Presidents Ford and Reagan and Rep. Gabrielle Giffords were all attacked by people with untreated serious mental illness. In spite of the risk to public safety and homeland security posed by letting some people with serious mental illness go untreated, the federal agency charged with helping them is instead working to see they don’t get the treatments they need. That’s one reason the newly formed debt-reduction supercommittee should eliminate the Substance Abuse and Mental Health Services Administration (SAMHSA). The other is money: The agency receives $3 billion annually.
SAMHSA was founded to “reduce the impact of … mental illness on America’s communities” by “target[ing] … mental health services to the people most in need.” Families of people such as Shayne Riggleman, who went off medicines for bipolar disorder and recently killed five in West Virginia, and Eduardo Sencion, a mentally ill man who killed three members of the National Guard and one other person in Carson City, Nev., often try to get their ill family members court-ordered treatment before they become dangerous. But SAMHSA stands in the way.
Involuntary treatment can help psychotic people regain sanity and lead more fulfilling lives. Families of people with serious mental illness in Kentucky, Tennessee, California, New York, New Mexico and other states are begging their state legislatures to make accessing involuntary treatment in the community easier. SAMHSA is funding groups whose mission it is to see that doesn’t happen.
c The Massachusetts-based National Empowerment Center does not believe mental illness exists. The center received a $330,000 grant from SAMHSA, which it used for a conference at which it taught people with mental illness how to go off their medications.
c SAMHSA provided $329,000 to the Mental Health Association of Oregon, whose board president lent her support to a group in New York that wanted to have involuntary mental health treatment classified as “torture.”
c The agency gave $330,000 to the Mental Health Association of Southeastern Pennsylvania, whose policy director as far back as the Clinton administration has been lobbying to eliminate all involuntary treatment, even for mentally ill people who are violent.
c Anti-treatment groups in California that banded together to prevent counties from implementing outpatient commitment received $138,000 from SAMHSA.
SAMHSA gave grants totaling $1.2 million to 18 organizations in California, Vermont, Pennsylvania and elsewhere that oppose making involuntary treatment easier to access for those who need it. Rather than support laws that prevent violence, these organizations support laws that require mentally ill people who don’t know they are ill to become violent before they can be treated.
Another way SAMHSA makes treating people with mental illness more difficult is through its distribution of $35 million Congress allocates to states for the Protection and Advocacy for Mentally Ill Individuals (PAMII) program. Public-interest law firms that receive those funds are supposed to use them to protect people with mental illness from abuse. Instead, under SAMHSA’s watch, they have decided that involuntary court-ordered treatment is abuse and work to prevent it. In Maine, mentally ill William Bruce killed his mother with a hatchet after SAMHSA-funded PAMII lawyers taught him how to avoid involuntary treatment.
SAMHSA also makes treatment of persons with serious mental illness difficult through the distribution of block grants. This pool of almost $2 billion is supposed to be used by states to improve care for people with mental illness, and much of it is. But under SAMHSA, states also can use it to fund groups that oppose care for the most seriously ill - something New York and other states do in order to keep their mental health budgets down.
Advocates for the seriously mentally ill are angry. When SAMHSA conducted an online survey of its own constituents asking how SAMHSA could improve care, the second-highest vote-getter was expanding the use of involuntary treatment. SAMHSA didn’t offer that as a choice. It was a write-in option that garnered massive support. SAMHSA ignored the poll result.
Other SAMHSA money is wasted on projects that have no relation to mental illness. SAMHSA awards a five-year grant of $1.75 million annually to the National Council for Community Behavioral Healthcare. According to Dr. E. Fuller Torrey, the council holds conferences on using “relaxation response” and other “holistic,” “recovery-oriented” approaches for people who do not have the most serious mental illnesses. SAMHSA uses its funds to create, publish and distribute children’s books like “A Day in the Park,” brochures on making and keeping friends and building self-esteem. It creates, manufactures and markets multicolor stickers children can wear saying, “I am cool” and “I listen well.” Looking for online games for your kids to play? SAMHSA creates those, too. Meanwhile, people with the most serious mental illnesses go untreated.
SAMHSA claims to give grants to “prevent mental illness,” but because no one knows how to prevent schizophrenia or bipolar disorder, one has to question where those grants are going.
Not every SAMHSA program is counterproductive or wasteful. If SAMHSA is eliminated, the good programs can be handed over to other, better-focused agencies such as the National Institute of Mental Health, the National Institute on Drug Abuse or the Centers for Disease Control and Prevention.
Eliminating SAMHSA should be an issue that unites Democrats and Republicans. It would save money and improve care. It’s not government cutbacks that are putting patients, the public and homeland security at risk - it’s SAMHSA.
D.J. Jaffe is executive director of mentalillnesspolicy.org.