After a summer of slayings, lawmakers and mental health advocates say they have more momentum than at any time in recent history to push through an overhaul of the nation's broken mental health system.
The opening they see involves timing, bill tweaking and sheer perseverance — a House lawmaker obsessed with the issue for many years teaming up with a powerful chairman, Fred Upton (R-Mich.) of the House Energy and Commerce committee. In the Senate, meanwhile, a bipartisan bill drew strong interest over recess from lawmakers facing pressure from people back home to do something.
Both proposals would create more psychiatric beds, and allow families to get more information about a loved one’s treatment — with the House bill tweaked to soften language that had linked state mental health funding to mandated treatment for some people.
More importantly, both bills avoid the poison pill of gun control while still addressing some holes in the mental health system that have allowed mentally ill shooters to get their hands on guns.
"I think the consciousness of the Congress is in a fundamentally different place because of the increasing number of mass shootings and the growing recognition that we can’t let political differences over gun policy stop us from reforming the mental health system," said Sen. Chris Murphy, the Connecticut Democrat said when he and Sen. Bill Cassidy (R-La.) introduced their mental health bill after a movie theater shooting in Louisiana in July.
Further gun restrictions remain a nonstarter -- despite another rally on Capitol Hill Thursday headlined by the father of slain Virginia journalist Alison Parker who called out lawmakers by name for thwarting stricter background checks.
On the mental health overhaul, optimism is real, but it’s tempered with realism. Similar bills have stalled before, even after the 2012 murder of 20 young children at a Connecticut school that was the impetus for Congress’ earlier attempt to enact comprehensive mental health legislation. And the calendar will be challenging as lawmakers face a Sept. 30 deadline to pass a government funding bill.
Rep. Tim Murphy (R-Pa.), a clinical psychologist by training, has engaged in two years of quiet negotiations to win support for his bill. But he said this summer's deadly events — starting with the June slaying of nine people in a black church in South Carolina through the execution-style murders of two Virginia journalists on live television — led to heightened interest.
“I don’t know why it’s taking so long but I sure as hell am not going to stop pushing,” he said. “These [shootings] are happening so frequently now that it’s gotten to the point where members of Congress can’t ignore it anymore.”
The action is likely to start in the House, where Energy and Commerce staff worked on Murphy’s bill over the summer. “As we look ahead to the next few months, this is an issue that is of bipartisan importance,” Upton said in a statement.
Upton has helped drive passage of two major recent bipartisan health bills. The House this summer approved sweeping legislation to accelerate the development of medical breakthroughs — a bill that was developed in his committee. And he was also involved in the long-sought overhaul of how Medicare pays physicians.
An earlier version of Murphy’s bill did not get buy-in from committee Democrats but the politics changed after the author of a rival Democratic bill lost his reelection bid in 2014. It also helped that Murphy softened one of the most controversial provisions in his earlier proposal, that proposal for mandatory outpatient treatment for some people. His legislation now has incentives for states to have these court-ordered treatment programs, but they aren’t required.
The primary House and Senate reform bills are similar. They would both strengthen requirements for insurers to provide equal coverage for mental health care — already enshrined in mental health parity laws but not fully enforced. Besides providing family members with greater access to patient information, both bills authorize new grant funding for an array of state and local mental health services, and create an assistant secretary position within HHS focused on mental health. Lawmakers haven't yet said how they would pay for the bill.
“The main disagreements we have now are about where we get the money,” said Rep. Tim Murphy.
In the Senate, leaders of the Health, Education, Labor and Pensions Committee plan to quickly call up a separate, smaller-scale bill that would reauthorize existing mental health programs, without the more ambitious Murphy-Cassidy agenda.
Sen. Chris Murphy said he's discussed his broader bill with Senate leaders and HELP Chairman Lamar Alexander (R-Tenn.) and is hoping for hearings later this fall. Bipartisan progress in the House might push those forward, he said.
He’s got some support.
“It’s a very positive sign when members from both parties and in both chambers are working to improve access to mental health services,” said Sen. Debbie Stabenow (D-Mich.), who has also worked on bipartisan mental health initiatives. “This is not a Democratic or Republican issue, but an issue that touches all of our families in some way.”
While advocates are concerned that the focus on mental health reform in response to gun violence will further stigmatize mental illness, they acknowledge the frequency of these shootings has put a spotlight on shortcomings in the mental health system.
“It used to be that lawmakers weren’t interested in talking with us about mental health issues,” said John Snook, of the Treatment Advocacy Center in Arlington, Va.
“Now we’re at the point where we have legislators who start having conversations about mental illness ... and then they get to their districts and hear all of the terrible things going on with mental health on a daily basis.”
Whether or how quickly they go beyond the talking stage is unclear.
“In the meantime," said Rep. Tim Murphy, "sadly and pathetically, we’ll have more moments of silence on the House floor.”