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How Mental Health Reform Fits Into The Mammoth Health Bill Awaiting Senate Approval

December 05, 2016

The hulking 21st Century Cures Act, which promises the biggest healthcare overhaul since Obamacare, includes provisions that would empower mental-health patients as perhaps never before.

“I consider this much more than a mental health bill,” says Dr. Harold I. (Hank) Schwartz, the Institute of Living‘s psychiatrist-in-chief, at a Dec. 2 press conference in support of the sweeping  legislation. “This is a civil rights bill. This is a bill that supports the right of patients to healthcare and, specifically, to mental health care by promoting access to programs that have been unavailable because they haven’t been supported, the money hasn’t been there and enforces laws we have to prevent the kind of discrimination — and that’s what it is, discrimination – against mental health patients who are trying to access the benefits they deserve, the benefits thatI believe they have a right to.”

The act, introduced three years ago,  would also boost biomedical research, accelerate the Food and Drug Administration’s approval of new drugs and encourage nationwide use of electronic health records in a $6.3 billion package that includes $1 billion in state grants over two years to fight the opioid epidemic. Parts of the Mental Health Reform Act, introduced  by Sen. Chris Murphy (D-Conn.) after the Sandy Hook massacre, are also included in the bill that swept through the House this week in a 392-26 vote and awaits a Senate vote next week. Dr. Schwartz joined Murphy, Sen. Richard Blumenthal (D-Conn.), Sandy Hook Promise co-founder Mark Braden and Dr. Miriam Delphin-Rittmon, commissioner of the state Department of Mental Health & Addiction Services, at the press conference at the Legislative Office Building.

“This legislation provides incentives to bring our physical and behavioral health systems together so that you can get one-stop shopping,” says Murphy. “You won’t have to go to one provider to get your knee fixed and another to get your brain treated.”

Murphy, who hosted a mental-health roundtable at the Institute of Living in 2014 to hear people talk about their mental-health needs, authored a bill that Dr. Schwartz says, if enacted, would reshape mental-health care in this country.

“It is one of the most important steps forward for mental-health patients,” he says, “that we have seen, I think, in my lifetime.”

Barden’s son, Daniel, was among the 20 children and six educators killed at Sandy Hook Elementary School  Dec. 14, 2012, by Adam Lanza, who then committed suicide with the semi-automatic assault rifle used in the killings. Barden says the bill would offer life-saving solutions.

“We know that my son’s killer was suffering from mental illness,” he says. “We know that his mother didn’t know what to do with him. I lay awake at night thinking that if the Mental Health [Reform] Act of 2016 were in place then that the quality of mental healthcare that this person needed would have been available to him. And maybe this never would have happened.”

Dr. Schwartz, in turn, says he, too, contemplates Sandy Hook as its fourth anniversary approaches.

“I ask myself,” he says, “‘So where have we gotten on the national dialogue on mental health that began shortly after that disaster?'”

The answer could come next week with the Senate’s vote. If approved, President Obama is expected to sign the bill into law.

“As a clinician, as a psychiatrist,” says Dr. Schwartz, “I have faced too often in my career patients who have been unable to access the outpatient care that they needed, deteriorated, and wound up in emergency rooms needed inpatient care because they couldn’t get the kind of preventive care that might have stopped that deterioration.”

And those who received inpatient care, he says, often spend inadequate time in the hospital and, because of it, are readmitted unnecessarily.

“This bill addresses that in very important ways,” says Dr. Schwartz.

It would, finally, make “mental health parity” a reality.

“What does that mean?” says Blumenthal. “It means an illness affecting your mind is just as important as one affecting your body.”