well-intentioned social policy gone bad. Unless they come from privileged families, the seriously mentally ill — SMI in industry parlance — are frequently bounced between jail and the streets in a miserable cycle that ends in death.

Critics of Mr. Murphy’s plan, many of whom make their livings from Big Mental Health and profit the most from the current misallocation of resources, complain that it will return us to an era of “One Flew Over the Cuckoo’s Nest” asylums and rubber rooms.

This is nonsense. His bill only would increase Medicaid reimbursements for psychiatric bed space and ask state legislatures to make it easier for judges to require involuntary treatment for SMI patients. This is where the suffering is greatest and where the real threat to public safety resides.

Had Loughner been ordered into a facility, it is probable that the Safeway shooting that killed six people never would have happened.

While the Barber bill mandates programs to counter school bullying that leads to mental illness, it fails to offer tougher protections against preventable mass shootings. Not every state, for example, yet has a version of California’s necessary “5150” provision, which permits police to ask for the confinement of an SMI person who poses an imminent threat. Had the Santa Barbara County sheriff’s office checked California’s gun-purchase list when paying a call on a future killer last month, six college students might not have died.

This must be said: Violent behavior is quite rare among the mentally ill, and the gun-rampage worries are centered among a small fraction of the SMI. Should the Barber bill prevail, citizens would be right to wonder if the next public slaughter (and another is surely coming) might have been stopped while mental-health funding was being squandered on redundant programs and vacuous studies.

The grease in the gearbox of our two-party system has always been a willingness among politicians to acknowledge that the other side occasionally has good ideas and more-sensible priorities and to have the courage to vote their dissent.

This is a case where Democrats in Congress need to stop coddling a powerful corporate interest and start using taxpayer resources for the highest and greatest good. It would be a disgrace — and a public health risk — if the curious sickness of blind partisanship gets in the way.

Tom Zoellner, a former reporter for the Arizona Republic, is the author of “A Safeway in Arizona: What the Gabriele Giffords Shooting Tells Us About the Grand Canyon State and Life in America.” A version of this column first appeared in The Press-Enterprise of Riverside, California.


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