As the waning days of summer float away like a soft cloud on a friendly breeze, we must continue to wonder whether this Congress actually will pass a viable piece of mental health legislation this year. In the U.S. House, Representatives Tim Murphy (R-PA) and Eddie Bernice Johnson (D-TX) recently have reintroduced their “Helping Families in Mental Health Crisis Act“(HR 2646). In the U.S. Senate, Senators Bill Cassidy (R-LA) and Chris Murphy (D-CT) just have introduced the “Mental Health Reform Act of 2015.“
Both of these bills include important advances for the field. However, both also include provisions that many of us will find to be problematical. On balance, the Senate bill is better than that of the House.
However, rather than simply analyze these bills, or several lesser bills that also have been introduced recently, it will be very important that we actually state and act on our “must” principles--those mental lines in the sand that we definitely do not want to cross. I will begin this very important process here. I do hope that you will add to, elaborate, and use these principles. They can become our yardstick on where to place our energy around current advocacy endeavors.
The following are five recommended core principles:
Principle 1: Do no harm to persons with mental health or substance use conditions. This means that our care systems must be designed to be trauma informed and recovery focused, and must fully respect human dignity. Much progress has been made in each of these areas during the past decade; we must protect that progress and develop it going forward. Consumers and peer supporters are the very best judges to determine whether these essential criteria are being met.
Principle 2: Do no harm to the community or its members. This means that our care systems must be prepared for crises and must engage in community interventions to prevent crises. We must have operational capacity to reach out and to work with community schools, county jails, homeless programs, and local businesses, among others. All local police must have crisis intervention training, and restoration services must be available as essential alternatives to incarceration. The front end of these systems must include warm call-in lines operated by consumers, as well as peer supporters placed in hospital emergency rooms, county jails, and local courts.
Principle 3: Engage in full integration with health and social service entities. The mandate for full integration of mental health and substance use services with primary health care has been crystal clear for decades. Just coming into focus now is the need to integrate social services, such as housing, job, and social supports, into our new health and medical homes. Health services simply cannot be effective without the availability of these supports.
Principle 4: Rapidly implement disease prevention and health promotion services. Both types of services represent exciting and essential features for behavioral healthcare in the era of the Affordable Care Act. In less than a decade, our current disease care system will be transformed into one in which significant attention and resources will be devoted to wellbeing rather than illness. As this unfolds, it also is becoming clear that behavioral healthcare will have an emerging role with businesses as senior managers adopt the culture of wellbeing for their employees and related family members.