Holzmann: CURES Act Promises Major Changes in Mental Health Care

Recently the president signed the 21st Century CURES Act, the first major mental health legislation in over 40 years. Originally proposed by Representative Tim Murphy (R-PA) and with bipartisan support, the Act represents a new direction in mental health care.

It elevates the director of the Substance Abuse and Mental Health Services Administration (SAMHSA) to Assistant Secretary level in the Department of Health & Human Services, placing greater emphasis at the federal level on this critical field. It also incorporates a number of key provisions to improve mental health services.

Orange County has led the way in Assisted Outpatient Treatment (AOT). The Act expands and strengthens these programs on a national basis. With this also comes greater emphasis on Assertive Community Treatment teams, an evidence based practice which provides intense wraparound care at home and in the community for individuals suffering from severe mental illnesses.

It also requires the states to expend a minimum of 10 percent of their federal block grant funding on early detection and treatment regardless of age. Early diagnosis and treatment are critical to better outcomes.

Another provision is to create databases of psychiatric beds, crisis stabilization units, and residential treatment programs. Currently, emergency room providers, CAT teams and others must call around to find beds, which are often not available. Access to these databases can speed treatment and have a significant positive effect on recovery.

De-criminalization of much mental illness is a significant component of the Act. The CURES Act will address some of the mental health issues for individuals engaged with law enforcement. It will provide for more crisis intervention training for first responders and for treatment opportunities before incarceration. It also provides continuing funding for mental health courts and crisis intervention teams.

Upon release from incarceration, persons with serious mental illnesses will also have greater access to treatment and housing. The revolving door between crisis and the streets, hospitalization, and incarceration costs billions of dollars per year and our jails and prisons are our largest mental health warehouses. Addressing these issues will help reduce this cycle of hopelessness.

Another key provision requires the Department of Justice to investigate the effects and costs of mental illness related to law enforcement activities and incarceration including serious crimes such as assault and murder.

One of the most difficult issues facing individuals with severe mental illness (SMI) and their families relates to the HIPAA privacy laws.  These laws, meant to protect individual privacy, sometimes conflict with the need for caregivers to support and care for their family members. The CURES Act requires the Secretary of Health & Human Services to issue guidance clarifying the circumstances under which healthcare providers can share and provide information about a loved one to family members.

The Act also addresses many of the issues related to parity of mental health care with other forms of health care. It requires federal guidance on parity compliance, and the Government Accounting Office has been ordered to conduct a study on parity enforcement to improve access to care.

The CURES Act will also provide for better funding for suicide prevention, screening and intervention. The suicide rate in the United States has risen by over 24% since 1999, a 30 year high. According to the American Foundation for Suicide Prevention, almost 43,000 people die by suicide per year.

There is no substitute for more beds and more compassionate treatment, but the CURES Act goes a long way towards addressing some of the fundamental issues in mental health care. Orange County is leading the way and together, we can help provide better outcomes and a more resilient system.

Matt Holzmann, Chair – Government Relations, National Alliance on Mental Illness – Orange County Affiliate

Opinions expressed in editorials belong to the authors and not Voice of OC.

Voice of OC is interested in hearing different perspectives and voices. If you want to weigh in on this issue or others please contact Voice of OC Involvement Editor Theresa Sears at TSears@voiceofoc.org

  • questionauthority2

    “Be nice”? Children have died ON those medications, none of which have been studied to be safe for use in children. Educate yourself, because you obviously believe in junk science– if the meds worked then why are there FULL psych wards?

    • buzzookaman

      You are a complete idiot. Get a job at a psych ward and get back to me

  • verifiedsane

    I actually have many years of experience working within and investigating the mental health industrial complex; which includes the APA, FDA, The pharmaceutical/device industry, and many of their well funded supposed non-profit affiliates.

    Though, this is not the proper place or venue to share large volumes of information, statistical data, in-depth investigations, personal information, or to produce a resume’ that would be in effect a coddling act to all the ill informed.

