Mental health and the campaign
As Donald Trump manufactured more controversy last week, suddenly flying to Mexico in a misguided bid to revive his failing campaign, Hillary Clinton steadily rolled out substantive policy proposals giving the American public a better idea of her priorities as President.
Clinton revealed her mental health policy agenda to much acclaim, with a major focus on the integration of mental and physical health-care systems. The emphasis on integration lines up nicely with current Republican policymaking in Washington, specifically with legislation spearheaded by Rep. Tim Murphy of Pennsylvania, the Helping Families in Mental Health Crisis Act of 2016. This bipartisan legislation was approved by the House in July but it remains to be seen whether the Senate will take up the bill this autumn or leave it, like so many other good ideas, to wither on the vine, as Congress typically does almost nothing as the election nears.
It’s refreshing to see that there are other areas where Clinton’s mental health plan already aligns with Republicans in Congress, proving that we know what to do to reform mental health care, if we can just find the political will. Each plan promotes early diagnosis and intervention and focuses on improving access to community-based treatment. Both plans cite the need to impact the nation’s suicide rate, now at its highest level in 30 years. While Clinton’s plan focuses on suicide prevention for high school and college students, Murphy correctly points out that other age groups are actually at a higher risk of suicide. Certainly that is the case in Nevada, which leads the nation in suicides by those 85 years and older, at triple the national average.
Rep. Murphy told reporters he was disappointed that Clinton’s plan didn’t highlight the need to change medical privacy laws so family members can more actively participate in treatment planning. The Clinton plan also didn’t mention assisted outpatient treatment programs, a growing movement to more aggressively treat severely mentally ill patients living in the community in an effort to keep them healthy and out of mental health hospitals and the criminal justice system. Murphy did tell USA Today, however, that “There’s a lot in there that I can work with her on.”
Clinton wants to improve access to housing and increase job opportunities for those living with a mental illness and other disabilities. She sees the need to create more supportive housing options to keep people out of institutions. The plan also focuses on enforcing mental health parity provisions in insurance coverage, training law enforcement officers in crisis intervention, and prioritizing treatment over jail for low-level offenders.
Clinton wants to invest in brain and behavioral research and develop new safe and effective treatments. She wants better mental health services for people in jail or prison and supports funding of specialty courts to divert them from incarceration.
While there was some grumbling among national mental health advocacy groups about what was left out of Clinton’s plan, such as eliminating the outdated Medicaid IMD exclusion, her plan won strong praise from leading mental health groups such as the American Psychiatric Association and Mental Health America.
Despite the differences between Clinton and Congressional Republicans’ approach to mental health reform, the joint focus on improving the nation’s mental health system bodes well for the new year, with Clinton promising to convene a White House Conference on Mental Health in 2017 should she win the election.
Even Rep. Murphy said the Clinton plan “absolutely” gives him hope that Republicans and Democrats can work together on this issue. Maybe we can finally address the shameful fact that the largest mental health treatment facilities in our country are local jails. Surely we can unite behind creating a better mental health system in our country. It’s way past time.