Clinton rolls out plan to improve mental health care

Democratic presidential candidate Hillary Clinton called for putting mental health care on par with other types of health care Monday as part of a wide-ranging plan to address key problems in the treatment of people with mental illness.

The proposal calls for expanding early intervention in mental illness; a national initiative to prevent suicide, which kills more than 40,000 Americans a year; increasing training for police who are called to the scene of a mental health crisis; providing mental health care for non-violent offenders to help them avoid going to jail for minor offenses; and investing in brain and behavioral research to develop better treatments.

In announcing the plan, Clinton said she would hold a White House conference on mental health during her first year in office if she is elected. "The next generation must grow up knowing that mental health is a key component of overall health and there is no shame, stigma or barriers to seeking out care," Clinton said in her proposal.

The USA's mental health system has been sharply criticized in recent years. A 2014 USA TODAY series found that more than half a million Americans a year fall through the cracks of a broken mental health system, ending up in emergency rooms, behind bars or on the street after failing to receive adequate medical care and social support. A 2015 report found that people with mental illness are 16 times more likely than others to be killed in encounters with police.

Mental Illness: The Cost of Not Caring

Clinton noted that the country loses nearly $200 billion in lost earnings every year when people with mental illness are too sick to work.

"We've got to make clear that mental illness is not a personal failing. Right now, it's our country that is failing people with mental illness," Clinton said Monday.

A leading Republican proponent of mental health changes welcomed Clinton's efforts.

"There's a lot in there that I can work with her on," said Rep. Tim Murphy, R-Pa., a child psychologist and author of the Helping Families in Mental Health Crisis Act, which was passed by the House of Representatives in July. It has not yet been considered by the Senate.

"I hope mental health reform is a keystone of both presidential candidates' campaigns," said Murphy, who noted that his bill and Clinton's proposal have several similarities. "Whoever gets in the White House, I intend to work with them and make an impact for the tens of millions of Americans who feel they have been forgotten."

A Senate committee in March passed the Mental Health Reform Act of 2016, which aims to expand access to care, although the bill also has not yet been considered by the full Senate.

Time is running out to pass a bill this year, said Ron Manderscheid, executive director of the National Association of County Behavioral Health and. Developmental Disability Directors.

Yet Murphy said he's more optimistic about improving mental health care today than he has been for a long time.

"Four or five years ago, we couldn't get anyone’s attention," Murphy said. "Now, we have Speaker (Paul) Ryan saying that mental health reform is a top priority."

Some advocates for people with mental illness praised Clinton for putting the issue on the national agenda.

"We applaud Secretary Clinton," said Paul Gionfriddo, president and CEO of Mental Health America, adding that his group "looks forward to the day that mental health is truly seen as an essential part of overall health, and the brain as a most essential part of the body."

Ron Honberg, a senior policy adviser at the National Alliance on Mental Illness, said he was glad that Clinton's plan includes more than just medical care.

Her plan would help provide "supportive housing" and "supported employment" to people with serious mental illness, who often can live on their own and hold down jobs if provided with help. About 80% of people with a serious mental illness, such as schizophrenia, are unemployed, even though surveys show that most want to work.

Clinton's proposal takes aim at some of the double standards faced by people with mental illness. For example, the federal Medicaid program today doesn't allow patients to receive primary care and mental health services on the same day, a practice that many have criticized as discriminatory. Clinton's plan would encourages states to lift these restrictions.

Mental illness: Families cut out of care

Not all mental health advocates are pleased with Clinton's plan. D.J. Jaffe, executive director of mentalillnesspolicy.org, says Clinton's proposal "largely ignores the most seriously mentally ill" who need hospital care. He notes that the closing of state psychiatric hospitals has led to a severe shortage of beds for people who need inpatient mental health care.

"It is the most seriously ill adults — those with untreated schizophrenia and bipolar disorder — who are most likely to become homeless, psychotic, arrested, incarcerated and suicidal," Jaffe said. "Our current system prioritizes the least seriously ill and offloads the others to jails. This plan will continue that practice. "