Dear Senator Alexander… A letter on mental health reform

For what it is worth below is a copy of a letter I will be sending Senator Alexander regarding S2680.   I offer it only as one example for anyone trying to figure out what they might want to say to their own Senator. This bill is by no stretch of the imagination the bill I wish was in front of us. Unfortunately that bill is not up for a vote. Unless they postpone the bill or the bill gets derailed by gun amendments something will pass. The voices for the Murphy Bill are strong, particularly in light of the ease it passed the House. I want to raise my voice for the Senate bill…. The only option in town. Everyone must decide what they think is best but for me my choice is clear. This letter does not begin to talk about all my reservations to the Murphy Bill but I hope gives a clear message Senator Alexander will hear.

Dear Senator Alexander,

My name is Larry Drain and I live in Knoxville, Tennessee.   I write to share my appreciation to you for your leadership trying to bring long overdue reform to our mental health system and in support of your efforts to pass S2680.

I have been following the fight in the Senate and in the House to make mental health reform a reality from the beginning of the first introduction of Representative Murphy’s bill till now.   I  feel like the bill you are proposing is vastly superior to the one that has come out of the House and my hope is that you will try to see it passed without incorporatating any language or provisions of the House bill not currently in the Senate already.

Briefly my objections to the House bill are:

1.  AOT-  As I am sure you know Tennessee is one of the few states that does not have an AOT program.   A pilot program was tried a couple of years ago and was closed upon recommendation of Commissioner Varney and the state department of Mental Health.   They saw it basically as being a waste of valuable resources and not having any needed role in our mental health system.   As a matter of fact under Governor Haslam and Commissioner Varney Tennessee has been a leader in trying to develop a system that decreases the reliance on any coercive services.   The proof of their approach,  as I am sure you know,  have been in the results they have achieved.

The original Murphy Bill incorporated within it a provision to financially punish states for not having an AOT program.   This would have been a major injustice for Tennessee and the proposal created wide spread criticism and was dropped as originally written.   In the current bill there is a provision to lengthen the time and money to be spent on AOT pilot programs that Representative Murphy put into the Medicare doctor fix bill a couple of years ago.   I strongly oppose that extension and am asking you to do the same.   I think that provision was offered to Representative Murphy as a compromise to get him to accept the removal of some of the more onerous provisions of his original bill and see no reason the Senate should be bound by that.   I know of no data or reason to justify the additional expenditure of tax payer money and think this pilot should be evaluated and judged under the terms it was originally written under.

2. SAMSHA- In the original debate one one of main focuses was Representative Murphy’s crusade against SAMSHA.   He tried to paint it as the villain and cause of all the problems in the mental health system and basically proposed legislation that would destroy it.   Once again this proposal prompted major controversy.   In Tennessee the partnership of the Department of Mental Health with SAMSHA has been a major driver of progress and Representative Murphy’s bill would have been a calamity.   Like every other federal agency SAMSHA has it’s problems and could make positive changes but it has been a leader in making the concept of recovery an essential part of the mental health system.   It has enriched the lives of millions of Americans and thousands of Tennesseans.  Destroying it is ridiculous.

The final House bill is once again a compromise with Representative Murphy but I believe the provisions of your bill in regard to SAMSHA are vastly superior and hope you will pass that section of your bill as  written.

There are several other ways I think the Senate Bill is far more effective than the House Bill,  but in the interests of your time I only want to mention one more thing.   If it would be helpful I would be glad to share additional concerns with your staff.

3. Anosognosia-  The House bill incorporates the term anosognosia into its discussion of the issues.   This I believe is a dangerous and major mistake and hope you will fight to prevent it from being placed in the final bill.   Anosognosia is a pseudo-scientific term based on a  real condition that afflicts people who suffer from strokes.   It basically says that half the people with severe mental illness suffer from brain damage caused as a result of their illness that causes them to be unaware they need help.   I have been involved in the mental health field for over 40 years and this notion is simply hogwash.   It doesn’t have the wide standing as an accepted scientific truth.   Its major function is to legitimize coercive measures and ultimately attack the civil rights of those with mental health issues.  Again in reference to Tennessee it is antithetical to the way we do business here.   I urge you to oppose any effort to include this notion in the Senate bill or in any final bill passed.

Again thank you for your leadership.   This bill is certainly not an answer to all the issues facing our mental health system but no bill can be.   I wish you good luck and success in your efforts ahead.

Yours truly, 

Larry Drain


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