We Need REAL Change in Mental Health Policy, Not the Illusion of Reform

By David Shern, Ph.D.

In a recent blog on the American Enterprise Institute (AEI) website entitled “Stop Ignoring the Needs of the Mentally Ill,” Drs. Sally Satel and E. Fuller Torrey outlined the reasons why they supported the Helping Families in Mental Health Crisis Act (H.R. 2646). Drs. Satel and Torrey suggest that we can fundamentally reform mental health services by introducing more coercive “treatment,” building more beds, and reorganizing the nation’s leading mental health and substance abuse authority. But these simplistic approaches ignore core elements of the problem. They are ‘quick fix’ solutions that have little promise of doing much to address our contemporary crisis.

Few people would quarrel with key features of the problem- we incarcerate intolerable numbers of people with severe mental illnesses, and we lack effective engagement strategies- not to mention the poverty and social exclusion that plague this population. A comprehensive approach to these problems, however, requires both more resources and better use of the resources that are currently available. Drs. Satel and Torrey propose more of the same – strategies that have characterized the last 50 years.

They cite a GAO report that documents the several federal programs that provide services and supports for persons with severe mental illnesses, including the Social Security Administration, HUD and others. They assert that the creation of an Assistant Secretary of Mental Health will create the organizational structure to coordinate these activities. Were it only so simple! Currently, the SAMHSA administrator, a Presidential appointee, reports directly to the Secretary of HHS, which organizationally parallels the Assistant Secretaries of HHS. There is no reason to believe that adding an Assistant Secretary title to the role will make any difference within HHS, and it would have absolutely no effect on other governmental departments critical for community life of people with mental illnesses. We’ve repeatedly learned that reorganizations are appealing but rarely accomplish the magic that the reorganizers hope to achieve.

In H.R. 2646, “Involuntary Outpatient Commitment” has euphemistically been renamed “Assisted Outpatient Treatment.” However, the marketing twist doesn’t change the basic rationale of the approach. Ostensibly, for people who are not compliant with the system’s idea of care, having a judge order an individual to comply with the treatment plan will fix the problems of an inadequate system. (An inpatient stay is the ‘punishment’ for noncompliance.) In New York State, where AOT has demonstrated some success, it was accompanied by $120 million dollars in enhanced service funding. Leaders in New York attribute the success of the program both to the enhanced services and to increased provider accountability for individuals assigned to their care. The latter could be achieved without coercion.

The approach proposed by H.R. 2646 and supported by Satel and Torrey ignores the fact that coercion and court involvement can increase stigma and drive people from the care system. What is needed are accessible, meaningful services with engagement-oriented outreach. Unfortunately, mental health budgets have been slashed in many states, and effective outreach services have been reduced and in many cases, all but eliminated. Many localities lack the resources to implement evidence-based, voluntary community treatments that reduce the need for involuntary or inpatient services. For example, trauma-specific treatments designed for people with co-occurring mental health, substance abuse and trauma histories have been shown to be effective, even with very hard-to-serve populations, but they have not been widely adopted. The current legislation does nearly nothing to improve community service capacity. Creating a legal mechanism to compel individuals into a non-existent system is a cruel fiction that creates the illusion of fixing a problem.

The third leg of the proposed “reform” involves opening a spigot of funding for inpatient services that was initially closed to keep states from shifting inpatient costs onto the federal government. That danger still exists. In addition, it is difficult to tell how many inpatient beds are needed or even how many are currently available. The numbers cited by Satel and Torrey relate to state-funded, specialty inpatient facilities (state hospitals, which comprise only a fraction of available inpatient and residential alternative beds). While the private psychiatric hospital lobby would love to have a new entitlement for their industry, and while there may be a need for more residential alternatives, any expansion should involve a systematic appraisal of the system of care available in each community and a plan for allocation of resources to ensure the range of services needed. Preferentially funding one component of the system while neglecting others isn’t a smart approach.

Perhaps an even more frightening aspect of this pendulum swing towards institutional models of care is that large psychiatric institutions historically have been breeding grounds for neglect and abuse. The exposure of horrors and atrocities in U.S. mental hospitals, in addition to their cost, was the impetus behind the move towards community mental health beginning in the 1960s.

