NYAPRS Note: The Senate is likely to vote TODAY on an urgent Medicare bill (HR 4302) that includes an unrelated program to fund forced psychiatric treatment (Title 224, Assisted Outpatient Treatment Program). A Medicare rule kicks in Tuesday, April 1, that cuts payments to doctors. The House passed HR 4302 on a voice vote with no debate last Thursday. The Senate could do the same today听and the President could sign it before midnight. Call both听听from your State IMMEDIATELY. (They will vote on this bill TODAY.) Leave a short message:
鈥淚 am (name, city). My Senator should NOT vote for a Doc Fix that includes Section 224 of the House bill (HR 4302). Section 224 has nothing to do with Medicare. It would use Federal dollars to pay for forced psychiatric treatment in our communities. Forced treatment is traumatizing. It criminalizes people in crisis. It scares people away from seeking help. It is costly but not effective. Keep Section 224 out of the Doc Fix bill. (Leave your phone number if you want a return call.)
Please make these calls This morning! Your voice counts if you make the calls!
Mental Health Advocates Decry Forced Treatment Provision in 鈥淒oc Fix鈥 Bill
National Coalition for Mental Health Recovery; March 28, 2014
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The听 听rushed through the House of Representatives by voice vote yesterday to patch Medicare听regulations includes a highly controversial provision that has nothing to do with听Medicare, and that would subject people in crisis to forced treatment. Studies have shown that such force causes trauma and drives people away from treatment, mental health advocates warned.
Today, an array of national mental health and disability advocacy groups joined together to decry this provision, which they view as a regressive attack on hundreds of thousands of听Americans听with serious mental health conditions.
鈥淚n its rush to fix a problem with听Medicare, the House passed a bill including a highly controversial听program, , with no debate and no roll call vote,鈥 said听Raymond Bridge, public听policy director of the听听(NCMHR), a coalition of 32 statewide organizations and others representing individuals with mental illnesses. 鈥淎nd it seems that the Senate may pass a version of the House bill including this troubling provision on Monday,鈥 Bridge added.
The 123-page Protecting Access to听Medicare听Act of 2014,听, includes a four-year,听$60 million grant program听(Sec. 224) to expand involuntary outpatient commitment (IOC) 鈥 also called Assisted Outpatient Treatment (AOT) 鈥 in states that have laws authorizing IOC. The laws allow courts to mandate someone with a serious mental illness to follow a specific treatment听plan, usually requiring medication. The facts show that involuntary outpatient commitment is not effective, involves high costs with minimal returns, is not likely to reduce violence, and that there are more effective alternatives.
Assisted Outpatient Treatment is central to the controversial Helping Families in Mental Health Crisis Act (), proposed by Rep.听Tim Murphy听in听December 2013.
鈥淭his legislation would eliminate initiatives that use evidence-based, voluntary, peer-run services and family supports to help people diagnosed with serious mental illnesses to recover,鈥 said听Daniel Fisher, M.D., Ph.D., a psychiatrist and an NCMHR founder. 鈥淚t would bring America back to the dark ages before de-institutionalization, when people with mental health conditions languished in institutions, sometimes for life.鈥
The provisions of H.R. 3717 would exchange low-cost, community-based services with good outcomes for high-cost yet ineffective听interventions, according to the NCMHR; the听听(NDRN), the non-profit membership organization for the federally mandated Protection and Advocacy (P&A) Systems and Client Assistance听Programs听(CAP) for individuals with disabilities; and the听听(NCIL), which advances听independent living听and the rights of听people with disabilities听through consumer-driven advocacy.
NDRN, NCMHR,听听and NCIL note that the bill does not represent the mainstream of national thought, practice and research.
鈥淭his legislation will have a devastating impact on persons with psychiatric disabilities by stripping SAMHSA Substance Abuse and听Mental Health Services听Administration support for consumer involvement in their recovery,鈥 said听Mark Perriello, president and CEO of the听American听Association of听People with Disabilities听(AAPD). 鈥淎mericans with psychiatric disabilities are our friends, co-workers, neighbors, and sisters and brothers. This legislation tramples their civil rights, and must not move forward as currently written.鈥
鈥淔orce and coercion drive people away from treatment,鈥 said听Jean Campbell, Ph.D., one of the nation鈥檚 leading mental health researchers. 鈥淚n 1989, 47% of Californians with mental illnesses who participated in a consumer research project reported that they avoided treatment for fear of involuntary treatment; that increased to 55% for those who had been committed in the past.鈥
Enlarging the capacity for inpatient commitment 鈥渃ould violate听Olmstead v. L.C.听(1999), the Supreme Court decision, because it would increase 鈥榰njustified segregation of persons with disabilities which constitutes discrimination in violation of Title II of the听Americans听with Disabilities Act,鈥 鈥 said听Kelly Buckland, executive director of NCIL.
Rep. Murphy鈥檚 bill is based on a false connection between mental illness and violence, the advocates say. 鈥淪tudy after study shows that听. In fact, individuals with mental illnesses are actually 11 times more likely to be听听of violence than the general public,鈥 Dr. Fisher said.
鈥淩ep. Murphy鈥檚 bill would eviscerate the rights and privacy protections enshrined in the federally mandated Protection and Advocacy (P&A) System, which is the largest provider of legal advocacy services to听people with disabilities听in听the United States,鈥 said NDRN executive director听Curt Decker.
鈥淲e all agree that incarceration and homelessness are not the outcomes people diagnosed with serious mental illnesses want or deserve,鈥 Dr. Fisher added. 鈥淲e urge Congressional leaders to engage in a meaningful dialogue with our mental health communities to learn about our creative innovations that truly support the health and safety of people with mental illnesses and of all听Americans.鈥
The advocates strongly urge the Senate to reject the forced treatment provision of the 鈥渄oc fix鈥 bill.
Contact:Dr.听Daniel Fisher,听info@ncmhr.org, 877-246-9058;听Raymond Bridge, 703-883-7710,raymond.bridge@ncmhr.org
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