    Here’s just a tid bit to answer your question as it pertains to seeking the “Truth”

    I have had investigative associations with:

    Journalist Robert Whitaker, who has won numerous awards as a journalist covering medicine and science, including the George Polk Award for Medical Writing and a National Association for Science Writers’ Award for best magazine
    article. In 1998, he co-wrote a series on psychiatric research for the
    Boston Globe that was a finalist for the Pulitzer Prize for Public Service. Anatomy of an Epidemic won the 2010 Investigative Reporters and Editors book award for best investigative journalism.

    Carl Elliott MD, PhD who is a professor at the Center for Bioethics at the University of Minnesota. He writes on the medical-industrial complex, and is the
    author of “Better than Well” and “White Coat, Black Hat”.

    Just to name a couple…

    What would you like to share Buzzookaman?

  • verifiedsane

    We are discussing/debating an issue, not coddling the grieving….if you can’t face the truth; then don’t come here, play the loss card, and then cry about it…… you have no idea what my background entails…but go ahead and keep reaching for straws…those are the cheap ploys used when a person doesn’t have much of an argument based upon the facts and the evidence.

  • The_Dread_Pirate_Roberts

    Having had a child who suffered from severe schizophrenia and was largely non-compliant on their medications who took his own life, I call BS on your mindless screed. Tell that to the people suffering with mental illness in our jails or howling at the moon on our streets.

    i would rather have my child back on meds than lying cold in the ground.

    • verifiedsane

      Well there you go…and who made you God, judge, & jury with the supreme power to deny large segments of our society their basic human right to self determination, and their protected constitutional rights …you sound like the typical pharmaceutical industry sponsored TAC/NAMI fear mongering control freak…do you happen to know that independent research (not skewed studies controlled/funded by the pharmaceutical industry and APA KOL’s for profit) has shown that those diagnosed with schizophrenia have much better long term outcomes with limited or no drug intervention. Please become informed and educated https://www.madinamerica.com/answering-the-critics-of-anatomy-of-an-epidemic/

      • Jacki Livingston

        Please be kinder. His son died.

        • verifiedsane

          Sometimes there is no kind way to tell the truth…it just is, what it is! It has been said..making the same mistakes over and over again, resulting in the same results; meets the definition of insanity.

          • buzzookaman

            There is always a kind way unless you are an a hole like me

          • Jacki Livingston

            And sometimes you get more results with honey than vinegar.

          • verifiedsane

            and sometimes you don’t 🙂

    • Jacki Livingston

      I used to work at SSA and handled Category 53 caseloads, basically patients who were forced into facilities, cleaned up, medicated, then released with two weeks worth of meds, which they either took to get high, sold, lost or refused, and a week later, the cops picked them up walking naked down the median on Harbor Blvd. I understand your grief. I have a daughter who is mentally ill and in an institution. My patients and my child…I get it, and my heart breaks for your pain. However, you know as well as I do that you cannot save someone who does not want to be saved. I pray for you, and your son. Not a day goes by that I don’t flinch when the phone rings, because that call is always just a heartbeat away. But this? This is not the answer.

      • The_Dread_Pirate_Roberts

        Most people with mental illnesses live full lives. It is the small percentage with severe mental illness who we have to care for, because they cannot care for themselves. They are either in deep psychosis or unaware of their illness. Their normal is not our normal, and when that goes too far, we have to act with compassion and common sense. We have to get people care quickly when they fall into psychosis. If that means medication, we have to consider side effects. Conservatorship is sometimes necessary. The consideration for a 5150 is whether someone is a danger to themselves or others. would you rather have family members in jail or on the streets or on meds?

        • verifiedsane

          “would you rather have family members in jail or on the streets or on meds?” This is the type of narrow mindedness and poorly derived public policy that has created this travesty in the first place. Which of those three limited and defeatist options would you like to choose for yourself?

          If this is all we have to offer; then we need to immediately stop throwing limited funds and resources down this inhumane rabbit hole; because we are doomed to repeat the same continued failures and travesties.

