H.R. 2646 - A good first step

The mentally ill are more than just a few people locked away in an institution; they are all of us. Our mothers and fathers, our sisters and brothers, our children, our close friends, and often ourselves have some form of mental illness.

In other words, the broken mental health system affects all of us. 

First, here is a quick chart popout that will summarize some things that this bill does.

A MENTAL HEALTH CRISIS

Our mental health care system is in crisis. Hospital beds for psychiatric care have sharply declined and many mentally ill end up homeless or incarcerated.

In the above, I advocate a top-down approach. Eliminate block grants and dedicate the 200 billion(!) in funds to go where they are needed.

What I like about H.R. 2646, besides the fact it is a rare bipartisan bill, is it makes sense. Eliminate the politics and use evidence based medicine (EBM) approaches to funnel money where it is most needed and will do the most good. The rest is commentary.

OK, a lot more than commentary, but the bill creates an Assistant Secretary for Mental Health and Substance Abuse disorders with a lot of responsibilities to set policy based on EBM and sound science. My two biggest concerns is that the privacy laws still do not allow for relatives to be part of the process if the patient refuses to let them in. Also, that there is no provision to eliminate the block grants as funding for mental health.

Why is this important? Block grants are large amounts of money given to states to be used for many purposes. States have the flexibility as to how it will be spent. What often happens is that the monies get siphoned off for the largest budgetary problems for each state, and not necessarily used for the intended purpose. By making mental health funds a categorical grant, it would allow the new assistant secretary to funnel the funds exactly where they need to be. And no budgetary priorities counter to that could alter that path.

A very helpful website for these legislative issues is Mental Health Policy Org. Please check this out and be more vocal in supporting these efforts. Also, props to House Representative and Congressman Tim Murphy for pushing this bill, and finally getting it to advance. There is much further to go in the process, but with enough support, I believe it can happen.