Gardner, DeGette Spar on Mental-Health Reform

March 6, 2013

Mental-health experts told committee members of large holes in the nation’s services and laws

WASHINGTON — Rep. Cory Gardner said changing a federal-health privacy law and state involuntary commitment laws would help avert mass shootings such as those that occurred in Littleton and Aurora, Colorado.

“It is something I’ve been talking about: the HIPPA law and commitment laws can preempt generally mentally ill people from committing violence,” the Yuma Republican said after attending a congressional hearing Tuesday on the link between mass shootings and mental illness. “These will do so much more good in terms of money saved and helping mentally ill people than drawing some arbitrary limit on gun-magazine clips.”

Rep. Diana DeGette disagreed. “It’s not an either-or solution. It’s a comprehensive approach,” the Denver Democrat, whose reshaped district includes Littleton, said in an interview.

DeGette reiterated her support for both the Obama administration’s gun proposals and its plan to spend $155 million this year  to train teachers, first-aid workers, and others to identify the symptoms of mental illness among their students.

She also defended the 1996 HIPPA law, which protects the confidentiality of patient’s records, from criticism that some states don’t ask hospitals of patients who suffer from severe mental illness. States that neglect to examine the records of patients with severe mental illness are “misconstruing the law.”

Gardner and DeGette’s differences mirrored those of many of their colleagues on a House Energy and Commerce subcommittee.  Conservatives like Gardner  emphasize the  need for states to broaden their criteria so that severely mentally ill people can be committed involuntarily more easily. Liberals like DeGette endorse greater federal funding for those who might identify people with mental illness.

The subcommittee’s hearing on the link between mental illness and mass shootings was the first for Congress since gunman Adam Lanza murdered 20 first graders and six others at Sandy Hook Elementary in Newtown, Conn. last December.

Lanza had been diagnosed with a rare form of autism. Severe mental illnesses like it have been attributed to other mass shooters, including James Holmes, the Colorado State graduate student who is on trial for perpetrating the Aurora massacre last July. “It’s not only what’s in a person’s hand that makes his act violent,” subcommittee chairman Tim Murphy (R-Pa.) said in his opening statement. “It’s what is in his mind.”

Mental-health experts and parents of children with severe mental illness told committee members of large holes in the nation’s services and laws.

Peter Earley, an author and former Washington Post reporter, criticized state laws that prevent authorities from committing the severely mentally involuntarily unless they represent a danger to themselves and others. He said getting his son sufficient treatment in a hospital bed in the state of Virginia was so difficult that he lied to police that he had threatened to kill him. “The biggest treatment center (for the mentally ill) is not a hospital. It’s the LA County jail,” Earley said.

Pat Milam, the father of a son with severe mental illness who committed suicide, criticized the federal-health privacy law as injurious to the interests of those with severe mental illness.

Milam said the problem with the 1996 Health Insurance Portability and Accountability Act is that doctors are unable to talk with the parents of patients, and the lack of a paper trail with releases and the cancellations of releases from patients.

“Doctors told me that HIPPA didn’t give them the financial incentive to share their records (with other institutions),” Milam noted.

Harold S. Koplewicz, president of the Child Mind Institute in New York, said a mere 7,500 practicing child psychologists are available to treat 15 million young people with some form of mental illness, such as depression. “The math doesn’t work,” he said.

Michael J. Fitzpatrick, director of the National Alliance on Mental Illness, added that only two in five mentally ill Americans receive regular treatment.

The nation’s patchwork system of laws and services has been in the making for half a century. President Kennedy signed  legislation in 1963 that sought to move mentally ill patients from hospitals and state-run institutions to federally-subsidized local and county health centers.  Although millions of patients left the hospitals, many did not wind up in community health centers for long, choosing to live  on their own or with family members.  Rates of homelessness, drug and alcohol addiction, and suicides among the mentally ill soared among those who did not received proper and consistent treatment, mental health-experts told committee members.

E. Fuller Torrey, a noted psychiatrist and author, warned of the dangers posed by the 1.2 million schizophrenic Americans who are untreated. He said the state of New York’s 1999 law that both mandates treatment for the severely mentally ill with a history of violence and not taking their medication and provides them with services is a model for the nation. “If we don’t add this critical issue to our laws, we’re going to be back here in six months and a year from now,” he said.

The subcommittee will hold another hearing on the link between mass shootings and mental illness later this month, Rep. Murphy said.

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