A Federal Vision for Improving Mental Health Care

Dec 14, 2017

In 2016, the 21^st Century Cures Act included a provision requiring the establishment of a Federal Intergovernmental Serious Mental Illness Coordinating Committee (ISMICC).  NAMI’s Chief Executive Officer, Mary Giliberti, was selected to serve as a non-federal member of the Committee.

The Committee is responsible for advising Congress and relevant federal agencies about the state of mental health care in the U.S. and making specific recommendations for actions that can be taken to better coordinate the administration of mental health services for adults with serious mental illness (SMI) and children with serious emotional disturbance (SED).  

On December 14, 2017, the Committee released an interim report to Congress.  The report contains many recommendations for improving the national response to adults with SMI and children and youth with SED, including:

• Expanding nationwide availability of coordinated specialty care for first episode psychosis
• Developing an integrated crisis response system for diverting people with SMI and SED from the criminal justice system
• Eliminating the use of solitary confinement for people with SMI and SED
• Enforcing full implementation of parity for mental health and substance use disorder coverage in health insurance
• Expanding availability of housing for people with SMI and SED
• Eliminating discrimination in reimbursement for mental health care in Medicaid and Medicare by repealing the Institutions for Mental Diseases (IMD) exclusion in Medicaid and the 190-day lifetime limit on inpatient care in Medicare
• Providing guidance, resources and training on HIPAA and communications with families and caregivers
• Expanding the Certified Community Behavioral Healthcare Center (CCBHC) program nationwide
• Establishing uniform data collection and outcomes measurement across all relevant federal agencies and programs
• Developing and disseminating national standards for a comprehensive continuum of health care for people with SMI or SED

Mary Giliberti was a featured speaker at a press conference to announce the release of the report. In her statement, Giliberti spoke about the pain caused by lack of mental health care. 

“The inability of people with mental illness to access needed care shatters lives and devastates families. Yet the health and mental health systems continue to ignore these conditions until crises occur—and then we only provide treatment and supportive services—if at all—for as long as necessary to alleviate the immediate crisis. If we treated other chronic conditions this way, far more people would die from diabetes, epilepsy, hypertension and heart disease.”

Giliberti expressed her strong support of the report’s recommendations and her fervent hope that they would be implemented. 

“There is no other way if we are truly serious about finding ways to reduce disability associated with mental illness and to help people stay in school, work, live lives of dignity and meaning, and avoid the horrific consequences associated with lack of mental health treatment”.   

Release of the ISMICC interim report is an important first step in addressing our national mental health crises. But, many federal reports have been issued over the years and most have not been implemented.  Ultimately, Giliberti said, evidence of the report’s success will be reflected in positive changes moving forward. 

“I sincerely hope that a year from today, five years from today, and ten years from today, we will be able to look back and say that this Committee played a key role in changing the paradigm of neglect to one of care and compassion for the millions of children, youth and adults of all ages who live with serious mental illness in America.” 

A full list of members of ISMICC can be viewed here.

Mary Giliberti’s full statement at the press conference can be found here.