Image by Nick Scott
One Friday morning last fall, I texted my partner to ask when he was heading my way. We live five hours apart, and I was waiting for him to visit. Instead, he told me he'd had a bad night and was checking himself into a behavioral health facility in Bloomington, Indiana. "I'm not doing well," he said, simply. My partner had a drinking problem—that I knew—but I didn't realize at the time how depressed he was.
Later that day, he texted, "They didn't check me in. Just referred me to a therapist. I guess I didn't use the right words. I'm taking time off work. I don't know what the fuck I'm doing."
Recently I asked if he knows why they didn't admit him. He doesn't remember that day at all. He looked back in his journal, at the sloppy fragmented text he'd scrawled, and told me he was drunk all weekend. He said, "I can tell from my writing I just felt despair."
A few days later, he tried again at the public hospital. This was the first time since he was sixteen that he sought psychiatric care. He told them he was considering killing himself, and they asked him to wait an hour for the next available intake specialist. He messaged me while sitting in his car and told me he was confused by the wait after being honest about how suicidal he felt. To top it off, they warned him it was illegal to smoke on hospital grounds—even in his car.
When he was finally admitted an hour later, he sent me a picture of a piece of paper with the ID number I'd need to call him on the psych ward, during the couple of hours a day when patients can receive calls. He would stay in the ward for five days. When he got out, he told me it saved his life.
Six months after his stay at the hospital, my partner is still having a hard time finding a psychiatrist to help manage his depression because of his accompanying issues with alcoholism. This dual diagnosis is more difficult to treat because the conditions feed off of each other, and many psychiatrists don't want to touch it.
But today, a number of senators, both Republican and Democrat, are trying to make it easier for those in need to get the help they deserve with the Mental Health Reform Act of 2016. The bill stands to make a difference for people who, like my partner, need help with substance abuse or suicidality. This Thursday, May 26, Senators Chris Murphy (D-Conn) and Bill Cassidy (R-LA) will host a Senate Mental Health Summit to urge leaders to push the bill through the Senate.
The new bill is the center of a large bipartisan effort to improve the mental health care system. It's supported by smaller bills that focus on substance abuse treatment and an increase in outpatient and crisis care clinics. It could help people in need get more consistent care by enforcing a current parity law, which requires health insurance companies provide equal coverage for behavioral and physical health matters, as well as ensuring more funding gets to state- and community-level programs. This funding would mean more treatment options and more qualified health professionals on staff. Currently, the US spends $130 billion a year on mental health, but as Congressman Tim Murphy pointed out in an _interview with the Hill, "_it's not getting to communities or states—and certainly not getting to the families and individuals who need it."
The bill would also directly address the rising suicide rate, which, per the most recent data, is the highest it's been in 30 years. The bill proposes full funding of the National Violent Death Reporting System, which would keep track of suicide deaths nationwide. "Until all states report fully about suicide deaths, we won't have a complete picture of who dies," Nancy Farrell, board chair of the American Foundation for Suicide Prevention, told VICE. "Because of incomplete reporting, we don't know about marital status, veteran service, LGBTQ, and other information that would help us better understand trends and challenges." She added, however, that the reform "can be a beginning, but as a nation, we need to invest substantially more in research and treatment options."
Of course, not everyone is happy with the legislation. Per Modern Healthcare, some advocates are disappointed that some of the changes they think are most important have been left out. "If this were to pass as is, it would be of no benefit to [people with] severe mental illness," said John Snook, executive director of the Treatment Advocacy Center. Missing also are efforts to support court-ordered outpatient treatment alternatives to incarceration, and fixes to the limited mental health care access for Medicare and Medicaid patients (though there's still hope to expand the influence of the legislation through amendments like one that would remove a Medicaid restriction to certain mental health facilities).
Asking someone who just admitted he was suicidal to wait patiently for the next available intake specialist is akin to asking an individual mid-stroke to just hang out in the E.R. waiting room. If people like my partner need to know the exact words to use to be taken seriously, then something is wrong with the system. If the bill passes in both the Senate and the House this summer, the new law would require most changes to be in effect by the end of 2017. I can't help but imagine that things might have gone more smoothly for my partner last fall if this reform had already been in effect. With more funding, staff might have been less burned out. The new legislation requires more accountability, so the private facility might not have been so quick to turn him away. As for psychiatrists who are wary of treating patients with dual-diagnoses of depression and substance abuse, a line in the legislation promises to make this very issue a matter of "regional and national significance."
Regardless of what impact the legislation might have made—or might still make—for my partner, this is bigger than him. More than 42,000 people ended their lives in 2014. Over half of adults with mental illness weren't treated in 2013. Something is obviously wrong, and this legislation is at least an acknowledgement by our lawmakers that something needs to be done.
If you are concerned about your mental health or that of someone you know, visit the Mental Health America website.