Wednesday, October 4, 2023
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Experts Push Senate on Mental Health Care

WASHINGTON (CN) - Government agencies are making strides against the stigma of mental illness, but - with nearly one in five U.S. adults affected - the need for more attention is clear, officials testified before the Senate today.

Just 6 percent of federal health spending goes toward mental health services, and 1 percent toward combating substance abuse, Kana Enomoto told the Health Education, Labor and Pensions Committee.

Nevertheless, Enomoto said her agency - the Substance Abuse and Mental Health Services Administration - has been able to provide grants to states and communities to help them create mental health programs.

Even with successful programs like these, however, the agency representatives acknowledged there is more progress to be made, especially in the way mental health is discussed and perceived.

"We have to always remember that the brain is part of the body, and that mental health issues need to be thought of as health issues," said Tom Insel, director of the National Institute of Mental Health.

For Insel and the other witnesses, the tendency to separate mental and physical health treatments and providers stems from a problem in how the United States handles mental illness.

More so than in many other areas of medicine, Insel said the mental health field must overcome "this unconscionable gap between what we know and what we do."

Sen. Susan Collins, R-Maine, told a story about a man with schizophrenia named Will who killed his mother in a psychotic state. Will was discharged from a mental institution after a federally funded advocate told him his parents had no role in his health care, no right to his medical records and that he could ignore his medication if he wanted, Collins said.

Collins asked what the role parents have in caring for adults with mental health disorders. Enomoto emphasized the importance of protecting the rights of people with mental illness, but said there is a place for families being able to help.

A common theme throughout the hearing was tendency in the system of channeling people with serious mental illnesses into prisons instead of into institutions that can provide them with care.

"By default, we're finding folks incarcerated not because they've necessarily committed a crime but because of their mental illness as the primary reason for their incarceration," Sen. Tim Scott, R-S.C., said during the hearing. "So that is something I think we must address we need to address and frankly from the financial perspective it's one of the most expensive ways of addressing it is to have folks incarcerated, losing their freedom, and at the expense of taxpayers."

Insel said better science, research and education can help make sure people, especially young people coming to grips with the first signs of mental illness, are given the help they need rather than simply sent to prison.

"You can't ignore that," Insel said. "You need to really ask in a bipartisan way, is this the country you want to be? Is this how you want to treat people with a brain disorder?"

Jim Macrae of the Health Resources and Services Administration spoke about the unique problems rural communities experience when it comes to mental health issues. These communities suffer from higher-than-average suicide rates, and they have a lack of professionals equipped to deal with mental illness.

While the witnesses didn't offer one simple answer to the disparate and wide-ranging causes of the country's mental health problem, they all acknowledged more research dollars and congressional legislation could go a long ways toward helping chip away at the issue.

"I want to stress that, as with heart disease and cancer, and maybe more so in this area, we don't know enough," Insel told the committee. "We just don't know enough to ensure that everyone will be covered, and have a cure for every one of the problems that people with schizophrenia depression, bipolar disorder, autism develop. These are really difficult, complicated problems and we have got to invest not only in better services but also in more science."

Committee Chairman Sen. Lamar Alexander, R-Tenn., told reporters after the hearing his committee is unlikely to undertake new legislation on mental health until next year.

Alexander did note, however, that the mental health bill that Sens. Bill Cassidy, R-La., and Christopher Murphy, D-Conn., introduced in August. Sen. John Cornyn, R-Texas, has another in the works in the Judiciary Committee, Alexander said.

"It'll be next year before we get the committee concluding work on mental health because we've got to finish No Child Left Behind, to finish our Innovation Medical bill and to finish reauthorizing the Higher Education Act by the end of this year," Alexander said after the hearing. "So we've got our hands full."

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