Monday, April 14, 2014

Why we need to overhaul the mental illness system

By LEISL STOUFER contributing columnist
Published: April 11, 2014 Updated: 5:28 p.m.
Imagine being diagnosed with cancer but being told you are not sick enough to qualify for treatment. Imagine having a serious medical emergency, but there are no hospital beds so you are turned away and denied care. Imagine having a debilitating disease, but instead of receiving treatment and being cared for, you are arrested, thrown in jail or forced to live on the streets.
These are the horrors and the realities that individuals and families who suffer from mental illness face every day. There is no other illness in America that is treated this way. We have abandoned an entire population of people. We deny them treatment, we walk over them in the streets, and we throw them in jail as we look away. For the first time in 50 years there is a real solution that will overhaul our nation’s failed mental health system.
Congressman Tim Murphy, R-Penn., has proposed the Helping Families In Mental Health Crisis Act that would dramatically change our nation’s approach to mental illness.
From left, Sen. Jack Reed, D-R.I., Senate Armed Services Committee Chairman Sen. Carl Levin, D-Mich., and the committee's ranking member, Sen. James Inhofe, R-Okla., listen as Army Chief of Staff Gen Raymond Odierno, lower left, and Army Secretary John M. McHugh, update the committee about the deadly shooting rampage at Fort Hood by a soldier who was being treated for mental illness.
In his bill H.R. 3717 Congressman Murphy, a clinical psychologist, lays out a comprehensive approach that would address critical gaps and barriers that keep the sickest patients from receiving treatment. These barriers include strict Health Insurance Portability and Accountability Act laws that prohibit family members from sharing vital information about their mentally ill loved ones with physicians. Murphy’s bill frees parents and family members who are caregivers from HIPAA restraints so that they can enter into a healthy dialogue with doctors allowing for a more proactive treatment plan and better treatment outcomes.

Tuesday, April 8, 2014


In few places are the consequences of non-treatment more visible than in jails and prisons, said the Treatment Advocacy Center

(ARLINGTON, VA.) The first national study to examine the policies and practices under which mentally ill inmates receive treatment was released today by the Treatment Advocacy Center and the National Sheriffs’ Association.

The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey
” reports that 10 times more individuals with serious mental illness are in state prisons and county jails than in the nation’s remaining state mental hospitals – an estimated 356,000 mentally ill inmates compared with 35,000 patients.

Background in Kentucky  
The Eastern Kentucky State Prison in West Liberty (1,705 inmates) and the Louisville Jail (1,353 inmates) both hold approximately the same number of individuals with serious mental illness as do the two state hospitals, Western State (205 patients) and the newly rebuilt Eastern State (239 patients). The county jails are plagued by revolving-door inmates who are mentally ill. According to an official at the Louisville Jail, “their average stay is about 18 days and in the past five years they have been in jail 140 times” (Courier-Journal, Nov. 24, 2012).
Kentucky’s prisons have also had increasing problems associated with the rising number of mentally ill prisoners.

