Last week, the House of Representatives almost unanimously passed one of the most significant bills targeting mental health reform since 1963, but mental health advocates say this notable victory is only the tip of the iceberg.
The Helping Families in Mental Health Crisis Act that passed in the House 422-2 on July 6 will help to address holes in the US' mental health system by providing more hospital beds for people dealing with a mental illness who will need short-term hospitalization. The bill, introduced by Rep. Tim Murphy (R-PA), will also require that the Substance Abuse and Mental Health Services Administration (SAMHSA) establish an interagency committee to create evidence-based findings into systems of care. HIPPA provisions may also be reinterpreted in the bill to further permit parents access to their seriously mentally ill child's medical information and treatment plan when their child is 18 years or older.
Despite the $130 billion bill the federal government pays toward mental health care each year, there is still a shortage of about 100,000 psychiatric beds in the U.S. and some of the largest mental health care facilities in the country are in jails in Los Angeles, New York's Rikers Island and Chicago's Cook County. On top of that, the leading federal mental health agency, SAMHSA, has not employed a single psychiatrist among its 500 or so employees, said Rep. Elise Stefanik (D-NY) in a release.
To address the lack of medical professionals within SAMHSA the bill also created a new federal position of assistant secretary of mental health and substance use disorders. A licensed psychologist or psychiatrist must hold the new position, which will accept the responsibilities formerly held by the administrator of SAMHSA.
Though Congress just began its seven-week recess Thursday, advocates say they're optimistic a similar bill could pass in the Senate by the end of the year.
"We certainly as advocates, along with our sister advocacy associations, are going to press for it. I think the champions and the senators that are the sponsors of that bill — they want very much to move it, so I'm hopeful," said Linda Rosenberg, CEO of the National Council for Behavioral Health, to NBC News.
If this bill does pass, some advocates say they would like to see future legislation work on increasing funds toward community services for mental health, including even more hospital beds, more access to treatment via psychiatrists and more reform in special education. Advocates also said housing and employment services for those who are seriously ill would be beneficial.
In 2012, 57.2 percent of adults with any kind of mental illness did not receive treatment, according to non-profit Mental Health America.
"It's one thing to do a lot around the issue, but the heart of the issue is that people don't know where to go and they can't get timely care for all mental illnesses, and that's a problem in almost every community," Rosenberg said.
Overall, Executive Director of Mental Illness Policy Org DJ Jaffe told NBC News that he thinks the House mental health bill is a solid first step toward benefiting the seriously mentally ill, such as those with bipolar and schizophrenia disorders. Jaffe also said he believes it's important for policies to focus more on serving the seriously mentally ill than generally seeking to improve mental health treatment across the board.
"The problem isn't that we're not spending enough. The problem is that we're not spending enough on the seriously ill," he said. "And it is the most seriously ill, not the highest functioned or the worried well, who are most likely to become homeless, arrested, incarcerated, suicidal, violent, etcetera."
The mental health reform bill was initially proposed in 2013 following the Sandy Hook Elementary School shooting in Newtown, Connecticut. What finally helped this bill getting passed with bipartisan support, Mental Health America's CEO Paul Gionfriddo told NBC News, was the reframing of mental health reform as a public health issue rather than one of public safety.
Gionfriddo added that he doesn't think it's helpful to view mental health reform as a response to mass violence, and by looking at the demographics of most mass shooters, Gionfriddo said he thinks it would be more helpful to address the issues of young men in general, starting in adolescence.
"But the truth is, the reason to do mental health reform is to reform the mental health system and to help people with a set of serious illnesses to recover and be healthy and to thrive," he said. "If you're doing it for the reason that you think violence in America is going to disappear ... or even mass violence in America is going to disappear, you're just going to be disappointed."