Last Thursday, the Trump administration issued the first iteration of its congressionally mandated Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) report. Titled “The Way Forward,” the report is intended to be a blueprint for how the federal government can improve care for the most seriously mentally ill. It is a step in the right direction.
The ISMICC, working under the leadership of Dr. Elinore McCance-Katz, the assistant secretary of Mental Health and Substance Use Disorders, comprises ten federal members representing different agencies and 14 members representing the public- and mental-health industries. These officials were tasked with evaluating the nation’s response to the seriously mentally ill and proposing improvements to Congress.
The problem with our mental-health policy is huge. As I documented in Insane Consequences: How the Mental Health Industry Fails the Mentally Ill, despite $147 billion of annual spending in federal funds and another $40 billion or so in state funds, 140,000 seriously mentally ill individuals are homeless while 390,000 remain incarcerated. Thankfully, the ISMICC defined the rates of homelessness, arrest, incarceration, violence and needless hospitalization as the biggest problems facing the seriously mentally ill.
Helping the most seriously ill, those who can’t help themselves, is a legitimate core function of government. Unfortunately, both the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Mental Health Services (CMHS) remain headed by Obama holdovers who refuse to focus on the most seriously ill or address the most-pressing issues like violence, fearing that doing so will cause a “stigma” by highlighting the association between violence and untreated serious mental illness. Instead, these officials focus their agencies on pumping out pop-psychology webinars, publications and grants to improve “mental wellness” among the higher functioning. President Trump and acting HHS secretary Eric Hargan should replace the leaders of SAMHSA and CMHS with doctors like Dr. McCance-Katz who are committed to using taxpayer dollars for the most important issues that affect the seriously ill, not for the sideshows.
Beyond defining the problem, this first report contains initial recommendations made by the public members of the committee. Many are relevant to reducing homelessness, arrest, incarceration and needless hospitalization, but others are not. This is likely the result of the committee having very little time to sort through their ideas: The final report is not due until four years from now. So there is plenty of time to modify the recommendations and prioritize the most-important ones. Hopefully, the committee members will.