Photo by Jenn Ackerman
Such problems were graphically demonstrated in 2013 by a series of photographs, entitled “Trapped,” taken in the Kentucky State Reformatory by photographer Jenn Ackerman. They include pictures of an inmate in a spit mask, to prevent him from spitting at the doctors or correctional officers, and they visually illustrate how difficult such living situations are both for the mentally ill inmates and for those who have to take care of them. As Ackerman summarized it: “The reason for my project wasn’t to show how terrible the conditions were in the prison; it was to [ask], ‘Is it really where we want these men to get treatment?’ We need to focus our energy on finding funding for mental health before this ever happens. The only place many of these men have been able to get treatment has been in prison” (Slate, Apr. 1, 2013).
Current Laws Governing Treatment in Prisons and Jails
Kentucky Department of Corrections (KY DOC) policies and procedures allow for nonemergency involuntary medication if an inmate suffers from a mental disorder and poses a likelihood of serious harm to self, others, or property, or if the inmate is gravely disabled.
Likelihood of serious harm means:
a risk that a patient may inflict physical harm upon himself as evidenced by verbal or written threats, gestures, past behaviors or attempts to inflict physical harm on one’s self, upon another, or upon the property of others.
Gravely disabled means a condition resulting from a mental disorder:
(1) which causes a person to be in danger of serious physical harm resulting from a failure to provide for his own essential human needs for health or safety; or
(2) in which the person manifests severe deterioration in routine functioning as evidenced by repeated and escalating loss of cognitive and volitional control over his actions and is not receiving care essential for personal health and safety.
Authorization of nonemergency involuntary medication is determined through a Washington v. Harperadministrative proceeding by an Involuntary Medication Hearing Committee composed of a nontreating psychiatrist and a nontreating psychologist as well as a high-ranking staff member who serves as chair of the committee. A majority of committee members must approve nonemergency involuntary treatment; the psychiatrist must be in the majority. 
Photo by Jenn Ackerman
State law does not prohibit Kentucky county jails from administering medication involuntarily on a nonemergency basis. Therefore, county jails could use a Washington v. Harper administrative proceeding to authorize involuntary medication for an inmate who is suffering from a mental disorder, is gravely disabled, or poses a likelihood of serious harm to himself or others. Based on the survey information, at least one jail has used a Washington v. Harper procedure in the past. Typically, Kentucky jails petition for civil commitment to state or community psychiatric facilities.
Note: Kentucky’s high rate of suicides in jails prompted the Kentucky legislature to invest in a new statewide program for integrating mental health services provided to jails. One component is a Telephonic Triage service to assist jails in assessing the safety of an inmate with mental illness. Based on telephonic assessments, recommendations are made for additional follow-up services that may include a face-to-face visit by local mental health professionals to evaluate inmates for civil commitment to a psychiatric facility.
The consequences of failing to treat individuals with serious mental illness in prisons and jails are usually harmful and sometimes tragic, the survey found. Without medication, the symptoms of the inmates’ mental illness become worse, leading them to sometimes behave in disruptive and bizarre ways. Such mentally ill inmates are vulnerable to being beaten, raped or otherwise victimized; are frequently put in solitary confinement for long periods; and sometimes mutilate themselves or commit suicide. Mentally ill inmates also contribute to the overcrowding of prisons and jails and to the increasing cost of corrections for both states and counties.

Kentucky uses a committee procedure allowed under a 1990 U.S. Supreme Court decision for providing involuntary treatment for prison inmates with serious mental illness whose symptoms render them dangerous or likely to deteriorate into dangerousness. This procedure is now sanctioned by law for state prisons in the majority of states and for a few county jails but it is only rarely used. Barriers to similar treatment for county jail inmates who are symptomatic result in the use of restraints, seclusion or observation rather than medication, the report said.

In almost every state, a prison or jail is now de facto the largest mental institution in that state. In Kentucky, the Louisville Jail and the Eastern Kentucky State Prison apparently each hold about the same number of individuals with serious mental illness as the two state mental hospitals, according to the study.

“The lack of treatment for seriously ill inmates is inhumane and should not be allowed in a civilized society,” said Dr. E. Fuller Torrey, founder of the Treatment Advocacy Center and lead author of the study. “This is especially true for individuals who – because of their mental illness – are not aware they are sick and therefore refuse medication.”


•    Maintain a functional public mental health treatment system so people with mental illness do not end up in prisons and jails

•    Reform mental illness treatment laws and practices to eliminate barriers to timely treatment before people commit crimes

•    Reform jail and prison treatment laws so prisoners with mental illness receive appropriate and necessary treatment,  just as inmates with other medical illnesses already do

•    Use court-ordered outpatient treatment – identified by the Department of Justice as an evidence-based practice for reducing crime and violence – to help at-risk individuals live more safely and successfully in the community

•    Implement and promote jail diversion programs

•    Institute mandatory release planning. A recent study reported that inmates who are not treated following
release have an almost four times higher rate of committing additional violent crimes compared to those who receive treatment.

