Tim Murphy
Appearances
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
This is people, we need to have someone in there who's like a psychiatrist, psychologist, who understands serious mental illness, who understands these problems, who wants to innovate and renovate programs there. We have to do things at work. And we have to track.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
No one is tracking the billions and billions of dollars spread out around the country, hundreds of billions of dollars, that end up dealing with serious mental illness. And that's just not Medicare and Medicaid. It's Veterans Affairs. It's Department of Justice. It's all these things take place.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
As a matter of fact, I'm on the board of an organization called Schizophrenia and Psychosis Action Alliance, SMPAA. And we did a study two years ago, another one we have that's going to come out in another couple months. We're tracking the expenses just of schizophrenia. Again, about 1% of the population.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And there we look at direct medical costs, direct treatment costs, criminal justice costs, family costs, unemployment costs, costs of not being in the workforce, and disability costs, a whole host of things. And just for schizophrenia, our best estimate of the costs for the year 2024 is about $380 billion. $380 billion for one disease entity.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Great question. So as a psychologist, I worked on issues involving mental health for my whole life, even when I was on the staff at Children's Hospital Pittsburgh. And there I go to Harrisburg and our state capitol and work on even awareness among legislators. And what I kept finding, I think they wanted to do well, but they just didn't know what to do. Everybody likes the idea of mental health.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Now, that is pretty remarkable, that amount of money. And you think that would shake up the federal government to say, where does it go? Is it doing any good? Well, the money is spent. And governors and mayors will say, well, we're spending money. We have these programs. We have social workers out there. And the question should be, are people getting better? Are you tracking them?
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Do you track the individuals or you just tell us how much money you spend? And the answer is they tell you how much money they spent. And they'll give you some general numbers. But every time there's a mass murder or some other crime committed by someone, you can pretty much bet if it's a person with mental illness, they're not on treatment. Case in point.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
A couple months ago, the event that took place in the New York subway, where the man who was in crisis ended up being restrained in a chokehold by a former Marine, Daniel Penny. So everybody got on Penny and said that he was terrible, cruel, and racist, went to trial for manslaughter. He was acquitted.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
The sad thing is the victim in this case wasn't just a homeless street performer that the media tried to portray him as. He was a man with severe mental and schizophrenia, and he wasn't taking his treatment. There was another case around the same time, a man who went through New York with a knife and killed three people, stabbed them, and they called him homeless. Well, he was homeless.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
But he was also a man with schizophrenia that wasn't in treatment. These are terribly sad stories that are taking place. When I was in Congress, I tried to wake people up to understand and say, many of these cases are treatable, preventable, but you've got to have someone be the grown-up in the room to say, these are folks who need to get them help.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Don't just say, well, if they don't want help, we're going to leave it at that. We wouldn't do that with a child who doesn't want to go to school. Let's not let them go to school. Well, some parents might, but... He's pretending he's sick. Let's let him stay home. But we have to understand these are lives worth saving, and they can be saved if we treat them. It's a massive burden on parents.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Their hearts break every day across the nation. Some groups like Mad Moms of Arizona, and there's one in Colorado, too, are fighting back. I love it.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
They're dynamic, wonderful women out there. Get in there and kick butt, take no prisoners. But what they do is they teach the legislators, here's what is really happening. And they're people of passion and information. And so the legislators thought, well, I was told that we could just talk them into care. No, they won't do that. So it's informing them.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And I hope any family member, any parent who's out there and thinks, why aren't things changing? Well, my point is you've got to talk to your U.S. congressman, your state senator, your state representative, and tell them what's going on. Why? Because they don't understand. It's not a fault. They just don't know. Nobody can know everything. And people say, well, are they going to read my letter?
