Mental Health Reform Should Also Help Families

Two separate mental health reform bills are now on the table, and both have fallen prey to the same old mental health politics. The limited research on the efficacy of various proposed treatment approaches brings the issue back to questions of ideology.
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Mental health reform has been in the air since the tragic 2012 mass shooting in Newtown, Connecticut. In that time, the nation has witnessed 74 more school shootings, including one last week. Justified or not, these crimes continue to fuel public discourse about our present mental health system. Many of these instances, including last month's mass killing in Isla Vista, California, highlight one glaring inadequacy: how difficult it is for families to get help for their loved ones experiencing a mental health crisis.

Two separate mental health reform bills are now on the table, and both have fallen prey to the same old mental health politics. The limited and inconclusive research on the efficacy of various proposed treatment approaches always brings the issue back to questions of ideology.

  • Helping Families in Mental Health Crisis Act of 2013 was introduced by Congressman Tim Murphy (R-PA). Among its endorsers is the Treatment Advocacy Center, which most notably advocates for the expansion of court-ordered assisted outpatient treatment (in New York State, known as Kendra's Law) as the most humane and best solution to the social problems associated with serious mental illness.
  • Strengthening Mental Health in our Communities Act of 2014, sponsored by Congressman Ron Barber (D-AZ), emphasizes Mental Health First Aid, an educational program that teaches mental health response skills, and the expansion of community-based services, such as those funded by the federal Substance Abuse and Mental Health Services Administration (SAMHSA).
  • Mental health advocates who embrace the second approach prize the right of an individual to make his or her own choices above all. But what if those choices result in the murder of innocent people? Continually repeating that the vast majority of people with serious mental illness don't commit violent crimes doesn't alleviate the suffering of the families of the victims or the perpetrators. These philosophical discussions, usually led by mental health policy makers, academics, or inside-the-Beltway advocates, are divorced from the real-life experience of many families with adult children with mental illness. Like the two Congressional bills, the families are stuck - helplessly watching their children follow a path of self-destruction.

    The rights-first approach evolved from a very real need. By the mid-20th century, more than 500,000 people with mental illness were languishing in state hospitals where they were isolated from their communities, often abused, neglected, and subjected to barbaric treatments or surgical procedures. Rights advocates fought for and won deinstitutionalization, a sweeping policy that came with the promise of the support and resources necessary for former patients to pursue fulfilling lives of their own choosing.

    The Fountain House community works together to achieve that goal every day, but we do it from a position of respect-first, rather than rights-first. Respect doesn't mean leaving people to waste away and die in the street for the sake of preserving their right to do so. It means creating opportunities for people to build lives that matter to them and developing treatment plans beyond a one-size-fits-all approach. Some may think this is too nuanced to legislate, but as the president of an organization in which my life and the lives of all my staff workers are intertwined with hundreds of people living with serious mental illness every day, I'm telling you that we have to try harder.

    Families deserve a better answer than the one mental health advocates are giving right now. More than 30 years ago, the National Alliance for Mental Illness (NAMI) was formed because families of people with serious mental illness were not getting the help they needed. Today, little has changed. Why is that so?

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