“The mistreatment of inmates in jails in prisons, including the denial of proper medical care, is a national embarrassment and has led to international condemnation,” Torrey said.  “Mentally ill individuals who end up in prison or jail should be treated for their mental illness just as they should be treated for their diabetes or hypertension.”

The full report is available at:


The Treatment Advocacy Center is a national nonprofit organization dedicated to eliminating barriers to the timely and effective treatment of severe mental illnesses. The nonprofit promotes laws, policies and practices for the delivery of psychiatric care and supports the development of innovative treatments for and research into the causes of severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder. The organization does not accept money from pharmaceutical companies. The American Psychiatric Association awarded the Treatment Advocacy Center its 2006 presidential commendation for "sustained extraordinary advocacy on behalf of the most vulnerable mentally ill patients who lack the insight to seek and continue effective care and benefit from assisted outpatient treatment.”

Friday, April 4, 2014

Congressman Congressman Ed Whitfield, 1st district of KY, cosponsors H.R 3717!

This blog was founded 4 years ago, to spotlight the 'system failures' individuals living with serious psychiatric brain diseases experience in the commonwealth and to give their families a voice.

Since December, many of those families as well as NAMI Kentucky, have reached out to their US Congressman asking them to support the Helping Families in Mental Health Crisis Act (H.R. 3717).

Brenda Benson, a Mother and President of NAMI/Murray, KY contacted Congressman Whitfield explaining her story and why she supports H.R 3717. 

(Below is Rep. Whitfield’s official letter pledging his support to co-sponsor H.R 3717!

Please join me to thank Congressman Whitfield for his important decision to help families and individuals living with a mental illness in Kentucky.

Contact Congressman Whitfield at (202) 225-3115

If you live in the 1st district of Kentucky, you can email Rep Whitfield here:

Thursday, April 3, 2014

Thank you Congressman Andy Barr for co-sponsoring H.R. 3717!

We are happy to report that Congressman Andy Barr, (R) 6th district, is stepping out to co-sponsor the Helping Families in Mental Health Crisis Act (H.R. 3717). Family members, individuals living with a mental illness, medical providers and law enforcement — all confronted with the broken mental health system, applaud Rep. Barr's efforts! 

Thank you Congressman Andy Barr for your action! 

This landmark act sponsored by Congressman Tim Murphy (PA), is the first piece of legislation to effectively rehaul the nation’s antiquated mental health system.

Please write to Congressman Barr thanking him for his support in co-sponsoring H.R. 3717.

1432 Longworth House Office Building
WashingtonDC 20515
phone: 202-225-4706

View recent a hearing on H.R. 3717 here:

Read an excellent editorial review on H.R. 3717, published on March 31st, from the Wall Street Journal here:

Carolyn Colliver, a 45-year Kentucky advocate for the mentally ill, said: “Thank you Rep. Barr for supporting one of your most humane and compassionate legislative processes in the US history.”

Pennsylvania Rep. Tim Murphy spent a year reviewing federal mental-health policies and in late 2013 introduced a thoughtful much needed overhaul. One proposal would create a new HHS assistant secretary for mental health to streamline federal programs—requiring that money go to evidence-based practices. 

