The Helping Families in Mental Health Crisis Act of 2016 is a bipartisan effort aimed at reforming federal mental health policies and programs so that patients—especially those with serious mental illness (SMI)—have more access to evidence-based care.
In particular, the legislation seeks to improve the coordination and visibility of mental health services on the federal level by creating an Assistant Secretary for Mental Health and Substance Use, who will be appointed by the president and will act as head of the Substance Abuse and Mental Health Services Administration (SAMHSA).
The bill was introduced by Rep. Tim Murphy, R-Pa., a child psychologist, and Rep. Eddie Bernice Johnson, D-Texas, a former psychiatric nurse. On July 6, the House voted 422-2 to approve an amended version of the original bill, which was introduced in June of last year.
How would it improve access to care?
For one, the bill allows for federal reimbursement of early and periodic screening, diagnostic and treatment services provided to children and young adults in psychiatric institutions. The bill also enables more inpatient psychiatric care under Medicaid. Right now, Medicaid will not pay for inpatient psychiatric care for patients ages 21 to 64 who are in facilities with more than 16 beds. H.R. 2646 creates exceptions that would allow more of these patients to get the care they need.
In addition, the legislation seeks to boost the number of providers in underserved areas by permanently authorizing the federal Minority Fellowship Program overseen by SAMHSA. Each year the program awards some 200 scholarships to fellows who receive culturally competent behavioral health training that prepares them to work with underserved populations. APA is one of seven national organizations that administers the program.
How would psychologists be affected?
Along with expanding care and supporting more training, the bill also seeks to clarify the type of health information psychologists and other providers are legally allowed to disclose to an adult patient's family members or other caregivers. While the legislation acknowledges that protecting patient privacy is critical, it recognizes that giving information about a patient's diagnosis and treatment to family members or other caregivers can improve patient care.
What else does H.R. 2646 do?
Among other provisions, the bill:
- Creates an Assistant Secretary for Mental Health and Substance Use. The Assistant Secretary would replace the SAMHSA administrator, and would be appointed by the president and confirmed by the Senate. Preference for the job would be given to individuals with a doctoral degree in psychology, medicine or osteopathic medicine with clinical and research experience.
- Establishes a National Mental Health and Substance Use Policy Laboratory within SAMHSA. The laboratory would work to identify, coordinate and facilitate policies that affect mental health, mental illness and substance use disorder services.
- Establishes a telemental health grant program to promote behavioral health integration in pediatric primary care, develop networks of child and adolescent psychologists and psychiatrists to work with pediatric providers, and support pediatric mental health teams.
- Reauthorizes two key programs: the National Child Traumatic Stress Initiative, which improves treatment and services for children and families who have experienced traumatic events, and the Garrett Lee Smith Memorial Act, which includes the Suicide Prevention Resource Center, youth suicide prevention strategy grants to states and tribes, and mental health and substance use disorder services and outreach on the nation's college campuses.
- Establishes a demonstration grant program supporting the education and clinical training of health service psychology students, interns and postdoctoral residents in community-based mental health settings.
- Strengthens the monitoring and enforcement of mental health insurance coverage protections under the Mental Health Parity and Addiction Equity Act.
How is APA involved?
Both APA and its sister organization, the APA Practice Organization, support the measure. Just before the House vote, APA and APAPO activated both of their grassroots advocacy networks, which ultimately sent 1,246 advocacy messages to Congress supporting the legislation.
What's next?
In March, the Senate Committee on Health, Education, Labor and Pensions passed its own mental health bill, the Mental Health Reform Act of 2016 (S. 2680), introduced by Sen. Lamar Alexander (R-Tenn.). That legislation would, among other efforts, promote more research on SMIs and work to implement evidence-based practices to help prevent, diagnose, treat and recover from mental illness and substance use disorders. It would also reauthorize the Garrett Lee Smith youth suicide prevention grant programs and establish an interdepartmental committee at the U.S. Department of Health and Human Services to better coordinate initiatives for people with SMIs.
At Monitor press time, the full Senate was expected to vote on the bill this month. The House and Senate bills are similar, but not identical. If the Senate passes its bill, the two legislative chambers would have to negotiate and approve a compromise package to send to President Obama to sign into law.