Bill sparks debate about rights, compulsion, and mental health

Rep. Tim Murphy (R., Pa.) speaks during a news conference on Capitol Hill in December about his legislative package of major mental health reforms. (AP Photo/Pablo Martinez Monsivais)
Rep. Tim Murphy (R., Pa.) speaks during a news conference on Capitol Hill in December about his legislative package of major mental health reforms. (AP Photo/Pablo Martinez Monsivais) (AP)
Posted: August 04, 2014

He accused them of poisoning his dinner.

Eric Stark and his wife did not know what was going on with their 18-year-old son, an athlete who played basketball, football, and baseball in high school. He was suddenly paranoid - "totally out of the blue," Stark recalled.

Now 25, 6-foot-3, 230 pounds, he still lifts weights. Little else is the same.

He has lost a brother to suicide. He has been hospitalized nine times in the last seven years. His diagnosis: bipolar disorder with psychotic features.

Stark, of Newtown, Bucks County, said that getting information about his son's mental health - sometimes even his location - has been an ordeal. Since his son is an adult, the Starks have to rely on an often unreliable source: their son.

"We're left in the dark," Stark said. "We have to wait until he signs off to give us information."

The Starks are rooting for a bill in Congress introduced by Rep. Tim Murphy (R., Pa.) that calls for the most sweeping overhaul of the nation's mental-health system in decades.

One of its widely debated provisions would make it easier for parents to get mental-health information about their adult children.

Introduced in response to the December 2012 shooting at Sandy Hook Elementary School in Newtown, Conn., the bill, which has bipartisan support, covers everything from mental-illness treatment in prisons to mental-health services for veterans. It is estimated that active-duty suicides outnumbered combat deaths in 2012, and both active-duty and veteran suicides have increased in the last 10 years.

Murphy, a clinical psychologist from Pittsburgh, and other representatives have been campaigning for the bill around the country during the summer. Murphy said he hoped to get at least parts of the bill passed by year's end.

His biggest allies, Murphy said, are family members whose lives have been touched by mental illness.

"They know the system isn't working," Murphy said. "These parents are saying we need the bill to save the system."

But the bill gets mixed reviews from advocacy organizations and others who have experienced the impact of mental illness firsthand. The mental-health associations of Pennsylvania and the Philadelphia region oppose it.

One sticking point is the call for state grants for involuntary outpatient treatments in severe cases. Opponents argue that this, as well as other provisions, would lead to more people being institutionalized against their will.

Susan Walther, executive director of the Mental Health Association in Pennsylvania, said any association of force with treatment could discourage some from seeking help. "We like many aspects," said Robert Gebbia, head of the American Foundation for Suicide Prevention, but "we are concerned about the approach to institutionalization."

Lauren Tenney, 42, who has a doctorate in psychology and teaches at the College of Staten Island, has personal reasons for her reservations about the bill. Tenney said she was first involuntarily institutionalized in New York state at 15.

Tenney said her parents signed her into an inpatient facility after she received a range of mental-illness diagnoses from various medical professionals.

"I wouldn't call it treatment," Tenney said. "It was torture."

'Ordeals'

She was sometimes kept in seclusion; it may have been for hours, days, Tenney said. She is still unsure how long.

There was light in the room, she recalled, and people could look through a small window in the door. A lone plastic mattress sat on the floor, she said, and an acrid smell hung in the air.

"What about that experience would make somebody want to live?" Tenney said. "You're treated like you're a criminal." Murphy's bill, she said, might put more people through similar ordeals.

The bill, called the Helping Families in Mental Health Crisis Act, was introduced in December and has 93 cosponsors - 32 Democrats, 61 Republicans - including two local Republican representatives, Patrick Meehan of Delaware County and Michael Fitzpatrick of Bucks.

A former prosecutor, Meehan said too many mentally ill people were in the criminal justice system. "We've been incarcerating rather than treating," he said last month.

More than 700,000 mentally ill adults are in state prisons, according to a 2006 special report by the Bureau of Justice Statistics.

"This law is really going to help," Stark said. "It's going to make it easier for me to get help for my son."

Second son

As the law stands, the Starks usually cannot get information about their son's treatment unless he consents.

Often, his son does not consent right away. In July, Stark said, his son was transferred from Lower Bucks Hospital in Bristol to Fairmount Behavioral Health Systems in Philadelphia. For days, the parents were worried. They did not know where their son was.

Stark, a member of the Bucks County Suicide Prevention Task Force, fights not only for his son, but also for his younger son, who died by suicide in 2011. He was 21 and, at the time, being treated for what his parents thought was mild depression. The younger boy "wasn't the son we were worried about," Stark said.

For whatever benefits the bill might yield, Tenney argues that the involuntary-treatment provisions would be harmful.

"This is going to extend the amount of lives psychiatry destroys," Tenney said. "People's rights are trampled on."

"Talk to parents whose children are in the coffin," Murphy said. "Ask them if their children have been stripped of their rights."


emccarthy@phillynews.com

@ErinMcPSU

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