Rep Murphy’s bill is a landmark project that has been sorely needed to overhaul SAMHSA's out of control spending and lack of accountability. 
Families in mental health crises face unthinkable challenges! When our loved ones threaten violence, medical professionals and the police encourage us to file restraining orders, hoping the ‘legal process’ will prevent tragedy – but instead of treatment, this process leads to homelessness or jail – not medical treatment! This creates a tremendous burden on untrained law enforcement officers and the judicial system! We would never force a person with heart disease to have a heart attack first, to gain access to treatment, but in the US, we force extremely ill individuals to become homeless or go to jail — for having an illness! The current system sets up young adults to fail, with a criminal record that prevents future employment and access to housing. IT IS INHUMANE AND YES, THE DEFINITION OF INSANITY!
For families like mine, there is nothing worse than depending on the police to be our emergency medial providers. In some cases, our calls can end deadly!
Finally there is a glimmer of hope to our hell! 
H.R. 3717 will unravel a broken system and addresses barriers to treatment for those who need it the most! 
GG Burns, founder: Change Mental Health Laws in Kentucky

Friday, March 28, 2014

Fixing the mental health care system: What Congress can do - video

Rep Tim Murphy Makes Major Mental Health Announcement at AEI
Expert panel to discuss Helping Families in Mental Health Crisis Act
For Immediate Release: Wednesday, March 26, 2014
Contact: Brad Grantz202.225.2301

(WASHINGTON, DC) –  Representative Tim Murphy will make a major announcement about the Helping Families in Mental Health Crisis Act (H.R. 3717) this Friday, March 28, 2014 at 10:00AM, during a special event at the American Enterprise Institute. Rep. Murphy has been invited by AEI to be the featured speaker for a panel discussion entitled, “Fixing the mental health care system: What Congress can do.” The forum, which will include former Rep. Patrick Kennedy, will be held in the AEI offices in Washington, D.C.

The federal government’s approach to mental health has been a chaotic patchwork of antiquated programs and ineffective policies across numerous agencies. Patients often fall through the cracks and land on the street or in the criminal justice system. The panel will discuss how Rep. Murphy’s Helping Families in Mental Health Crisis Act will address persistent problems like psychiatric bed shortages, the scarcity of evidence-based treatment, and the questionable priorities of America’s leading mental healthcare agencies.
To RSVP or for more information, click here.

WHO:Rep. Tim Murphy (PA-18)
Former Congressman Patrick J. Kennedy (RI)Sally Satel, MD, AEI Resident Scholar, Jeffrey Lieberman, MD, President of the American Psychiatric Association, E. Fuller Torrey, MD, Stanley Medical Research Institute
WHEN: Friday, March 28, 201410:00 AM — 11:30 AM
LOCATION: AEI, Twelfth Floor1150 Seventeenth Street, NW, Washington, DC 20036
CONTACT:With Rep. Murphy - Brad Grantz,
With AEI – Lauren Aronson,
MurphyPress | Congressman Tim Murphy (PA-18)

From: Mental Illness Policy Org

This afternoon, the House of Representatives adopted two major components of HR 3717, the Helping Families in Mental Health Crisis Act, a bill authored by Representative Tim Murphy, Chairman of the House Energy and Commerce Subcommittee on Oversight & Investigations.

The House-passed Protecting Access to Medicare Act incentivizes counties to establish Assistant Outpatient Treatment (AOT) programs, a successful alternative to long-term inpatient care for those with mental illness cycling through the system but never receiving needed care. AOT has been proven to save money for state and local governments by reducing the rates of imprisonment, homelessness, substance abuse, and costly emergency room visits for individuals with a persistent and serious mental illness.

“The Assisted Outpatient Treatment model, which is a cornerstone of my Helping Families in Mental Health Crisis Act, has proven track record of success in helping those who need treatment lead productive lives in the community. Under Kendra's Law in New York, AOT has reduced homelessness, ended the cycle of repeat hospitalizations and incarceration of those with mental illness by more than 70 percent. The legislation passed today is a tremendous step forward in expanding mental health services, and gives our effort to bring mental illness out of the shadows a major momentum boost as the Helping Families in Mental Health Crisis Act moves through the Energy and Commerce Committee,” said Rep. Murphy.

The Protecting Access to Medicare Act also includes another section of Murphy’s H.R. 3717 to expand access to community mental health services and strengthen the quality of care provided for those living with mental illness. This section was introduced in the Senate as a stand-alone bill by Senators Debbie Stabenow (D-MI) and Roy Blunt (R-MO).

