Behavioral healthcare advocates and federal lawmakers are amplifying their call for legislation that would expand access to community behavioral healthcare
services after this week's deadly shooting spree at the Washington Navy Yard.
The strong interest on Capitol Hill and at the White House to improve mental healthcare services after the Sandy Hook Elementary School shooting massacre late last year has waned, but the murder of 12 people as they began their workday on Sept. 16 has renewed that attention—for now.
On Monday morning, Aaron Alexis, 34, a former Navy reservist, opened fire at the Navy Yard before he was later gunned down by police. The Veterans Affairs Department
issued a statement Wednesday that said Alexis was treated for insomnia in August at the VA Medical Center in Providence, R.I. According to the VA, physicians asked Alexis if was struggling with anxiety or depression or had thoughts of harming himself and others, which he denied.
“Instead of merely talking about this issue in the wake of tragedies, it is time to finally take bipartisan action to improve our mental healthcare services,” Sens. Debbie Stabenow (D-Mich.) and Roy Blunt (R-Mo.), lead co-sponsors of the Excellence in Mental Health Act, said in a joint statement Thursday.
The two lawmakers introduced the bill in February and it now has the support of 19 other senators and more than 50 mental health, veterans and law enforcement organizations, such as the American Psychiatric Association, the National Sheriffs Association, the National Council for Behavioral Healthcare, the National Association of Psychiatric Health Systems, and Iraq and Afghanistan Veterans of America. Meanwhile, a companion bill from Reps. Doris Matsui (D-Calif.) and Leonard Lance (R-N.J.) has a total of 24 co-sponsors.
Stabenow and Blunt also proposed their bill as an amendment to Sen. Harry Reid's ill-fated gun control bill
this spring, but the upper chamber didn't consider the measure before Reid pulled the full legislation after failing to muster enough votes to pass it.
The bill would establish criteria for federally qualified community behavioral health centers based on evidence-based quality standards and reporting measures to make sure that those facilities cover a broad range of outpatient and crisis services and also better integrate physical and mental healthcare. The legislation would also authorize prospective Medicaid
payments to centers that meet those standards and support the construction and modernization of behavioral health facilities.
“Columbine, Aurora, Sandy Hook, now the Navy Yard—how much more does our nation have to endure before we take this seriously?” said Chuck Ingoglia, senior vice president for public policy and practice improvement at the National Council for Behavioral Healthcare.
Ingoglia said there is strong bipartisan support for the legislation and that Stabenow served as the “send-off speaker” to more than 600 National Council members on Tuesday, when the organization hosted its “Hill day” for member organizations to meet with their senators and representatives in Washington.
“We're seeing an increased number of co-sponsors,” Ingoglia said. “But what we really need is for Sen. Reid to bring them to the floor in some way. We think we really need an opportunity for these bills to be considered and hopefully passed this year.”
The National Alliance on Mental Illness echoed that sentiment in a statement Thursday that urged Congress to pass mental health legislation that the group said has been stalled since the gun-control bill stalled in the Senate. In addition to the Senate and House versions of the Excellence in Mental Health Act, that legislation includes the Mental Health Awareness and Improvement Act in the Senate and the Justice and Mental Health Collaboration Act in both chambers. NAMI Executive Director Mike Fitzpatrick said in the statement that Navy Yard gunman Alexis's “struggles were not a secret” and that people who knew him observed symptoms of mental health disorders.
“Just last month, Newport, R.I.'s police responded to a call for help from him and were so concerned about his mental health that they reported their concerns to the Navy,” Fitzpatrick said in his statement. “Yet nothing apparently was done at the time of these events to get him the mental health evaluation and care that might have averted tragedy.”
Fitzpatrick urged Congress to pass and the president to sign mental health legislation before the one-year anniversary of the Sandy Hook Elementary shootings in December.
But with Congress and the White House preparing for a face-off to avert a government shutdown
, that goal has long odds.
That's why Mark Covall, president and CEO of the National Association of Psychiatric Health Systems, said there are measures that behavioral health and general acute care providers can—and should—take in the absence of legislation, which is not likely to pass this year. That includes not only pushing for more access to services, but also spreading the message that mental illness is like any other illness and requires treatment.
“As the whole change in payment and the Affordable Care Act unfolds, there is going to be a lot more incentive to look at care in a more comprehensive way,” Covall said. “I think it's going to be a natural evolution. We know there are so many more discussions between medical colleagues and psychiatric colleagues on how we can strengthen this relationship and it starts in the emergency department,” with screenings, for example, to test for alcohol abuse and addiction.
Covall's group has resources on mental illness and violence available on its website to help members learn what they can do to address the issue in their communities. And the organization is a sponsor of “The Kennedy Forum” that former Rep. Patrick Kennedy (D-R.I.)—who has battled addiction—will launch on Oct. 23 in Boston. Designed to help improve healthcare policy for those with mental illness, intellectual disabilities and addictions, the forum is meant to coincide with the 50th anniversary of President John Kennedy's signing of the Community Mental Health Care Act
. After kicking off with a dinner at the John F. Kennedy Presidential Library, the forum will include a one-day conference of panels and break-out sessions as well as a task force that will reconvene each year.
“I think maybe the legislation has waned, but I think the importance of mental health in broader policy discussions has increased, and I don't think it's going to go away,” Covall said. “I think it's here to stay.”Follow Jessica Zigmond on Twitter: @MHjzigmond