In hearings of the House Energy and Commerce Committee last week, forensic and clinical psychiatrist Michael Welner, Chairman of The Forensic Panel, submitted forceful testimony on the need to account for Crisis Psychiatry as an emerging specialty within mental health, and the how H.R. 3717 specifically engages its different dimensions. Dr. Welner underscored how what he calls "crisis psychiatry" must enhance the partnerships between families and mental health. Dr. Welner also underscored the vital bridges between mental health and law enforcement, corrections and other front line first responders who need to be mobilized when those in crisis reject mental health support. You can reads Dr. Welner's testimony here.
The public safety aspects of the bill were very much in focus this week with three events: a mass shooting at Ft. Hood, a stabbing rampage Wednesday by a Pittsburgh teenager and yesterday’s Department of Justice report on the Albuquerque Police Department, which was highly critical of how police have handled the mentally ill. "People in crisis who are not accessing the services they need or who find services unavailable are burdening law enforcement and schools with crisis management responsibilities. It isn't fair, but it's a reality that lawmakers have to adjust to. We have to rethink crisis management in mental health, and Congressman Murphy's bill does just that," noted Dr. Welner, who has and continues to contribute to the formulation of H.R. 3717.
Congressman Murphy, a longtime child psychologist, has brought the depth of his background and dedicated purpose to a broader vision of focusing resources allocated to mental health on those programs with track records of therapeutic benefit and scientific foundation. His proposals for defunding programs that encourage treatment non-compliance have inspired criticism from some, but Dr. Welner expresses respect for the tough choices. "Our lawmakers are expected to lead and to enact a vision of E Pluribus Unum – out of many, one. Congressman Murphy is to be commended for demanding that federal mental health funding not only be performance based, but aligned with having mental health consumers and their families work with doctors, and not undermining well-researched treatment. Right now, anti-psychiatry programs being funded with the mental health budget. If psychiatry ever wants the stigma to be taken out of treatment, it can start by no longer funding groups that demonize the behavioral sciences. That has to change, and Congressman Murphy is showing leadership by showing how it can. Psychiatrists, psychologists, families and those who want better access to specialty services benefit enormously from this legislation – and those of us who live in the real world need to speak loudly on this. Those who oppose this bill are opponents of psychiatry for personal reasons or are entrenched special interests soaking up resources that can come from private foundations, and should."
In the wake of the Ft. Hood shooting, Dr. Welner appeared with CNN’s New Day and discussed the legislation in a lengthy segment, which you can view here. Host Chris Cuomo pointed out to Dr. Welner that opponents of the bill point to its adjustments to thresholds for commitment, and adjustments to HIPAA enabling doctors to communicate with caregivers during mental health crises, as civil liberties breaches. But Dr. Welner responded, "Crisis psychiatry is not (mere) psychiatry, and when a crisis happens we have to treat it exceptionally," whether it is mass violence or a batterer who is plundering a terrified family that cannot get him help. For those who are alienated from treatment by crisis intervention, he added, "The reason it got there in the first place is because we were dealing with someone who was never going to get treatment….if your caregivers support you, pay for you, pick up the pieces, you have responsibilities to your illness and denial is not one of them. Denial never solved substance abuse…Denial never solved medical illnesses. I think we have to look at psychiatry in the same way, but we look at it differently because sometimes a crisis degenerates into a public safety issue and that's what makes psychiatry different…You can't let the illness run the treatment…When we lose more people in a Newtown than we do in a terrorist attack, we should look at crisis psychiatry as a homeland security issue."
Dr. Welner continues to encourage the general public to call their Congressmen to support the Murphy legislation, calling it "groundbreaking," and "an opportunity for solutions that are actually available. We cannot miss this opportunity to rethink what is not working, and to make changes that are less about spending money and more about simple changes to viewing mental health and its partnerships with law enforcement, schools, and families to draw the best and brightest to crisis management."
To read Dr. Welner’s Congressional testimony, click here
To view the CNN interview with Chris Cuomo, click here
To view a recent editorial from the Wall Street Journal on the legislation, click here
To read recent coverage from The New York Times on debate over the bill, click here