Hours after these mental health provisions passed the House, Chairman of the Energy and Commerce Subcommittee on Health Joe Pitts (R-PA) announced he will be convening a legislative hearing on Thursday, April 3rd at 10:30AM to review Murphy’s Helping Families in Mental Health Crisis Act. Witnesses and additional information on the hearing can be found here.

“Our yearlong Oversight and Investigations Subcommittee investigation revealed that individuals diagnosed with a severe and persistent mental illness are more likely to end up in jail or on the streets because they aren't getting the treatment they need from our broken mental health system,” said Murphy. “The Helping Families In Mental Health Crisis Act will turn the sorrow of loss and tragedy into the joy of recovery for millions of families across the country by advancing evidence-based medicine, fixing misunderstood HIPAA rules, and expanding access to evidence-based treatment.”

Sunday, March 9, 2014

Dr. Michael Welner On Piers Morgan -- Speaking of the need for HR 3717

Published on Mar 7, 2014

Dr. Michael Welner, forensic psychiatrist and Chairman of The Forensic Panel in New York City, speaks with Piers Morgan on mental illness and Congressman Tim Murphy's: Click HERE:


Rep. Tim Murphy, PhD:

More than 11 million Americans have severe schizophrenia, bipolar disorder, and major depression yet millions are going without treatment and families struggle to find care for loved ones.
The federal government’s approach to mental health has been a chaotic patchwork of antiquated programs and ineffective policies across numerous agencies. Sadly, patients end up in the criminal justice system or on the streets because services are not available.  

The Helping Families In Mental Health Crisis Act fixes the nation’s broken mental health system by focusing programs and resources on psychiatric care for patients & families most in need of services.



Bill Information


Congressman Murphy's Interviews and Floor Speeches

Rep. Murphy introduces H.R. 3717 on the House Floor
(December 12, 2013)

In The News
OP-ED: Overhaul of mental health care long overdue, by Rep. Tim Murphy, Philadelphia Inquirer (January 26, 2014)

New Bill Reduces and Improves LEO Interaction with Mentally Ill, Mental Illness Policy Org for Law Enforcement Today (December 14, 2013)

Letters of Support
(Click on thumbnail to view Letter of Support)


Wednesday, March 5, 2014

An ever hopeful mom … AOT is a proactive stance!

A must read from my blogger friend an advocate extraordinaire ~ Karen Easter!

It's Time to Change Tennessee's Mental Health Laws!: An ever hopeful mom ...

This mother is ever hopeful that someday soon the severe and persistent mentally ill may receive timely treatment and that lack of insight (anosognosia) will trump the "civil rights" argument that currently prevents many from receiving this life saving intervention. 

Over my 7 years of advocacy, I have discovered Important Truth #1 critical to making this happen: 

We ALL must accept the full extent of the dependency needs of these chronically ill patients and that requires ... funding.

Which brings me to Important Truth #2:

Taking a proactive stance costs a whole lot less in the long run that taking a reactive one. 

Treatment instead of jail.

Treatment instead of living on the streets.

Treatment before tragedy. 

Let's make treatment accessible for all by improving our laws - not just for some with mental health issues - but for the folks considered the least of these by our society, the severe and persistent mentally ill.

Let's pass a statewide AOT law in Tennessee, sooner rather than later.

Because later is too late.

Which brings me to Important Truth #2: Taking a proactive stance costs a whole lot less in the long run that taking a reactive one. 

Treatment instead of jail.

Treatment instead of living on the streets.

Treatment before tragedy. 

Let's make treatment accessible for all by improving our laws - not just for some with mental health issues - but for the folks considered the least of these by our society, the severe and persistent mentally ill.

Let's pass a statewide AOT law in Tennessee, sooner rather than later.

Because later is too late.