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Well, I'll tell you, they never read the letter you don't write. They never answer the call you don't make. And so it is important you let them know. Absolutely. Reach out to them. What are some of the things you hope they do? We have more things to do. I believe that, I hope we get a strong assistant secretary of mental health. Wish I could talk to someone about that, but I hope we do.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And I hope we also lift the IMD exclusion, the bed. I hope we lift the limit on number of days. I hope we change some of the HIPAA laws, allow doctors to get a more accurate history and help the person upon discharge. I hope that we can have accountability for the states of how much money they spend, where they spend it, and is it effective? And publish that information, make it public.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
so that states know and taxpayers know where it is going. I want to know what's taking place in prison, what is done with people who are in prison and the crimes associated with or maybe unrelated to mental illness, what money is being spent, what treatment is being provided, what's the outcome. Same with the homeless population.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
So with all these things we don't have data on, the federal government and state governments are flying totally blind here. It is a sham. It is cruel. And as a nation, we shouldn't be putting up with this. We wouldn't put up with it anywhere else. But we sometimes think, well, Those are mentally illing. A guy named Ron Powers wrote a book and it's called No One Cares About Crazy People.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Because that's the attitude amongst people in leadership positions. Nobody cares. Well, we need to care. We need to say this must be done. We have to handle this. So that's why I'm continuing to fight on these things. That's why I'm going to continue to work on these things. That's why I hope we can make things happen.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Quite frankly, it can be kind of scary for a lot of folks and other folks aren't quite sure. And there's some folks who just have a prejudice towards it. I'm not talking about stigma. I mean, a prejudice towards it. Some people think it's a weakness until they start really digging into it and understanding there's a biological, neurological basis for much of this.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
That's a great question. You know what the answer is? Not everybody's under the same umbrella, multiple umbrellas. So for example, NAMI, National Alliance for Mental Illness, at one time was really focused on serious mental illness. Now it's all over the place. And when it's too broad and all over the place, it's trying to please so many people that it can't please anybody at all.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And it goes where the money is and it goes towards government and companies will give money towards mental illness. It's a great sounding organization by name. They have to have the accountability. Are you making a difference with serious mental illness?
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
So NAMI has this place in terms of information and talking about stigma, but it's not pushing for innovation within and accountability within serious mental illness. Mental Health America, great organization. They work on issues to make sure people with a serious mental illness can get care, but they're opposed to assisted outpatient treatment.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
I agree with them for those who can with a serve community treatment and help them and guide them along. And those people are cooperative. Awesome. That's a very important pool, but not everybody is the same. And so disability rights organizations say everybody's the same, same diagnosis, same treatment plan. We have to stand up and say, no, that's not right. So SAMHSA needs leadership.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
The assistant secretary needs to lead and say, I get what you're concerned about, but what you're concerned about does not apply to everyone. Everything else that takes place, when your only tool is a hammer, everything looks like a nail.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And I tell people, well, gee, if you have a problem in your house with, I don't know, pick anything, a broken light bulb, you don't send the road crew in to pave your driveway. You know, that's not the same thing. You wouldn't do that. You have to work very refined on that. And in the field of medicine, we don't treat every diagnosis the same.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And with mental illness, we should not treat every diagnosis the same. And the subcategories of diagnosis based upon the symptoms. A lot of what I do now, for example, I work with people with very serious post-traumatic stress disorder.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
which can have very, very major consequences from moments, severe depression, severe anxiety, debilitating levels of that, psychotic behaviors from massive stress, but you don't treat them all the same. And what we can do is help a lot of people with PTSD.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
So two, it is with psychosis, we can help a lot of people, but it's going to take a leader within SAMHSA, that assistant secretary coming in and say, no, we're not doing everybody the same way. And two, we're going to stop the goofy programs. Absolutely stop them. There's no more room for grants for yoga classes or for art classes or anything like that.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
You want to do that, go somewhere locally for that. Go to your local community center and get people some art classes. It's valuable, but it's not mental illness treatment. And say the money we have, the very limited money we have, we're going to spend on these things. For example, I think this year's cyclic grants, I think it's something like 15 to 20 million nationwide for AOT. You kidding me?
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
A couple of counties could eat that up. In Pennsylvania, they passed a law in 2018 that said they gave counties wherewithal and permission to do AOT. One county is doing it so far and not very much. Major counties like Philadelphia and Allegheny, they're not doing it. So it is this level that the assistant secretary has to hold states accountable. Say, what are you doing?
