Last month's mass shooting near a California college campus has revitalized Congress' efforts to reform the country's mental health system. One bill from 2013 that's getting renewed attention is the Helping Families in Mental Health Crisis Act. Among other things, the law would loosen patient privacy rules to give family members more of a say in the care of loved ones with mental illness. But mental health advocates in Maine oppose the idea of chipping away at patient rights.
Hanna Sturtevant is all too familiar with frustrated families who want to help an adult loved one with mental illness. Sturtevant is program coordinator for Amistad, a mental health support and recovery center in Portland. She recalls one of the more memorable cases she worked on involved an adult child who was trying to help a parent with mental illness.
"And this person had been missing for many years from the family's life," Sturtevant says.
The parent's name came up in a minor criminal incident report in Maine, says Sturtevant, and the adult child called mental health care facilities around the state - including Amistad - to find their parent.
"Quite frustrating for the family to call here and us not being able to say, 'Yes, that person is here.' Not being able to give that confirmation," she says. "All I could do was sort of hem and hedge and say, 'Well, I'll look into it. I'll get back to you.' "
Sturtevant felt for the family, but she says a patient's right to privacy is also important.
"You don't know what this person might really want when they're lucid and at their very best," she says. "You don't want to be in the position of making decisions for other people."
In this case, Sturtevant jsays she told the parent that their family was trying to get in touch, and the parent decided to reconnect. A bill before Congress would make it easier for families to access health information about a loved one with a severe mental illness. It would also make it easier to impose involuntary treatment.
The bill, called the Helping Families in Mental Health Crisis Act, was penned by Republican Rep. Tim Murphy of Pennsylvania. Murphy is also a psychologist, and was prompted to act in the wake of the shootings at an elementary school in Newtown, Connecticut in 2012 .
The bill has gained more attention since a shooting-spree in California in May, and the proposed reforms are embraced by some experts here in Maine.
"I think overall it's a very positive thing," says Dr. Doug Robbins, the director of child and adolescent psychiatry at Maine Medical Center. He points out that most people with mental illness are not violent. But he says there are times when families have good reason to believe that a loved one is not following through with a critical treatment and could be more prone to aggressive behavior.
"But the laws for requiring involuntary treatment are often, unfortunately, pretty restrictive - meaning, you can't do anything until the person is really imminently at risk for hurting someone," Robbins says.
And by then, it could be too late. But the executive director of the Disability Rights Center, Kim Moody, says loosening standards for patient privacy and involuntary commitment is a slippery slope in a system that has a history of abusing patients.
"Forced treatment, more often that not, in my 30 years of doing this work, I've seen it push people away from treatment," Moody says.
Moody points out that individuals with mental illness can sign an advanced directive if they want their family members to be involved in their treatment. The Murphy bill, she says, strips away rights and further deteriorates funding for community services in favor of more psychiatric beds.
"People need acute care when they need acute care. But we do not need to open up snake pits again for people with mental illness," she says. "It doesn't work. It's not like it makes people healthy and well and they go off and never need the system again."
While the National Alliance on Mental Illness supports the bill, the Maine chapter is not taking a position. Executive Director Jenna Mehnert says ideas to improve mental health care should start with the people directly involved.
"Have family members and peers in the same room and come to consensus about incremental steps to reform the system, not force wide-spread reforms down anyone's throats, so to speak," she says.
Murphy's bill is expected to be divied up into different parts to help quell the controversy its stirring up. In the midst of it all, Kim Moody of the Disability Rights Center questions why the focus on preventing horrible incidents like the ones in Newtown and California now seem to be squarely on the mental health system.