Murphy’s Law

© Icefields | Dreamstime.com

© Icefields | Dreamstime.com

In December of 2013, Congressman Tim Murphy, a Republican representing the 18th District of Pennsylvania, introduced H.R. 3717, the Helping Families in Mental Health Crisis Act. You can red a shorter summary of it here. Almost immediately, it drew opposition from several advocacy groups. H.R. 3717 says it’s purporse is: “To make available needed psychiatric, psychological, and supportive services for individuals diagnosed with mental illness and families in mental health crisis, and for other purposes.” Why would advocates for the mentally ill be opposing a bill that is supposed to help the mentally ill?

One of these was MindFreedom, a nonprofit organization that seeks to nonviolently unite “people affected by the mental health system with movements for justice.” MindFreedom noted that the bill eliminated legal advocacy on behalf of those with psychiatric disabilities. It cut 85% of the existing funding for protection and advocacy programs. Under the bill individuals with psychiatric disabilities won’t get the same HIPPA protections. It would increase institutionalization, giving more money to psychiatric institutions than programs to help people live within the community.

A press release from the Mental Health Advocates suggested the measure would reverse some of the advances of the last 30 years in mental health services and supports. “It would exchange low-cost services that have good outcomes for higher-cost yet ineffective interventions.”  The bill was said to target the rights of individuals with mental illnesses and restructure federal funding “to heavily encourage the use of force and coercion.” It would seek to expand involuntary outpatient commitment (IOC), where an individual with serious mental illness would be court-mandated to follow a specific treatment plan, typically requiring medication.

Several bloggers for Mad in America also voiced their opposition to the legislation. Corinna West said the bill “replaces peer support, which works, with forced treatment, which doesn’t.” She cited the National Association of State Mental Health Program Directors, who after a review of forced treatment found it wasn’t helpful. Additionally, peer support was the #1 most effective method. She also noted in her December 2013 article that two of the top five industries donating to Rep. Murphy’s reelection campaign were healthcare professionals and the pharmaceutical industry. We’ll return to this issue later.

Faith Rhyne noted the legislation presented itself as having “worst case scenarios in mind;” that it was “not about most people” with psychiatric diagnoses. However, the criteria in the bill for patients eligible for IOC are not limited to individuals with a history of violence and incarceration. “It includes those with a record of non-medical hospitalizations,” and those deemed unable to care for their basic needs. “In many ways the legislation carries the theme and intent of E. Fuller Torrey’s Treatment Advocacy Center, which is noted on Representative Murphy’s website as being a leading supporter of the bill.”

Mad in America wrote an editorial opposing the bill, focusing on the dangers of the mandated treatment relying on antipsychotic medication. The editorial referred to research showing that these medications shrink the brain and may actually impair recovery. “But American psychiatry and the NIMH have never publicized those findings.” The false impression of the benefits of antipsychotics made passage of H.R. 3717 possible.

The House Subcommittee on Health held a hearing on H.R. 3717 on April 3, 2014. You can watch a video of the hearing and review documents associated with it here. Still trying to gain support for the bill, Rep. Murphy addressed the American Psychiatric Association in May of 2014. In his introduction, he was called “a friend of psychiatry.” He gave an impassioned plea of support for his “comprehensive mental health legislation.” The APA President, Paul Summergrad said:

The APA is committed to achieving needed legislation to transform mental health care on the basis on the best science and clinical care. We are pleased to work closely with Representative Murphy as well as Representative Barber and others to craft the best bill to benefit the American people.

Elise Viebeck reported for The Hill that House Republican leaders announced in June of 2014 they were going divide the Murphy Bill into pieces in an attempt to pass the less controversial provisions. This was said to be a major blow to the bill and Rep. Murphy, who had argued that only “dramatic and comprehensive reform” would help people with serious mental illness. “The defeat of the comprehensive bill is a victory for the broad swath of national mental health groups that were uneasy about or opposed to Murphy’s legislation.”

But Murphy continued to lobby for support of his comprehensive bill.  A December 2014 updated summary of H.R. 3717 listed 34 organizations supporting the bill, including the American Psychiatric Association and the American Psychological Association and the Treatment Advocacy Center. There were 115 cosponsors of H.R. 3717.  The twenty-one media outlets included: The Wall Street Journal, The Washington Post, the Pittsburgh Post-Gazette, the Seattle Times, and the Houston Chronicle.

In February 2015, Congressman Tim Murphy was a keynote speaker at an event, “Fixing America’s Mental Healthcare System.” He said he hoped to reintroduce H.R. 3717 as early as March of 2015. Senator Chris Murphy, who participated in the same panel discussion event as Congressman Murphy, voiced his intent to introduce similar legislation in the Senate this year. Senator Murphy is from Connecticut, where the Sandy Hook shooting took place.

Rob Wipond of Mad in America, citing a 2013 analysis of the bill by the National coalition for Mental Health recovery, once again noted how the existing legislation would “heavily encourage the use of force and coercion.” This would likely involve “treating people with pharmaceuticals. It would undermine the rights and legal support of people seeking non-drug options. It would cut funds for community-based services with a proven track record of helping people stay out of the hospital. “(T)his bill would cost more money for worse outcomes.”

Wipond also cited information on donors to Congressman Murphy for the 2014 election cycle. Maplight listed contributions from pharmaceutical companies such as: GlaxoSmithKline, AstraZenaca, Pfizer, Johnson & Johnson, Merck & Co, Eli Lilly & Co.—many of them on multiple occasions.  Murphy received $95,830 from 10/1/2012 to 9/30/2014 from pharmaceutical/health care product companies.

OpenSecrets.org reported that within Murphy’s top 20 contributions from industry were health professionals, pharmaceuticals/health products, hospitals/nursing homes, and health services/HMOs. Murphy received over $283,000 from the political action committees related to these industries for the 2014 election cycle. There were individual contributions in addition to these. His campaign committee reported that during the 2013-2014 fundraising cycle they raised $1,854,010. In his political career from 2001-2014, he has received $701,235 in contributions from health professional political action committees, and $430,030 in contributions from pharmaceuticals/health products political action committees.

In all the readings linked here; in the videos I watched of Congressman Murphy gathering support for his bill, I did not hear any substantive reference made to the concerns raised and noted above by MindFreedom, Mental Health Advocates, or Mad in America. Specifically, I did not hear anything addressing the concern for the proposed IOC.

Congressman Murphy advocates for increased social control over individuals with “mental illness.” He’s a friend of psychiatry, who dismissed the opponents to his legislation as marginal and “anti-psychiatry” in his rhetoric to the American Psychiatric Association. He is passionate in his views and has a well-polished stump speech that he gives as he drums up support for his legislation. He has been heavily supported by the medical and healthcare industry throughout his political career. And he is getting ready to try again to get Congress to approve legislation giving psychiatry increased power and authority.

This is happening just as the validity of what he has referred to as “anti-psychiatry” is becoming more widely known and accepted. What’s more, there is scientific evidence to support much of it. The evidence-based “treatment” of psychiatric medications has been repeatedly shown to be marginally effective at best. Look at the information on Mad in America; Psychiatric Drug Facts and PsychRights.

Any legislative reform that gives psychiatry more power should be sidelined until the existing questions on the validity of psychiatric diagnosis and practice are resolved. Otherwise, we may have to live with the consequences of a different Murphy’s law—anything that can go wrong, will go wrong. If we really want to help the “mentally ill,” we should wait until we are clear that the proposed changes will help and not harm them.