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And when states say we need more money, it says, tell me what you're doing. We want to see your plan of action and give evidence that what you're doing makes sense. Give us some accountability numbers and don't just tell us it's improving by a percent of points. That's in general what has to happen, but it really is going to take someone.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
The way I word this, it has to be the tenacity of Teddy Roosevelt and the compassion of Mother Teresa to combine those two. Neither one of them would take no for an answer. Neither one. And both of them improve the world.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Well, one has to assess what your area has. If your county is not putting in, for example, EOT, it is important that people become a very strong voice appealing to the county government and accountability. And that is not just a private meeting. That means showing up to your county meetings and your local community meetings and city meetings and say, here's a problem. Take care of this.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
What happened was I ran for state senate in the 1990s. There I worked a number of health care reforms, and among them making sure that people could get access to care and insurance would pay for it in a general sense. In Congress, it was a much deeper dive. There I was chairman of a subcommittee of oversight and investigation in the Committee on Energy and Commerce.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And I'll guarantee you at some point there'll be some crisis that occurs that these same parents can go and say, this murder, this assault, this suicide took place because we don't have the program. The blood's in your hands. Now, that's strong words, but having been in politics for a while, you need strong words.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
I would suggest that people look at the bad mom's model out in Arizona and find out the same thing. But definitely do that. And yes, appeal on the federal government because the federal government is going to pay with Medicare, Medicaid, and other grants. So let your congressman know and understand they may not know what you're talking about.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Please don't look down on them and say, well, we told them they're not doing anything. You have to make a very specific ask. So you can't say, we want you to do more for mental health. And the person will say, thank you very much. I agree with you. Let's do more for mental health. And one day that member of Congress will say, hey, do we have any mental health bills I can vote on?
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Well, that's not good enough. You want to say, I need you to specifically do this. Accountability within SAMHSA. Emphasize serious mental illness. Drop the 16-bed rule. Drop the 15-day one-time admission. Drop the 190-day lifetime admission. Change the HIPAA laws. Put some money into AOT. You got to punch and punch and punch in those ways.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And all this with that massive accountability, just demand it all the time. You ask a member of Congress, where does the money go? I think now that Elon Musk is in there with this whole Doge principle of making government accountability, that could be a real plus here.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Don't cut the money out, Elon, but please have it in such a way that people are, that the government is asking, what did you do with the money we gave you? What did you do with it? And if that area says, well, we don't know, well, then you don't get any more. well, then we will have a problem. Then you've got a problem.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And we're going to publish that information and say, you're wasting your money and you're causing cruel problems. That's boldness, but it's going to need that kind of boldness for us to do. I mean, it's just like in the Pentagon. If we have generals that are not preparing our military for protecting our nation, it has to be exposed all the way down the line.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
So, and these are lives of people with mental illness. So we need to Push it there too.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Speak up. Do not be silent. Silence doesn't work. It's not a means of getting action in there. And in that, please... Please let your legislators know what your concerns are, what your personal concerns are. Tell them your story. Tell them what you want them to do. Some of the articles I published are at my website, which is drtimmurphy.com. That's D-R-T-I-M-M-U-R-P-H-Y.com, drtimmurphy.com.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
I suggest people go there. They can read some of these articles because it does have some plans of action in there. But don't give up. Please don't ever give up. I've been fighting this for years, and I know it gets very, very frustrating. Very frustrating. We have a lot of sleepless nights, a lot of painful stories to swap with each other. But we can't give up.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And sometimes when the only people we have is each other holding us up, that's what it is. But there's a great saying that says, you never know how strong you are until being strong is the only choice you have. And that's what we have here.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
We don't have any other choice except to be strong, to speak up, to be persistent, not to be mean, but to certainly be assertive in this and say, we want to help Congress and state legislators understand this. But please, you got to do this. Lives are at stake. Families are at stake.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And Energy and Commerce has jurisdiction over mental illness and health in general. But in that, what happened was right after the terrible shooting in Sandhook Elementary School, the majority leader tasked me with the idea, says, we've got to do something about this. I know a lot of the human cry was, well, let's ban guns or let's restrict guns. I always knew it's not what was in their hand.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
