by Mitch Kokai
Senior Political Analyst, John Locke Foundation
Once again Speaker Paul Ryan has committed to mental-health reform, recently telling USAToday, “I think there’s promise in that area, because there are some Democrats who are agreeing with us on that.” He’s right. Forty-nine Democrats co-sponsored the Helping Families in Mental Health Crisis Act (HR-2646), which was introduced by Representative Tim Murphy (R., Penn.). Many of the bill’s co-sponsors are members of the Congressional Black Caucus who, rather than giving a knee-jerk “no” to a law associated with a Republican, recognize that Murphy’s proposals will improve services and reduce incarceration. It has 149 Republican co-sponsors who support the same goals as well but also want to save money and use federal funds more efficiently.
What makes the bill unique are its five provisions — frequently championed in National Review, the Wall St. Journal, the Washington Post, and elsewhere — to reduce homelessness, arrest, incarceration, and violence by people with untreated serious mental illness by using existing mental-health funds more effectively.
It saves money and comports with conservative principles by eliminating the Substance Abuse and Mental Health Services Administration (SAMHSA), which drives federal mental-health dollars away from the seriously ill and toward the worried well. SAMHSA’s failure has been well documented. It replaces SAMHSA with an assistant secretary of mental health, who will focus existing spending on the most seriously ill and require programs to be evidence-based before the government funds them. This will help end SAMHSA’s funding of anti-psychiatry, pseudo-science, and pop-psychology “treatments.” …
… Most important, the bill reduces the use of expensive and inhumane incarceration and hospitalization by providing seed money for Assisted Outpatient Treatment (AOT). AOT is the most successful program for those whom police call “frequent fliers” — the seriously mentally ill who regularly and predictably wind up in jails because they refuse to stay on treatment. It allows judges to order those who have already accumulated multiple episodes of incarceration, violence, homelessness, or hospitalization — as a result of their own refusal of treatment — to work with a case manager and stay in mandated and monitored treatment while they live free in the community. Replacing expensive hospitalization and incarceration with community treatment will save taxpayers money and keep patients and the public safer.