Privacy and Treatment in Mental Health: How the Laws May Soon Change
by Wendy Hoke
If you have a family member or friend with a serious mental illness (SMI), you may be painfully aware of the difficulties presented by current laws pertaining to healthcare.
More than 11 million Americans suffer from an SMI, such as bipolar disorder, schizophrenia or major depression. However, many of them go without treatment, and their families not only face the chaos and pain an untreated SMI can cause, but they also struggle to find healthcare providers for their loved ones.
The federal government’s attempt to address this distressing situation has resulted in ineffective programs and policies implemented by unaccountable agencies. Unfortunately, many patients become entangled in the criminal justice system or end up homeless without appropriate mental health services. Even more heartbreaking, patients who need it can refuse treatment and keep their health records completely private.
In an effort to address this broken system, Congressman Tim Murphy from Pennsylvania has introduced a new bill, The Helping Families in Mental Health Crisis Act. This act would provide critical fixes to the ailing mental health system by directing resources towards psychiatric treatment for patients in the greatest need of services.
While the majority of individuals with an SMI are non-violent, the headlines have seared the images of James Holmes (Aurora, CO); Adam Lanza (Newtown, CT); Aaron Alexis (Washington, D.C.); Jared Loughner (Tucson, AZ); and Elliot Rodger (Santa Barbara, CA) into the minds of concerned Americans .
According to the House Energy and Commerce Subcommittee on Oversight and Investigations, the federal government disburses $130 billion per year to meet mental health needs. However, the rates of violence, homelessness, suicide, incarceration and victimization have increased over the last two decades, and those who need the most help are receiving the least assistance. The Subcommittee estimates that a shocking 40 percent of Americans with an SMI receive no treatment.
On his official website, Representative Murphy states, “That is why I will reintroduce the Helping Families in Mental Health Crisis Act (H.R. 3717, 113th) to refocus programs and resources to families and patients with the most challenging cases of serious mental illnesses and bring accountability to federal programs.”
While the headlines focus on the tragedies of mass shootings, debates about gun control and mental health treatment continue to escalate. Despite this national conversation, Murphy’s bill puts the treatment issues front and center.
Representative Murphy is a Pennsylvania psychologist, and his approach has received broad bipartisan support, with 115 co-sponsors to the bill from both Democrats and Republicans. If passed, the new law would overhaul much of the current mental health bureaucracy and eliminate the Substance Abuse and Mental Health Services Administration by replacing it with an assistant secretary for Mental Health.
This new position would be responsible for reallocating federal dollars away from unproductive, redundant programs and those that target “behavioral wellness” and milder types of mental illness toward programs that directly impact the most seriously ill. One such program that has a proven track record is assisted outpatient treatment, which studies show reduces the rates of violence, incarceration, drug and alcohol abuse, and repeated hospitalization among individuals with an SMI.
The expected effect of reducing incarceration and hospitalization is cost savings as well as improved treatment. These programs should drive critical savings to the healthcare and criminal-justice systems at both the state and federal levels. Just as crucial, the bill will provide a way for families to have dangerously ill relatives admitted into psychiatric care without treading on their individual legal protections.Roadblocks to #mental health treatment may soon be eliminated by Congress. Click To Tweet
Addressing the Right to Privacy
Representative Murphy’s bill will also make modifications to the Health Insurance Portability and Accountability Act (HIPAA), thus allowing family members of those with an SMI to be involved in the healthcare of their loved ones. As many family members may recount, a patient’s right to privacy can trump even a family’s right to safety.
The extensive scope of medical privacy laws — many of which were supported by the insurance industry and detrimental to mental health care providers — will be scaled back. This will give family members access to data on prescriptions, doctor’s appointments and other critical information that is necessary to protect safety, health and welfare.
Murphy’s bill does not change other HIPAA privacy protections, such as notes from psychotherapy. However, the changes proposed recognize that patients whose families remain actively engaged in the treatment process have better outcomes and that the current privacy laws frequently put families in difficult, sometimes dangerous, circumstances.
Giving family members access to critical patient data is also designed to lessen the impact of SAMHSA-endorsed “patient advocates,” who frequently hinder rather than facilitate access to treatment for seriously ill patients. The Helping Families in Mental Health Crisis Act will amend the Protection and Advocacy for Individuals With Mental Illness Program, which Congress passed in 1986, to return it to its original intent: protect mentally ill patients from neglect and abuse.
According to Representative Murphy’s website, the proposed legislation will accomplish nine key objectives. These are:
1. “Reforms the Substance Abuse & Mental Health Services Administration (SAMHSA)”
“For the first time, brings accountability to how mental health dollars are spent. Requires grant recipients to follow evidence-based standards, eliminates unauthorized programs, and mandates congressional oversight of all federal behavioral health grants. Prohibits taxpayer dollars from going to legal advocates and anti-psychiatry activists working to stop medical care.”
2. “Empowers Parents and Caregivers”
“Breaks down barriers to allow families to work with doctors and mental health professionals to be part of the front-line care delivery team.”
3. “Fixes Shortage of Inpatient Beds”
“Provides more psychiatric hospital beds, instead of expensive emergency rooms, for those experiencing a mental health crisis and in need of immediate inpatient care.”
4. “Reaching Underserved and Rural Populations”
“Advances tele-psychiatry to link pediatricians and primary care doctors with psychiatrists and psychologists in areas where patients don’t have access to mental health professionals.”
5. “High Quality Behavioral Health Clinics”
“Improves quality, accountability, and access to integrated medical and mental healthcare at community mental health providers.”
6. “Alternatives to Institutionalization”
“Helps those with serious mental illness get into treatment when they are unable to understand the gravity of their condition and cannot voluntarily seek out care, thereby reducing rates of imprisonment, homelessness, substance abuse, and costly ER visits.”
7. “Advances Critical Medical Research”
“Increases funding for brain research to better understand the underlying causes of neurological and psychiatric conditions. Advances successful NIMH early intervention programs like Recovery After Initial Schizophrenia Episode (RAISE), which reduces suicide rates & helps patients recover through a combination of low-dose medication and support services.”
Families who have faced the frustrating and painful outcomes from a mental health system that seems broken may finally see the light at the end of the tunnel. Reforming the bureaucracy and amending privacy laws should offer much-needed support for those trying to help a loved one with schizophrenia, bipolar disorder or another serious mental illness.
The Helping Families in Mental Health Crisis Act currently enjoys support from the National Alliance on Mental Illness, the American Psychiatric Association, and numerous media outlets such as CNN, the “Washington Post,” the “Wall Street Journal” and the “Pittsburgh Post-Gazette.”