The Murphy Bill suffers from a lack of connection to reality

The article below by John Grohol convincing dismantles the Murphy Bill. He also explains what he likes about the Barber Bill.

The Murphy Bill offers nothing to the mental health system. It believes that the mental health system serves two discrete groups of people: the severely mentally ill and everyone else. He thinks that those in the everyone else category take up far too much money and resources and that much more needs to go to the severely mentally ill. He believes that psychiatric hospitals are seriously underutilized and that many more beds need to be added. He seems to think that the solution to people with “mental illness” in jails is to put them in hospitals. Little of this has any contact with reality. The notion that Medicaid can pay for these beds seriously underestimates the cost of making more beds a reality, the importance of whether or not a state has expanded medicaid, and shows little knowledge of how medicaid works on the state level. Most importantly it totally ignores the fact that at the state level with the professionals that actually run the mental health systems there is little or no support for turning back the clock to the glory days of psychiatric hospitalization. Regardless of what Murphy says or does I dont see Tennessee adding one bed as a result of what he says.

(If he really believes that there are two discrete groups in the mental health system he needs to take a look at what most experts like Thomas Insel seem to believe about the validity of psychiatric diagnosis. The growing consensus is that a diagnosis is simply a name for a grouping of symptoms, not the explanation of an underlying pathology. The two discrete groups idea is nonsense based on the belief that a diagnosis is more than a label. One person told me once he had been cured of bipolar. I asked him how. His answer was simple. “I changed doctors.”

There is a basic logical absurdity in the Murphy plan. His ideas would in the end eviscerate a community system already struggling with years of budget cuts. Yet his other idea is to promote widespread assisted outpatient treatment to meet the needs of the “severely disturbed” who dont know they need help. On the one hand you build the hospital system on the ruins of the community system and then turn around and say the system you have destroyed is essential to the health of the people you say you care about.

The Barber bill may or may not be what you want in terms of mental health reform. I am sure it will undergo much in the way of change before it ever reachs reality. The Murphy Bill gives me everything I dont want. I think it is a no brainer.

And one last point. I do not know this is true. I wonder. Someone made a bad joke to me not long ago. He said Dr. Torrey was a ventriloquist. I asked him what he meant. He said, “Every time Rep. Murphy opens his mouth Dr. Torrey talks.” That might be kind of a stupid comment but I have to wonder how much of all this is fueled by Dr. Torrey’s failures with states dealing with real world budgets to spend as much money on his ideas as he thought they should. I dont know. Sure do wonder though.

Psych Central Supports The Strengthening Mental Health in Our Communities Act (HR 4574) | World of Psychology
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