A VICTORY FOR MENTAL HEALTH REFORM IN CONGRESS—YET MUCH REMAINS TO BE DONE!

mental health
Congressman Tim Murphy. By Timmurphy (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
Parents, siblings and friends are rejoicing over Wednesday’s passage in the House, by a 392-26 vote, of the seminal 21st Century Cures Act, a $6.3 billion bill to overhaul mental health care in America. The bill is expected to quickly pass the Senate and secure President Obama’s signature, transforming it into law.

The Cures Act’s unexpected success thus far signals a radical departure from decades of Congressional indifference toward the mentally ill, interrupted occasionally by maladroit and socially damaging efforts at reform such as “deinstitutionalization.” Its strengths, weakness and potentially controversial sections are superbly analyzed by the pre-eminent mental-health blogger Pete Earley: http://www.peteearley.com/2016/11/30/murphys-family-mental-health-bill-finally-approved-next-step-senate-then-white-house/

The Act incorporates the language of the Helping Families in Mental Health Crisis Act, a measure created and promoted for years by Congressman Tim Murphy (R-PA), the pre-eminent champion of reform on this issue in all of Congress. https://murphy.house.gov/latest-news/breaking-helping-families-in-mental-health-crisis-act-language-finalized-full-vote-to-take-place-next-week/.

Despite the euphoria and likely full passage, even its advocates acknowledge that the 21st Century Cures Act faces strong opposition from several influential sectors. The reliably progressive Senator Elizabeth Warren (D-MA) has criticized it for failing to constrain the “Big Pharma,” the notoriously profiteering multinational pharmaceutical industry, from profligate pricing and lax testing standards for protecting the safety of customers. On the other side of the spectrum, the conservative group Heritage Action for America,which has denounced the “gimmicky nature of the pay fors” in the Act—“the newly creating funding mechanism designed to bypass spending caps, or the overall level of spending.” 

Congressman Murphy pinpointed his satisfaction with the House vote while agreeing that it is far from a cure-all for serious mental illness in America: “We didn’t get everything we needed, but we needed everything we got.” The Congressman, who is a Navy veteran and a practicing psychologist, went to work on his Crisis Act in 2012, following the massacre of schoolchildren in Newton, Connecticut, by the 20-year-old Adam Lanza, who had murdered his mother before the shooting spree and who killed himself afterward.

I have devoted a couple of chapters to Congress’s history of ineptitude and indifference to mental illness in NO ONE CARES ABOUT CRAZY PEOPLE. In Chapter 13, “Debacle,” I examine the lingering social damage wrought by deinstitutionalization, the early-60s experiment in mass removal of patients from the nation’s flawed and overcrowded mental asylums without following through on guarantees that they would be cared for in a vast network of community-based centers operating without government oversight.

And finally, lest anyone imagine that the surviving mental and psychiatric hospitals have solved their problems, I offer the following short list of recent atrocities suffered by mental-hospital patients (all women, interestingly). I will add that my book takes its title from a string of horrific abuses, including at least one patient death by starvation (another woman, for whatever that may mean), that occurred at Milwaukee County Hospital in the years around 2010.

So: let us justly celebrate the House action on Wednesday in advancing the 21st Century Cures Act. But at the same time, let us not forget that much remains to be done—on the Act itself, and in our still-chaotic world of mental health care.

http://www.nbcnews.com/health/mental-health/after-mom-starves-death-questions-about-care-mentally-ill-n569461

http://www.sfgate.com/bayarea/article/Lawsuit-says-woman-died-because-SF-psychiatric-8346738.php

http://www.fox25boston.com/news/family-begs-for-answers-after-woman-dies-unexpectedly-at-psychiatric-hospital/290007987

http://www.wfaa.com/news/local/tarrant-county/woman-suffering-mental-problems-dies-after-shes-tased/185712630

http://www.post-gazette.com/news/health/2016/09/04/Young-woman-s-journey-ends-tragically-in-mental-hospital/stories/201609040069

On the Road With Kevin

I just answered a post by dear friend from college and early-career days. He grew up in Sudbury, Ontario. He’s feeling a little down, like a lot of us, over the election, and expressed a wish to return to his hometown.

I don’t know that I managed to cheer him up, but his message reminded me of a passage from NO ONE CARES ABOUT CRAZY PEOPLE. It involves a night spent in Sudbury as I drove Kevin, then 14, from Vermont across Canada and then south through Michigan to commence his studies at the Interlochen Music Academy. I’m reposting it below. If not exactly a cheerer-upper, it at least is a reminder of moments of beauty that appear from nowhere, conjured by the fingers of a gifted child and his guitar. This was before Kevin’s fatal onset of schizo-affective disorder:

Kevin at Interlochen
Kevin at Interlochen

“That September, I drove Kevin the nine hundred miles to Interlochen. It was a memorable ride.

“We chose a route that took us north to Montreal, then westward on Highway 17 for six hundred miles, skirting Ottawa and then the vast and pristine Algonquin Provincial Park, its primitive interior saturated with lakes and moose. We ate hamburgers at a log-built restaurant and gift shop somewhere along the route, and it became our traditional stopping-place on future trips. Traditions were important to both boys, but especially Kevin. We stopped for the night in a motel in Sudbury, Ontario. At Sault Ste. Marie, we turned south into Michigan along Interstate 75. We crossed the Straits of Mackinac, linking Lakes Michigan and Huron, on the majestic suspended arc of the Mackinac Bridge that stretched five miles.

“Kevin was upbeat during the long drive, but he admitted to me that he was worried about meeting new people at the arts academy. For one thing, he said, he didn’t know any good jokes. I told him that jokes could be over-rated, and the best way to make new friends was to ask them a lot of questions about themselves. This went for girls too, I added. Girls especially.

“In our motel room in Sudbury, Ontario, I was unpacking toiletries from my suitcase. Kevin was sitting behind me on one of the twin beds. I heard acoustic guitar notes, and turned around.

“The lamplight brought out the gold in Kevin’s hair, and he was in his usual playing position, bent forward a little, head down, the sole of one messy sneaker planted on the arch of the other.

“The piece was short, but lyric, and haunting, like a medieval ballad, and as it went on I stopped unpacking and sat down on the bed beside Kevin and listened. When he had finished, and when quotidian sounds—traffic horns, voices in the hall, TV sounds in other rooms—had resumed their noise, I asked Kevin where he’d learned it and how long it had taken him to memorize it. He shrugged and said that he’d made it up as he went along. He was just doing some finger exercises.

“Some weeks later, walking with him around the Interlochen campus during a visit, I brought it up again. I asked my son if he could reconstruct that piece from memory. He gave an absent shake of his head; his attention, at that moment, was on a pretty girl riding a bicycle in and out of the sunlight. A temporary, beautiful, golden thing had passed through that motel room in Ontario that evening, and then vanished, a presence to be experienced only once, and briefly, and then never again.”

Advance Praise for No One Cares About Crazy People

A new advance notice for NO ONE CARES ABOUT CRAZY PEOPLE (due March 21) has arrived–from Dr. E. Fuller Torrey, one of the true statesmen and -women of mental health-care reform. I’m humbled to receive it:

“Ron Powers and his wife never expected to visit the exotic lands of schizophrenia until their two sons became affected. A gifted professional writer, Powers takes the reader along on his explorations as he tries to understand why it happened and what to do. What he finds is ‘the most dreaded of all human mental disorders.’ Very readable and highly recommended.”

E. Fuller Torrey, MD
Author, Surviving Schizophrenia

Click here to read more advance notices for No One Cares About Crazy People.