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Rep. Tim Murphy: Mental Health Bill Would Make Patients, Communities Safer

May 28, 2014
Originally published on May 28, 2014 4:24 pm

In California yesterday, two assembly members proposed a gun restraining order that would allow family members and therapists to ask police and a judge to bar someone from buying a gun.

Lawmakers are also proposing a law that would adopt new protocols for police making well-being checks on people. It would require that police check whether someone has bought a weapon, rather than just talk to them.

The measures are being proposed following the deadly rampage in Santa Barbara, which reignited the debate over what to do about the seriously mentally ill who become violent. Is it possible to make them, and others, safer through legislation?

Republican U.S. Rep. Tim Murphy of Pennsylvania, who is also a practicing clinical psychologist, thinks so.

He’s lead author of the “Helping Families in Mental Health Crisis Act,” which proposes better access to physicians through measures such as creating mental health courts, instead of putting mentally ill patients in criminal courts.

At its heart, the measure backs court-ordered outpatient care, empowers parents and caregivers of people with serious mental illnesses by providing them more information about their loved ones, and gives first responders more guidance.

Murphy joins Here & Now’s Robin Young from Washington to discuss his legislation.

Interview Highlights: Congressman Tim Murphy

On the need to reform patient privacy laws

HIPAA laws were put in place to protect people from being mistreated. They weren’t put in place to prevent people from being treated, and they have gone to that level now. When you have someone who has severe mental illness, oftentimes they are not aware of their illness, and you have to get accurate information, and very often, that is family members. To not be able to get information on mental illness, and history and background and current behavior, it’s like telling an orthopedic surgeon, ‘You’re not allowed to look at an x-ray. We just want you to guess at whether the bone is broken.’ We can’t possibly expect that. So what we see here is not a loosening or relaxing of the HIPAA laws in our bill; it’s clarifying them. Since the time our bill was released, we had hearings about this, we had parents coming to us and saying, ‘You know, I called the doctors, I go to the hospitals, I tell police what the problems are, and I can’t get anyone to listen, and many times, they say, “We can’t even talk to you.”‘ Well, they need to understand, professionals need to understand, you can listen to parents. You can get that information.”

On providing the mentally ill with proper care

“Communities have a right and a need to be safe. Parents care about these folks. Let’s pay attention to this. When some will argue about the person’s right to refuse treatment, shouldn’t we be arguing about their right to to be well? When what we have is that 40 percent of the time, someone’s first interaction with a professional, when there’s serious mental illness, with a policeman, you’re 10 times more likely to be in jail than in a hospital if you’re mentally ill; that half of people in jail have some level of mental illness, the majority of homeless. The list goes on and on. And so I say, the real compassionate thing is to get people treatment, get them care. Look at the wide range of care that can be available, from peer support to professional psychologists, social workers, psychiatrists, medication when it’s needed. And in a moment when someone has completely collapsed and they’re in crisis, rather than leave them on the street, let’s get them in some place, for a short period, where they can get things back together in a protective setting, get them back in treatment. What could be wrong with that? That’s the kind of thing that we know, in the field, helps people who are in the midst of a psychiatric crisis.”

On the how to spend effectively on mental health 

“Right now, we’re spending money in the wrong places. What happened is, we closed hospital beds in the ’60s and ’70s and ’80s and reduced that population down, we increased jails proportionally. So we’re spending in jails, in homeless shelters, on funerals for those 40,000 last year who committed suicide. We’re spending it on people who have lost their jobs and are now getting disability payments. We’re spending billions and billions and billions in these other areas, and we ought to be spending it in smart spending. That’s why part of our bill is also to have accountability for federal agencies and asking them, ‘Where’s your money going? Is it effective?’ If it’s not effective, you lose your funding. If it’s effective, let’s transfer the money there. If it’s redundant, let’s combine it. So we’re getting the money to communities and people. And I believe that when I’ve talked to members, I haven’t heard a single member of Congress saying we shouldn’t be doing that sort of thing.”

Guest

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ROBIN YOUNG, HOST:

It's HERE AND NOW. In California yesterday two assembly members proposed a gun restraining order that would enable family members and therapists to ask a judge to bar a severely mentally ill person from buying a gun. Lawmakers there also proposed a law that would adopt new protocols for police making welfare checks, checking on, again, the severely mentally ill for concerned families.

The proposal is that police be required to check to see if someone has bought a weapon in addition to talking to them. Of course, this is all in response to the mass killing in Santa Barbara. And it's reignited the debate over whether it's possible to make the severely mentally ill and those who come in contact with them safer through legislation.

Congressman Tim Murphy, the Congressman from Pennsylvania who's also a practicing clinical psychologist, thinks so. He's lead author of Helping Families In Mental Health Crisis Act. It proposes more funding for doctors and beds. But at its heart, it backs court ordered outpatient care, mental health courts and judges, and it gives more power to parents and first responders.

And this has landed in the middle of another debate between people who wonder if the HIPPA privacy laws go too far, often preventing parents from talking to doctors or police from picking the mentally ill up if they don't appear to be a harm to themselves or others, and advocates who think the mentally ill, abandoned for so many years, deserve their hard-won privacy.

Congressman Tim Murphy joins us now. And we say right away, the mentally ill responsible for only a tiny fraction of violence in the U.S. But you are calling for empowering parents. So address the concerns I just mentioned.