It's not just the law, but it really is, quite frankly, even the Bible says, you know, that when you don't visit someone in prison, when you don't feed the hungry, when you walk by the homeless, that's sinful too. We've got to be working on all these things on every level and never, ever give up.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Well, Tony, great. I hope we get to work together again.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
It was what's in their mind that was the big issue in this. So we really had a year or two of just investigation. We had many, many witnesses come forth, dozens and dozens of parents, hundreds and hundreds of letters, millions of social media hits telling us the problems that were occurring. And it was on several levels. We did not have enough trained providers.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
No, I don't just mean counselors. I mean providers trained to deal with serious mental illness such as schizophrenia, psychosis, bipolar, and the more severe autism spectrum disorders. We had lots of people who were going to deal with some of the milder things, you know, the people with general angst or anxiety or mild depression, but the more serious ones we didn't have.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
The second thing is we had restrictions in the law. Medicaid only pays for two weeks at a time, 15 days stay, or a lifetime limit of, what, 190 days in the hospital? That's a problem. Or they didn't want to have more than 16 beds in a hospital. That's a problem. So it was these artificial limitations on serious mental illness, particularly when you're dealing with schizophrenia and psychosis.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
15 days is not enough. I mean, it takes that much time to get off of one medication and stabilize on another one. Your time is up before you know it. And this 190-day lifetime limit, I was thinking, boy, can you imagine if we did that with cancer? And said, I'm sorry, we're not going to give you any more days on this.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
There's other things with insurance companies more recently come to light, and that is that insurance companies have a tendency, when you start to get better, they stop payment. In other words, well, you don't really need this inpatient stay anymore because you're improving, so we're going to stop payment, which means before the person's even stabilized, they're out on the street.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Another aspect we discovered was that there's this concept of this practice called assisted outpatient treatment, different from assertive community treatment. The community treatment is one where basically services are provided, people can talk to the person with severe mental illness with the belief you can talk them into getting care. And that can work in a lot of cases.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
It does not work when someone is so compromised. with their self-awareness, with a condition called anosomnosia. They don't even know that they're not sick. They do not have that self-awareness. It's like the blind person who doesn't even know that they're blind. Those are people who resist treatment, who become very paranoid about treatment.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And of course, in the throes of their psychotic or schizophrenic crisis, they can easily become paranoid because they think, well, you're part of the group that's plotting against them or trying to force them into treatment.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Unfortunately with that, there are groups called the disability rights groups, which in concept make a lot of sense. They say they don't want to force anybody into treatment without their consent. I get that. And there was a time, 50 years ago, 100 years ago, when many people were just put into these asylums. You thought granny was the law of control, Uncle Bob was the law of control, the son.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
You send them to these asylums. The asylums, by the way, were set up originally to keep people out of homeless and from prisons, to be a more humane place to put people. So they started off with a good concept. But they became overpopulated, understaffed, dumping grounds. So the disability rights people said, hey, you can't just be putting people there. I get it.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
What happened is they went too far, far, far, far, too far. and assumed everybody was the same. That in itself is such a far-fetched concept in medicine. It's like we give everybody the same medicine in medical. You go see the doctor, take two aspirins, call me in the morning. That's about where we are. And some people you can talk into getting care, but some people you simply cannot.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And they can keep it together long enough, quite frankly, to see you and say, I'm fine. I'm not going to kill myself. I'm not going to harm myself. I'm really good. Because they know that they conceptualize, at least, if they're paranoid that something's wrong with you, then you're trying to talk them into this care and they don't want it.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
They've also probably had a lot of bad experiences anyways where the police have been called and they're afraid of those things. So what happens is the disability rights groups oppose a lot of these things where we're trying to have assisted outpatient treatment where the judge could order using what's basically the black robe effect saying, no, you need to get care. It's compassionate.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