Sadly, the days of “One Flew Over the Cuckoo’s Nest” are not in the past. A recent series of exposes in the Tampa Bay Times and Sarasota Herald-Tribune has highlighted disturbing coverups of abuses and preventable patient deaths in Florida’s state hospitals. This is not an isolated occurrence. Indeed, the Service Employees International Union (SEIU) has created a website called “Behind Closed Doors” dedicated to “bringing to light serious problems in care at Universal Health Services Inc., America’s largest provider of inpatient behavioral health care.” If H.R. 2646 passes, we can expect even more of these horrifying reports.

In short, these components of the current House bill, while superficially appealing, just don’t cut it. They are “more of the same” – an expansion of the approaches that got us into our current difficulties. Increasing institutional care and coercion sounds much like the strategy used in the state hospital era in which we warehoused people interminably in snake pit conditions. Organizational shake-ups rarely make the difference that shared vision and collaboration can achieve. Early intervention and prevention, assessable and patient-focused services with a rehabilitation orientation and increased funding for the community supports needed for successful recovery are the tickets to system improvement. The bill has some of these components (like early intervention) but neglects others (like prevention). It ignores major trends in healthcare that emphasize meaningful patient involvement. People diagnosed with severe mental illnesses and their families deserve real mental health reform. This is not it.

David Shern is Senior Associate, Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University.

Our Civil Rights and the Murphy Bill

Screen Shot 2015-11-13 at 1.28.37 PMBy Iden Campbell McCollum, CPRP

As I look back on the civil rights movement and all that my ancestors marched for, I sometimes feel as if the civil rights movement has been a dream deferred.  We have come far but still have a long road ahead.  The intersection of civil rights, poverty and the psychiatric survivors’ movement has played out now for four generations.  As in 1963, the need for equal economic access still exists. Affordable housing and affordable healthcare are more accessible than ever, but much more is needed.

In the later 1960s, the targets of Dr. King’s activism were starting to focus more often on the underlying poverty, unemployment, lack of education, and blocked avenues of economic opportunity confronting black Americans. Like so many of us today who are fighting for social justice, dignity and respect for the psychiatric survivor community.  We are faced with the highest unemployment rate among those with disabilities, our poverty level as a group is among the highest of the disability community.  In 2015, we are still being told that we can never get better, marry or become educated.  Dr. King believed that all people had the right to be treated by the content of their character and not their skin color or economic status.

Dr. King went to Memphis in April of 1968 to march with the city’s striking sanitation workers. The march had not gone as planned and the city placed an injunction against the marchers. Julian Bond, one of Dr. King’s protégés and an up and coming young leader, was charged with negotiating with the city to come up with a plan that would allow the next march to move forward.  Mr. Bond was successful in getting the city to lift the injunction, and the march was back on.  Mr. Bond relayed this information to Dr. King on April 4, 1968.  To celebrate, they decided to head out to dinner.  As Dr. King joined his colleagues for dinner, they stepped out of the door and he was assassinated.  A dream deferred for generations of black Americans.

Now the psychiatric survivor movement faces its biggest hurdle in 2015.  We are asking our allies, representatives and members of our community to stand up. We urge you not to endorse the Murphy Bill.  We ask you to work with Congress to create an alternative that won’t strip the rights of those with psychiatric disabilities.

The bill calls for the defunding of the Substance Abuse and Mental Health Services Administration (SAMHSA). It tries to define what peer support is, but peer support should only be defined by those who created this para-profession and that consists of folks who provide and live within the culture of true support. Someone who has no interest other than to hamper how we support each other should not define it. Peer support was never meant to be a replacement for clinicians, we are and have always been complementary and non-clinical.  No one gets to define my personal recovery story. My reality and my narrative come from my lived experience — not a clinical handbook of supervision.

This is our fight today.  We must speak up and demand what we want for our communities: dignity, respect, economic opportunities, and the decriminalization of those with mental health issues.  Remember Dr. King, Fannie Lou Hammer and Julian Bond and the hundreds of thousands folks who walked, marched and sang ‘We Shall Overcome.’  Our struggle involves brutality, the denial of basic human rights such as voting, affordable housing, equal and affordable access to medication and treatment. Access to treatment that is not physically forced and/or judicially mandated is a basic human right we should all have. None of us should fear that our privacy would no longer be between us, our treatment teams and whomever else we give permission to.  An act from Congress should not open our privacy door wide open for all to bear and witness.