REPRESENTATIVE TIM MURPHY: Well, a couple of things. First of all, HIPPA laws were put in place to protect people from being mistreated. They weren't put in place to prevent people from being treated, and they have gone to that level now.

When you have someone with severe mental illness, oftentimes, they are not aware of their illness. And you have to get accurate information. And very often, that is family members. To not be able to get information on mental illness in history and background and current behavior, is like telling an orthopedic surgeon you're not allowed to look at an x-ray. We just want you to guess whether the bone is broken. We can't possibly expect that.

So what we see here is not a loosening or relaxing of the HIPPA laws in our bill. It's clarifying them. Since the time our bill was released, we had hearings about this. We had parents coming to us and saying, you know, I call the doctors. I go to the hospitals. I tell police what the problems are. And I can't get anyone to listen. And many times they say we can't even talk to you.

Well, they need to understand, you can listen to parents. You can get that information. And so what our bill does, it says here are - here's the laws. Here is the regulations that have come out since then with HHS clarifying them. If we could just get people to pay attention to the reality, we could get a lot further.

YOUNG: What about the California proposal that family members and therapists be allowed to ask a judge to bar someone from buying a gun?

MURPHY: I think getting information from family members to appropriate authorities, in terms of stating that someone may be at some level dangerous, is part of the problem we don't have communication with right now. But let me tell you. California has a law in the books for something called Assisted Outpatient Treatment whereby family members and a judge, who's there to make sure the person goes through proper procedures to protecting their rights, and doctors to sit down with patients and say, look. You've been in and out of jail. You've been in and out of treatment. We know the treatment makes you better. We need to keep you in treatment.

But what happened is despite that law being in the books in California, California isn't doing it. Only certain counties like, I believe, Warren (ph) County just voted on that. Nevada County is doing it. And you have other counties around America that when they do that, they find it to be effective if done right.

YOUNG: Is this the court ordered Assisted Outpatient Treatment that you refer to?

MURPHY: Yes.

YOUNG: Yeah.

MURPHY: Now, I might say when people say, well, what about their rights and their freedoms? Well, what freedom do you have if you're in jail? I would also suggest talk, if you could, to the parents of Adam Lanza. Unfortunately, his mother's dead now. Listen to the parents of the current shooter in California.

So often, these parents are saying I'm telling you something is wrong. I'm telling you he's falling apart. He's deteriorating. Won't someone listen to me and make them get help?

YOUNG: Well, what about the California case? Here were parents were very involved. They were calling police for welfare checks. And they had a son who had, it sounded like, a lot of therapists in his life, but he refused medication. Now, you mentioned that a lot of people don't think they are sick when they are. You mentioned that that can be court ordered treatment. What about the first responders and the police and welfare checks? How would you change that?

MURPHY: Well, you have two things that you've mention here. That is, the parents were begging for help. And here was a young man who was refusing it. And I think it's important to listen to parents when they're reliable and loving people.

The second thing is with police when they're doing a welfare check, I don't know what level of training they have. One of the things I offer in my bill is more grant funding to help police get training to know the kind of questions to ask and also know when you have this information before you, there's times when you want to call in psychiatrists or psychologists to do more evaluation.

The Assisted Outpatient Treatment could have helped Rodgers in this case. And that's an important part that everybody seems to get that we're still not acting on. It really is that black robe effect. And when you look at cases that have been held, for example, in Laredo, Texas or Dade County or places in New York, when the judge sits there and explains and works with that patient, you can see remarkably positive results.

When you see someone who simply tries to say you need to go get your medication and be in therapy, next case, that's going to be a failure. And that is not right. And that's not appropriate for anyone.

YOUNG: It sounds like at its heart, your bill proposes more empowering of the people who are actually around these, again, seriously mentally ill person who might be going into a psychotic break, for instance, more empowering of them. And sort of a secondary system between prison and a hospital that would be able to monitor these people.

MURPHY: You have - look, communities have a right and a need to be safe. Parents care about these folks. Let's pay attention to this.

When some will argue about the person's right to refuse treatment. Shouldn't we be arguing about the rights to be well? When what we have is that 40 percent of time someone's first interaction with a professional when you're seriously mental ill is with a policeman. You're 10 times more likely to be in jail than a hospital if you're mentally ill. That half of people in jail have some level of mental illness, majority of homeless - the list goes on and on.

And so I say the real compassionate thing is to get people treatment, get them care, look at the wide range of care that can be available. And at a moment when someone is completely collapsed and they're in crisis, rather than leave them on the street, let's get them in some place for a short period, a week or two in a hospital setting, where they can get things back together in a protected setting, get them back in treatment. That kind of thing we know in the field helps people who are in the midst of a psychic crisis.

YOUNG: Congressman Tim Murphy from Pennsylvania, author of the Helping Families in Mental Health Crisis Act. It'll be presented in a briefing in Washington tomorrow in a whole new spotlight after the events of this week. Congressman, thanks for speaking with us.

MURPHY: Thank you very much. Have a great day.

YOUNG: And the Republican Congressman's bill in the works for a while is backed by the Democrat Patrick Kennedy who's been very open about his mental health issues. Again, a briefing tomorrow. But a lot of opinions right now at hereandnow.org. Let us hear yours. Transcript provided by NPR, Copyright NPR.