But it sure is different from the police grabbing the person, handcuffing them, taking them to jail. They get in a fight with the prison guard. They're given another penalty. They get in a fight with somebody else. They get another penalty. Fight with somebody else. Before you know it, they're in solitary confinement. The worst possible thing you can do in a jail with someone there.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Jail is not a place to treat schizophrenia. It never was. And eight out of 10 people in the jails get no treatment for that. So, and what is about 40% of people in prison have a serious mental illness. About 90% have something. And among the homeless, the numbers are similar too.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
So what has happened in America is as we close these hospitals down from 550,000 in the 1950s to about 38,000 today, we provided nothing else for them in terms of having enough hospital beds. In terms of assisted outpatient treatment, there's people who oppose having a judge say, no, you've got to go in the hospital, you've got to send your medication. And we still have a shortage.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And we also have people who just do not engage families. HIPAA laws are extremely important to protect someone, but they have gone too far in the sense that doctors are tied up and not being able to communicate with families when they know what's going on. I'll give you an example. Let's say a young woman, maybe in her early 20s, has a suicide threat. She's taken to the hospital.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Two in the morning, she's able to tell the doctors, look, I'm not going to kill myself, really. I was just kidding about that. And the doctor's thinking, well, we don't have a bed. We don't have a place to put. We don't have a psych ward. What are we going to do? We'll trust her to go on the street and say, well, can we call someone to help you out?
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And if she says, don't call my parents because I don't get along with them, then that's it. They literally open the hospital doors and say, go on, find a ride home, do something. But what if the doctors know the family? What if the doctors say, Mary, I know your folks. Come on, we're all in the same community. Let me call them. They'll get your ride. Well, under HIPAA laws, you can't do that.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And also under HIPAA laws, when you know someone is in the throes of deep psychosis and they're in crisis and they're fighting and they don't want help, if the doctors could call the family and say, we need some background history on this. Can you give us more background? And find out, oh, this person's had multiple times before. They're prescribed this medication. They don't want to take it.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Whatever else goes with that, it's important to be able to have that information too.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Well, that also is something that runs into a barrier. And a lot of doctors operate at this idea that, well, the confidentiality of sacrosanct, I won't do that. You know what? But they don't always do that. For example, if someone has Alzheimer's and is wandering the streets in the snow, it's two in the morning. And grandma's out there in her bare feet.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
They don't say, let's let her go because she doesn't want to be picked up and she thinks she's on her way to second grade. They say, let's call the family. Let's take care of this. Well, quite frankly, that is a personal anosognosia. And someone else who we ought to put in the same category of many people with schizophrenia in a crisis to say, we need to get this person help.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
It's not against their will because they don't have a free informed will. So where does all this go? When I was doing my investigations in 2014-2015, we finally introduced a bill to do several things. Make some tweaks to HIPAA laws, allow what we call compassionate communication. Lift the 16-bed rule. Expand the number of days someone could get care.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Fund assisted outpatient treatment and push states to do more of that.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
We also wanted SAMHSA, Substance Abuse and Mental Health Service Administration, to focus, to shift its focus to look at serious mental illness and mental illness and not just mental health. Quite frankly, it was pretty goofy before, Tony. It was funding pictures and artwork and how to make a fruit smoothie and sing songs and have yoga classes. You know what? All that's good for mental health.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
It's great if people eat right and sleep right and get involved in social activities. That's not a treatment for mental illness. And again, I go back to my cancer metaphor. Can you imagine if someone was checking into a major cancer clinic? They go into Sloan Kettering and they say, well, can I have chemotherapy and this and this and this? No, no, no, no.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
We're going to have yoga class in the morning. Then we're going to teach you how to make a fruit smoothie. Then we're going to go do finger painting and send you home. This is how absurd the system is. And that's because people within SAMHSA, quite frankly, don't know what they're doing. SAMHSA's leadership has been weak, ineffective. Some years it has had a lawyer in charge.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
In the last couple of terms, there's been psychiatrists in charge. But in the last four years, it has gone back to mental health and not to work a serious mental illness. And so what we've ended up with is massive increases in homelessness, massive increases in incarceration.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