Make your calls today to your representatives and let them know why you do not approve of them signing on to the Murphy Bill.  Create the future you want by being the change you want to see in the world.

Iden Campbell McCollum is the Founder and Executive Director of The Campbell Center, a Certified Psychiatric Rehabilitation Practitioner/CPRP, and a Certified Peer Specialist (in both DC and North Carolina). Iden serves on the Executive Board of Cornerstone Investments, the Center of Excellence (CoE) on Behavioral Health for Racial Ethnic/Minority National Advisory Board as well as serving in an advisory capacity to the Substance Abuse and Mental Health Services Administration (SAMHSA) and HRSA/Ryan White HIV/AIDS Program (RWHAP).

Change is a Choice: Reflections on the Markup of the Helping Families in Mental Health Crisis Act

This blog originally appeared on author and journalist Pete Earley’s website.

Change is a Choice: Reflections on the Markup of the Helping Families in Mental Health Crisis Act

By Leah Harris

“Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive.” — C. S. Lewis

I spent several hours revieLeah-Harris250wing the House Energy and Commerce Health Subcommittee markup of “The Helping Families in Mental Health Crisis” Act (H.R. 2646). Some supporters of the Murphy Bill claim that Democratic objections to the bill should be dismissed as typical partisan wrangling. But this markup was much less a matter of partisan politics and much more a question of just how to fix our broken system. It is a battle about resources: whether to focus on funding a few costly, late-stage crisis interventions that only apply to a very small subset of people, or to reform the system from the ground up with a focus on preventing the very crises that the bill purports to address. It is a battle between outdated, authoritarian approaches to care, versus collaborative, person-centered approaches that represent the latest in science and good medicine.

At the markup, Democrats put forward the same arguments against the bill that have been made by mental health service users and advocates since the first version of the legislation was introduced in December 2013. The laundry list of objections to the bill are far too numerous to reiterate in this piece, but can be found  here and here. Arguments against the Murphy bill have rarely been heard in the mainstream media, which overwhelmingly endorse the bill and fail to include critical perspectives. For this reason, I was heartened to see clear critiques of the bill finally make it into the public record.

The very basis of the bill — to prevent future Newtown tragedies — is deeply problematic. This is not just a philosophical issue, but one of intent. To approach comprehensive mental health reform as a matter of public safety – as Congressman Murphy (R-PA) does — and not as a matter of public health, represents a failure out of the gate. Representative Murphy cannot have it both ways. He cannot say that most persons with mental health concerns are not generally violent, which is true; or that persons with mental health disabilities are 11 times more likely to be victims of violence, which is also true — while holding up a series of photographs of people who have committed violent acts as the impetus behind this bill.

Congressman Murphy repeats ad infinitum that “people with untreated serious mental illness are 15 times more likely to commit violence,” but fails to cite the most important finding of many of these studies – that such violence is more associated with substance use than psychiatric disability. Substance use raises the potential for violence across the population – not just for people with a diagnosed mental disorder. But his bill would take funding from substance use prevention and treatment to pay for late-stage, coercive, unproven mental health services. How does this make any sense?

Congressman Murphy and his supporters also shut down any discussion of the egregious civil rights and health privacy concerns in the bill by shifting the focus to the “right to treatment,” or the “right to be well,” as if one right must necessarily cancel out the other. Why do we never consider the possibility of funding a continuum of quality supports, while also  continuing to guarantee the same civil and privacy rights to persons with psychiatric disabilities as everyone else? We must move beyond such dichotomous thinking, which only serves to polarize.

One of the more frightening aspects of the markup was the GOP’s unwillingness to address provisions restricting systemic advocacy under the Protection and Advocacy for Persons with Mental Illnesses (PAIMI) program. My mother, who was diagnosed with schizophrenia at age 18, got the H.R. 2646 “solution” – involuntary outpatient commitment, beds, and meds. She died at age 46 as a direct result of metabolic syndrome due to extreme overmedication on antipsychotics. She was also deeply traumatized by being secluded and restrained over and over in inpatient settings.

If only my mother’s experience was unique. But in my fifteen years as an advocate, I have heard untold stories of people who were re-traumatized by their “care” when forced into inpatient settings. And many others have died as a result of abuse, neglect, and overmedication. It is right to point out the horrific abuses occurring in our jails and prisons, but we cannot and should not imagine that these abuses would be absent from the large institutions Representative Murphy wants rebuilt. As Representative Lois Capps (D-CA) noted, “Another bad system layered on a bad system before it is not going to do the trick. We have to tread carefully.” I agree. Restricting the activities of the PAIMI program would only further hurt the people most vulnerable to abuse and neglect.

