WASHINGTON — More than 90,000 people in Connecticut are struggling with severe mental illness. But nearly half of them will go untreated, slipping through the cracks of the mental health system and landing in unemployment, homelessness or even prison.
The mentally ill are twice as likely to be incarcerated as to be hospitalized, according to the National Institute of Mental Health.
After hosting 11 roundtables and listening sessions with local mental-health advocates across Connecticut, U.S. Sen. Chris Murphy aims to change this with a bipartisan mental health bill that balances the right to privacy and self-determination with the need to provide care for those who may not be able to care for themselves.
Set to introduce the bill later this summer, the senator is carving out a space for himself in the realm of mental health advocacy — a space next to Rep. Tim Murphy, a Pennsylvania Republican who introduced a House version of the mental health bill last month.
The two have more in common than just a last name. Sen. Murphy’s bill will mirror the House effort on many points, like opening new inpatient beds and giving funding priority to recovery programs that are proven to work. But at the forefront of Sen. Murphy’s overhaul is a push to place mental and physical health services under the same roof.
“In order to keep somebody healthy, you might have to treat their brain and the rest of their body together,” Murphy said in a phone interview. “That means that when you walk into a community health center, and you present with a behavioral health issue, you shouldn’t be sent offsite.”
Sen. Murphy is backed by the American Foundation for Suicide Prevention, which awarded him the Allies in Action Congressional Award last month for his work in preventing suicide, the second leading cause of death in Connecticut for those ages 25-34.
Dr. John Murphy, president of Danbury Hospital — and yet another mental health advocate who shares the senator’s last name — said hospitals often “lose patients to follow-up” this way.
“What happens typically today is that we recognize that maybe somebody is depressed, you give them a piece of paper and say we’d like you to make an appointment, and it’s six weeks from now,” Dr. Murphy said. “We may have lost the opportunity for meaningful intervention.”
But drafting legislation on mental illness can be a hairy issue, especially when it involves patients’ rights.
Connecticut is one of only five states in the country that lacks assisted outpatient treatment laws, which authorize court-ordered treatment plans. Proponents of court-ordered treatment laws — like Rep. Murphy of Pennsylvania — claim mentally ill patients are often unfit to make decisions about their treatment. But patients’ rights advocates disagree, arguing that the laws are simply unwarranted force passed off as help.
Daniela Giordano, public policy director of the National Alliance on Mental Illness Connecticut Chapter, views court-ordered treatment as an “unnecessary overreach.” She said there are already policies in place in the state, such as designating a conservator to make health care decisions, to aid patients whose mental illnesses prevent them from making these decisions on their own.
“We would never think about doing this to somebody with diabetes or cancer or whatever else, even though people really don’t comply with their treatment,” Giordano said. “Just from that one angle, we’re really concerned about telling people what they can and cannot do.”
Sen. Murphy said he can’t accept any legislation that would force the state to change its laws. In what the senator calls a “carrot approach,” Rep. Murphy’s bill will dole out funding only to states with court-ordered treatment programs, a provision Sen. Murphy calls “more reasonable” — though he’d be prepared to forego the funding to keep those programs out of Connecticut.
The senator plans to address a different but equally controversial topic: Patient privacy laws as outlined in the Health Insurance Portability and Accountability Act. Murphy said current laws can prevent caregivers of the mentally ill from involvement in the treatment process, or even from knowing their loved one is sick at all.
In some cases, Murphy said mental illness can prevent patients themselves from realizing they are sick, let alone allow them to make rational decisions about their privacy.
“We’re looking at ways to amend our privacy laws so that our providers could share information about a client with a parent if they believe it’s in the best interest of the patient,” Murphy said.
Patients’ rights advocates, however, argue that changes to privacy laws like these unfairly target those with mental illness.
Kathleen Flaherty, executive director of the Connecticut Legal Rights Project and a member of Gov. Dannel P. Malloy’s Sandy Hook Advisory Commission, said “with physical illnesses, we would not even be having this conversation.”
“The reality is that people have the right to choose who they want to disclose information to or not disclose information to,” Flaherty said.
No gun provisions
The bill will completely avoid addressing one contentious issue: Gun rights.
After 20-year-old Adam Lanza fatally shot 20 children and six adults at Sandy Hook Elementary School in Newtown in 2012, the state tightened its gun laws in regard to the mentally ill.
Connecticut now prohibits individuals who have been confined in a mental hospital for psychiatric disabilities within the preceding 12 months from obtaining handguns. Researchers have found little to no proven link between mental illness and violence, although several mass shooters in recent years were suffering from severe mental illness.
Murphy said in a news release he doesn’t want mental health “to get tied up in the politics of gun laws,” which could stall the bill’s passage. Since the Sandy Hook shooting, Republicans have mostly avoided the gun debate by putting the problem “onto the back of the mental health system,” Murphy said, when the issues should really be dealt with separately.