Tim Murphy calls for nationwide mental health reform bill

This past week at Heinz College, U.S. Representative Tim Murphy of the 18th congressional district of Pennsylvania spoke about his recent bill, the Helping Families in Mental Health Crisis Act of 2015. Describing the alarming state of mental health issues in America today, Murphy demonstrated that our current laws are inadequate in terms of providing a solution.

Currently, Murphy is the only practicing mental health professional in elected government and one of only a handful in government with a background in healthcare. He pointed out that 60 million Americans a year are diagnosed with some type of mental illness, ranging from very mild and transient cases to severe disorders like schizophrenia, bipolar disorder, and major depression. Of the approximately 10 million people with severe mental illness, around four million do not get treatment, or even recognize that they have mental illness.

Emphasizing that severe mental illness is a brain disorder and “not an attitude,” Murphy spoke about misguided views on the causes of mental illness that were thought to be true not too long ago, such as blaming schizophrenia on the “schizophrenogenic mother” or autism on “refrigerator parents.” Despite the fact that we’ve now realized how baseless these claims are through the discovery of genetic markers, Murphy said that “a lot of what we’ve been doing in the mental health field hasn’t really changed much for the last century or so.”

To illustrate his point, Murphy referred to the 19th century American activist Dorothea Dix. Dix sympathized with the brutal treatment and imprisonment of numerous mentally ill people, and subsequently created America’s first psychiatric hospitals. Initially serving as places of rest where the mentally ill could get better, psychiatric hospitals “became places where we dumped people [when] we didn’t want to see them,” Murphy said. “We’d send people to the ‘funny farm,’ the ‘loony bin,’ the ‘cuckoo’s nest.’”

As World War II ensued and doctors and nurses were called away to the fight, psychiatric hospitals employed many people who had minimal training, while becoming more and more packed. “Institutions that were there perhaps to house originally a few hundred, became the homes of a few thousand,” Murphy said. In the 1960s and 70s, after a civil rights movement for mental health, two sides emerged. While some people believed too much money was being spent on mental health, others fought for patients’ rights, recognizing the struggle of people who could be easily put away by relatives signing a form and were held captive in psychiatric institutions where abuse and neglect were rampant. Eventually, in the 1980s and 90s, many mental institutions were closed in response to both sides.

In part, the development of medications and psychotherapy did effectively treat some people and reduce the number of those who needed psychiatric help. However, another aspect of the decline of psychiatric hospitals was the subsequent increase in prisons. As more people were let out of mental institutions, some with severe disorders committed crimes. Some, who couldn’t take care of themselves, became homeless. And some were sent to the emergency room where, if there wasn’t enough space and they were too problematic, they were chemically sedated and fully strapped to a gurney, referred to as a “five point tie down.” All of these situations still happen today. Murphy said, “I look upon that and say, ‘What are we doing? Have we really advanced since the 1800s?’ And I believe we have not.”

“We’ve replaced the hospital bed with the prison cell, the blanket on the subway grate, the emergency room, and lastly, the county morgue,” Murphy said. The scale of mental illness-related deaths in America is “staggering,” as described by Murphy. Last year, there were 41,000 suicide deaths and 1.2 million attempts serious enough to require medical attention. 45,000 deaths were from drug overdoses, with many more near misses, and in Los Angeles, it’s estimated that one homeless person dies every day.

“A person with severe mental illness tends to die 10 to 25 years sooner than the rest of the population,” Murphy said, possibly due to medical complications that arise when those who need treatment don’t receive it. Though we don’t know the exact number of mental-illness related deaths, Murphy said that even the most conservative estimate of 85,000 mental illness-related deaths exceeds the total number of combat deaths in the Korean and Vietnam wars combined. Murphy pointed out that in any other case, for example, “if the flu swept through the country and caused 85,000 deaths” we would all be greatly concerned.

Murphy’s bill, the Helping Families in Mental Health Crisis Act of 2015, focuses on breaking down barriers that prevent those with mental illness from receiving treatment.
A federal investigation initiated after the tragic shooting incident at Sandy Hook Elementary School found numerous flaws in our current system in dealing with mental health. Some notable aspects of the bill deal with modifying privacy rules for physicians that prevent family members from helping their loved ones, increasing the number of psychiatric beds nationwide (currently short by 100,000), increasing the mental health workforce, and refocusing mental health related programs. “We have to change and transform how this country is dealing with mental illness,” Murphy said.

To those who are concerned about the monetary cost imposed by the bill, Murphy responds that the cost of not doing anything is “85,000 lives. How much of a price do you put on each of those lives?” As for concerns about patient’s rights being affected by the bill, Murphy believes that a patient’s right to get well outweighs their right to stay sick. Referring to the tragedy at Sandy Hook that was committed by Adam Lanza, a man plagued with significant mental health issues according to a state investigation, Murphy said, “Those children at Sandy Hook Elementary School had the right to make it through first grade.”