Measure would strengthen mental health-care system


Senator Debbie Stabenow (D-MI) speaks as David O. Russell, director of the film Silver Linings Playbook, and Senator Roy Blunt (R-MO) (R) look on during a news conference Feb.7, 2013 on Capitol Hill. A bipartisan group of senators will introduce the Excellence in Mental Health Act to help strengthen the nation's mental health services. (Alex Wong/Getty Images)
February 7, 2013

A bipartisan group of senators, citing renewed urgency after the shooting massacre at Sandy Hook Elementary School, introduced legislation Thursday aimed at strengthening the nation’s fragmented mental health-care system and improving access at the community level.

The bill would put in place standards for about 2,000 “federally qualified” community behavioral health centers, requiring them to provide such services as substance abuse treatment and 24-hour crisis care.

In return, facilities meeting criteria would be able to bill Medicaid for their services — a change intended to open the door to treatment for many more people and one that is estimated to cost about $1 billion over the next decade.

“There is an important gap here,” said Sen. Debbie Stabenow (D-Mich.), one of the bill’s main sponsors. She warned that too many people receive inadequate or no treatment and are at risk of their problems becoming more dangerous.

Sen. Roy Blunt (Mo.), the lead GOP sponsor of the measure, cited his state’s work in providing community health centers but also said that the recent shootings in Newtown, Conn., spotlighted shortcomings in mental health care that demand attention.


Reporting mental health cases to the national database used for background checks varies from state to state. Here is the number of mental health reports made per 100,000 residents in each state.

“We have a moment that works, and we have a model that works,” he said.

Additional Republican co-sponsors include Sens. Marco Rubio (Fla.) and Susan Collins (Maine). Other Democrats backing the legislation include Sens. Jack Reed (R.I.), Patrick J. Leahy (Vt.) and Barbara Boxer (Calif.).

The senators introduced the legislation Thursday at the Capitol alongside David O. Russell, the Academy Award-nominated director and screenwriter of “Silver Linings Playbook,” which stars Bradley Cooper and Jennifer Lawrence as a mentally troubled couple. Russell said Thursday that he wrote the film for his bipolar 11-year-old son, whom he wants to have the most normal life possible. Without such access to mental health facilities, the director said, children like his son could be left to go down “a dark path and they live in a parallel society.”

Russell and Cooper have been barnstorming Washington to seek more federal help for mental disorders. They met Thursday evening with Vice President Biden.

The bipartisan bill comes amid a far-ranging debate in Congress — and nationwide — about how to curb gun violence after December’s massacre in Newtown. President Obama and some lawmakers have pushed for tighter restrictions on firearms, including a measure that would expand background checks for potential gun owners. Although many gun-control proposals remain contentious, Democrats and Republicans alike have agreed that improving mental health care must be a part of any broader effort to reduce violence.

Thursday’s announcement pleased many mental health advocates, who have pushed for such changes with limited success.

“We support the bill 100 percent,” said Andrew Sperling, director of legislative advocacy for the National Alliance on Mental Illness, who said patients would benefit if the proposed changes become law. “We hope that at the end of this process that we’re going to get better outcomes.”

Linda Rosenberg, president of the National Council for Behavioral Healthcare, said the bill would go a long way toward making sure people get the treatment they need — no matter where they live.

“The standard of care is too mixed right now,” she said. “This would raise the floor in terms of the quality of service and consistency from community to community, and that’s vitally important.”

Rosenberg and other advocates say they worry that the renewed focus on mental health care after the Newtown shootings could stigmatize the mentally ill. But they also recognize that this may be the best opportunity for fundamental change in years.

“It’s our moment to take advantage and say, ‘We can do better.’ We want to take advantage of the public sentiment,” Rosenberg said. “Out of tragedy, hopefully something good can come.”

Brady Dennis is a national reporter for The Washington Post, focusing on food and drug issues.
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