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Monday, 11 December 2017

The Murphy Bills and Beyond

In June of 2015, Representative Tim Murphy of Pennsylvania re-introduced the "Helping Families in Mental Health Crisis Act" (HR 2646), better known as the Murphy Bill.  A month later, Senator Chris Murphy of Connecticut introduced a very similar bill in the Senate called the "Mental Health Reform Act of 2015" (S2680).  Both pieces of legislation threatened to dramatically increase the use of force and dismantle many of the more progressive and healing alternatives that have been developed in recent years. As of November 2016 the fate of both bills remained uncertain.

Meanwhile, another piece of legislation called 21st Century Cures was in development and garnering increasing bipartisan support. A sweeping and expansive healthcare bill, 21st Century Cures was, initially, minimally focused on mental health provisions. Having been stalled in part due to resistance from Senate Democrats' concerns that the bill was dangerously empowering for the pharmaceutical industry, 21st Century Cures also faced an uncertain fate in November. However, the election of President Trump and consequent fears for the bill’s fate prompted a reworking of the bill that also included the absorption of many aspects of HR 2646, “Helping Families in Mental Health Crisis.”

21st Century Cures was passed by the House and Senate on November 30th and December 7th of last year, respectively. On December 13, 21st Century Cures (now including substantial portions drawn directly from HR 2646, "Helping Familties in Mental Health Crisis") was signed into law by President Obama. 

 

  

recent posts

 

A Declaration of Interdependence for the Era of the Murphy Bill

rbassmanBy Ron Bassman (Originally published here)

How we think about health, happiness, and self-fulfillment, and a myriad of issues including suicide, inexplicable violent acts, and the influence of technology/information glut, ecology, the impact of war, poverty, the inequitable distribution of wealth and power and how they are linked with flawed systems of government has been assigned to the domain of social scientists.  The most influential of those are the psychiatrists who have been given the government-mandated power to diagnose, incarcerate and forcibly drug those who are perceived to have a form of mental illness. I believe that such power is arbitrary, unjust and frequently harmful.

Madness defies explanations that prize uniformity.  It is a dynamic chaos without boundaries that is unique to the individual.  Yet madness contains enough common features to seduce our thought leaders to create all-encompassing theories.  At its simplest, madness may be a reaction to pain, suffering and confusion in which the individual attempts to use all of his or her resources to find a way out of ever-shifting mazes. Too many of others'  attempts at help, where force is used without regard to the person's wishes, needs, and timing that is so important to the individual, often serve to make the maze' s walls more confining and impenetrable.  . 

I have been trying to generate outrage about the new iteration of the Murphy Bill.  Unfortunately the response has been more of mild agreement - that it is not good - rather than what I hoped would be enough outrage to mobilize actions.  NAMI, if it has not already, will be calling on its huge network to generate a response that would make the Bill look like it is mandated by a public majority.

Today I got a surprise call from a dear friend, Tom Olin, whom many consider the premier visual documentarian of the disability rights movement.  He said he had just come from Tennessee and had visited the Highlander school where we had first met.  While talking to people there, they asked him if he could get a copy of the statement we created there in 2000, so that they could display it next to a photograph of his that was already hanging there.  Tom asked me if I still had the statement and if I did to send it to him.  I dug it up and read it over.  It brought up great memories of the comraderie of that meeting, and how thrilling it was to be part of that historic site of civil rights activism.  But too soon I felt sad, realizing that what we had fought to change back then had not changed much.  And now, more disturbing, is the potential damage to our rights, dignity and ultimately our freedom if the Murphy bill is passed.

Read more: A Declaration of Interdependence for the Era of the Murphy Bill

H.R. 2646 (Murphy Bill) What does it mean? A survivor’s perspective

sharonBy Sharon Cretsinger (Originally published here)

In this document, I have attempted to summarize all of the sections of this bill by their most important points so that they can be easily understood and referenced.  If someone is interested only in grants, for example, that individual can easily access information about the section of the bill that deals with grants.  At the same time, this is more than an informational document.  I am not a professional policy wonk and the renderings of policy are not intended to be perfect.  They are intended to be comprehensible.  Similarly, the commentary I add at the end of each section is mine alone.  Many will agree or disagree, or some combination thereof.  This summary is written from my perspective, as a former clinician and service user and present survivor of psychiatric atrocities.  It is written for my community of people who feel similarly about the atrocities, abuses and social controls of psychiatry.  I can say that, if I held same positions as this bill’s author, I would be very proud to have written H.R. 2646.  Each section supports and reiterates other sections in a cohesive manner.  Given that I do not hold their positions, I can say it is a very dangerous document, whether or not it passes, because it indicates the directions of force, coercion and dehumanization that my community currently faces.  Particularly, this bill targets not only those persons labeled with a psychiatric diagnosis, but also those who are doubly disenfranchised by being young, old, poor, differently abled cognitively or part of a minority community.

This bill has nine sections that are outlined below, with a bit of commentary on each.

Section 1:  Creates the position of Assistant Secretary for Mental Health and Substance Abuse,

*will report to the Secretary of Health and Human services
*must be a doctor or psychologist
*an increase of carers in MH/SA
*increase in services to children/adolescent and underserved populations
*integration of MH, SA and Primary Care services

—Defines Peer support Specialist

*uses lived experience plus learned skills
*is supervised by licensed professional
*active participant in MH or SA services over past two years
*provides no direct medical services
*provides no services outside of scope of practice

*certification includes hours of formal work or volunteer experience, exams, code of ethics
*certification training includes:

psychopharmacology
integration of MH/SA w/primary care
ethics
scope of practice
crisis intervention
identification & treatment of MH conditions
confidentiality (state & HIPAA)
others to be determine

*skill sets include:

documentation
identification of risk indicators/stressors/triggers
de-escalation techniques
suicide prevention
indicators of abuse/neglect
responses to stressors/triggers/indicators
identification of current stage of recovery
ability to explain process to access services
identify when to get help from other professionals
CEU’s annually

—Counties without AOT will have to submit special reports.

Commentary:  SAMHSA is essentially dismantled under this section.  Mental health care is expanded by targeting younger people, as well as communities that, for whatever reason, have been prone to use fewer MH services.  A peer is no longer simply a person with lived experience who wants to use that experience to reach out to others living the same experience.  The peer is now required to have been in treatment for the past two years, so individuals who do not endorse the lifetime recovery model are excluded.  The peer is also trained in essentially the same subject matter as a BSW level Social Worker and is supervised by an independently licensed MH or SA professional.  This will eliminate funding for any completely peer run programs and will also impact the Social Work profession by creating individuals capable of the same work as a BSW at a much lower salary level.  Pressure is placed on states (most states already have an AOT law) and counties to implement AOT.  An additional paperwork burden is placed on those that don’t.

Read more: H.R. 2646 (Murphy Bill) What does it mean? A survivor’s perspective

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