More homicides, as you know, 10% of homicides are committed by someone with schizophrenia, even though schizophrenia is 1% of the population. And 30% of mass murders are some with uncontrolled schizophrenia. Sometimes people will use this phrase and say, well, a person with schizophrenia is no more likely to murder someone than some without. And that's totally false.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
That study was done comparing people with schizophrenia in treatment and people who don't have schizophrenia. And so among those groups, that's pretty similar. But when you have someone without treatment, without care, without wraparound services, without their medication, they can deteriorate and become violent, not only in the streets and to their family, but also in jail or somewhere else.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
What also is occurring in terms of the homeless area, in terms of the number of homeless that have increased dramatically in this country, we've had a system that has been strained far beyond its capacity. It's already beyond strains. when you have several million immigrants come to this country and they have no place to go.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
So they've shoved people out of homeless shelters and put the immigrants in there, which puts a homeless on the street again. Last year in 2024, HUD just released information from a January assessment done, January of 2024. But they didn't release it until Christmas week, the Friday after Christmas in December of 2024, that homelessness actually grew about 18% in the United States.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Absurd that they waited 12 months to give that. Cruel that they waited 12 months to do that. True, because Congress can't do anything without data. But then they say things like, oh, look, someone is getting better. They've got some cities have reduced homelessness. And that's silly because what happens is they reduce homelessness by helping those who can easily adapt to help.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Like some people just don't have an apartment or they don't have the money or they miss payments. All right, we'll get them into temporary housing and they'll move towards getting a job in permanent housing.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
But even if they reduce homelessness in those towns by 10 or 20 or 30 or 40 percent, well, that's expected because that's the people who are mentally much better and some of them pretty okay and with some assistance they can do better. But it doesn't address the chronically seriously mentally ill people with major problems. And so that gets ignored.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
There's something pretty cool called assisted housing, where it's not a huge apartment building. Maybe there's only 30 units or something like that. But there's a nurse at the front desk. So as you're coming and going, she checks, hey, Bob, did you get your medication? Rebecca, did you take your pills today? Make sure you got an appointment today.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
That little checkup for some people who can function with that is great. But the ones who have more serious problems, just checking up on them isn't enough. In fact, parents will tell you when they check up on them, it may end up in a violent or heated altercation.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
So when I put my legislation in it, as I said, it was to make some of those changes, also to create the position of the Assistant Secretary of Mental Health. I wanted to elevate the issue and have someone in there who could do that. And also we wanted something called ISMIC, which is the Interdepartmental Serious Mental Illness Committee and Coordinating Committee.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
And that was to take all these federal agencies from HUD and HHS and everywhere else and say, you have to coordinate your services. Make sure we're evaluating on a government-wide level exactly what's going on.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
Here's where a major problem broke down. The reason we did that is because, as it turns out, when we asked the general accounting office, so we wanted a survey of the federal programs, they said, we really don't know what we spend in this country. What? Said it may be over $100 billion, scattered over 130 programs. We don't know. We just wrote letters to departments.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
They threw a number at us, but we don't know if it really treats mental illness or if it does any good or what's going on. So that's a pretty amazing amount of money that no one bothers to track. And we wanted SAMHSA to track it. They don't. They don't. There's absolutely no data to say that.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
In fact, their last report, which I think was in March of 2024, they spent a few days talking about their colorful logo, how they came up with the logo, the symbolism, all those colors. But I didn't tell you success stories of here's how we have worked innovative programs throughout the federal government, got these programs to work together. It's not there. It's an abject failure.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
It's an embarrassment of the government. And because of that, more people are dying, more people are homeless, more people are in prison. So try to put these factors in to get accountability there. Try to put factors in to get assisted outpatient treatment and more treatment options. And it has just ended up rather disastrous for people with mental illness and their family.
Tony Mantor: Why Not Me the World
Tim Murphy's Fight for Mental Health Reform
I'm hoping that President Trump and RFK appoint someone who's a fighter who will go in there and clean this mess up. This isn't any more time for goofball ideas, no more time for sing-alongs, pats on the back.