        • questionauthority2

          When the pharmaceutical industry is in charge of how to treat mental illness in America, this is what happens. Meds don’t work, you know that, and nothing prevents suicide unfortunately, you know that as well. Until the medication-based modality stops being the ONLY one we have in America your story will be the same for hundreds and thousands. Forced medications at your front door (AOT) is NOT the answer to mental health “care”. Ask what the patient wants not what you want.

          • OCservant_Leader

            The Profit-Medical model is the problem.

            The goal is to extract profits not provide care.

            Most Meds- and the purpose they are prescribed – I agree- don’t work for the patient or family.

            But SOME meds – in certain circumstances- do work. Let’s not throw-out the baby with the bath water.

            Unless you have personally experienced a loved one suffering from a psychotic break…tread lightly.

            We need to take back our health-care and beware not to become a victim of the profit-model.

            For example-Nutrition is ignored in mental health and in health care -period for that matter. Nutrition is not taught in medical school and it has the most important impact on health.

            Get nutrition into the bodies of those experiencing any kind of mental duress – first.

          • buzzookaman

            You are full of BS. Properly prescribed meds do work on most people and absolutely keep most people from committing suicide. I see it on a daily basis working at a psych hospital. So you might be right about this legislation but you are definitely wrong about meds.

          • verifiedsane

            Now that’s some concrete objective scientific evidence your presenting… “meds do work on most people and absolutely keep most people from committing suicide” Really! You see it daily (subjective observation) while observing patients in a controlled psych ward environment…that’s some hair-brained statistical data you are bringing to the table & debate…

            Psych wards are basically psych prisons today, where patients either comply under threats, coercion, & under heavy duress while being literally forced to consume ineffective (if not down right dangerous) pseudo medication pills thrown at them; or they will languish there under the rouse non-existent medical care & mental health court ordered protection. I call out your colossal mountain of BS, and raise you some actual REALITY….

        • Jacki Livingston

          Dear, you are preaching to the choir.

  • verifiedsane

    Cures act has very little or nothing to do with cures, but it does have a whole lot to do with profits for the industrialized medical industry. How it effects supposed mental health, is by giving government plutocrats more control over individual health care choices and treatments. Don’t be fooled by slick terms and the plays upon language usage.

    “Assisted Outpatient Treatment” = Court ordered forced drugging, “evidence based practice” = whatever pseudo-science theory the APA and pharmaceutical industrial complex conjures up for more power and profit, “Early diagnosis and treatment” = casting an overly broad net to misdiagnosis, label, and drug those who least are able to protect themselves: the young, poor, uneducated, minorities, and foster children. mental health courts = politically appointed judges with little or no experience or expertise making critical and life altering medical decisions over the citizens individual rights.

    In fact CURES comes directly out of TAC and the Fuller Torrey lobby/playbook/mold of demonizing mental duress and by removal/curtailing basic human/constitutional rights from those who are experiencing often temporary or situational human mental suffering.

    This brings us back to the dark days of class warfare eugenics, 1900th century blind ignorance, and roughshod acts of profiteering by the elite class that preys upon the misery of others by legal decree.

    Don’t buy into this coined do-gooder legislative illusion. It is not what it seems. This is just another instance of big government approved poison being packaged as something it isn’t; therapeutic, proven, evidenced, or effective medicine/care.

    • Jacki Livingston

      You may find this shocking, but I actually agree with you. It is bad medicine, pure and simple.

    • OCservant_Leader

      I actually agree with you.

      We must de-criminalize mental illness first. Law Enforement (HS graduates with guns) is not the solution- contrary to the OC strategy.

      OC got a Billion Dollars via MHSA and could they even create ONE sadly needed crisis psych bed?? Nope.

      The MHSA Medical Director got caught taking 100K kickbacks from huge Pharmacy contracts…and guess what – the OC (by diagnosis) pumped those drugs into our most vulnerable for profit! Where is the outrage?

      The Pharmaceutical-Prison complex is destroying our Country.

  • Jacki Livingston

    You want to know what promises are worth in the OC?