Congressman Murphy expresses deep concern for the most marginalized people in society who are homeless or incarcerated with mental health issues. But his bill would do nothing to help them. Representative Pallone (D-NJ) did a good job of pointing out the logical flaws in Congressman Murphy’s rhetoric about homelessness and mental illness. “This bill is not going to deal with the person on the blanket who needs help…what are we doing to prevent homelessness so that the person doesn’t get to the point where they are sleeping on a blanket? …We have to start from the beginning. We can’t just look at the end. We have to provide housing, we have to provide treatment, and food…”

Representative Murphy has heard these same sorts of concerns from advocates for nearly two years now. I published an op-ed in The Pittsburgh Post-Gazette over a year ago advocating for more supportive housing and outreach services. He wrote a letter to the editor dismissing housing as “no substitute for treatment.” Earlier this year, a former member of Congressman Murphy’s staff asked me what should be done about the “homeless people in Chinatown.” I sent him a series of links and extensive research behind Housing First programs, which have phenomenal outcomes for persons with psychiatric disabilities who are chronically homeless. I never heard a word in response. This is typical of the approach of Congressman Murphy and his supporters: pretending to listen, while attacking, discrediting, or simply ignoring anyone who dares disagree – whether they are grassroots advocates or other members of Congress.

If Republicans were seriously concerned about access to services for the most vulnerable and marginalized people in our society, they wouldn’t have voted down Representative Butterfield’s (D-NC) amendment encouraging Medicaid expansion in the 20 states that haven’t adopted it. They wouldn’t have voted down Mr. Butterfield’s other amendment asking for Congress to study and address the social determinants of health that disproportionately affect minorities. The actions of Congressman Murphy and the other Republicans on the Health Subcommittee give me cause to question their commitment to minority mental health and that of people with mental health issues who are homeless and incarcerated.

Perhaps one of the most powerful statements in the markup came from Congressman Joe Kennedy (D-MA), in clear frustration with the GOP’s refusal to accept amendments addressing disparities in access to care for people living in poverty in rural areas: “When we say we can’t do it, that is because we are choosing not to do it.”

Congress does have a choice: to layer a bad system on top of another bad system, as Representative Capps noted, or to overhaul the whole continuum of care using proven, trauma-informed, culturally-competent public health approaches. That’s comprehensive mental health reform — not rearranging the deck chairs on the Titanic, as H.R. 2646 does.

Make no mistake: as my colleague Larry Drain observed, if this bill passes the House, it will pass because the GOP can pass it, not because it’s the right approach to reform. Everyone who cares about civil rights and positive health and social outcomes for persons with psychiatric disabilities will continue to fight this bill, until our concerns are taken seriously and addressed.

Leah Harris is a mother, advocate, storyteller, and organizer with the Campaign for Real Change in Mental Health Policy.

Gun Violence vs. Psychiatric Diagnosis

By Sera Davidow

When something terrifying and tragic happens, people want answers. When they want answers, they naturally turn to those seen as being ‘in charge’. Inevitably, those seen as being ‘in charge’ (understandably) feel pressed to ‘do something’. Unfortunately, that pressure can lead those people to ‘do something’ more for the sake of the doing and to settle the public’s nerves, than because it will actually alleviate the problem at hand. In fact, all too often, those actions make the problem worse.

The Helping Families in Crisis Act (H.R. 2646 – also known as the Murphy Bill) is one such action that threatens to send us tumbling down a rabbit hole of extremely costly and regressive policies and protocols. While problematic on many levels, one clear issue is its contribution to the conflation of gun violence and psychiatric diagnosis.

There are several problems with the practice of linking gun violence to psychiatric diagnosis, the most obvious of which include:

There is no actual link between gun violence and psychiatric diagnosis: Most of us have now heard the phrase, “People with psychiatric diagnoses are more likely to be victims of violence than perpetrators.” It’s hard to hang on to that fact with the media (both news and entertainment outlets) consistently painting such a different picture, but it’s nonetheless true.

In fact, every significant research study since Macarthur (1998) has suggested that people who have been given psychiatric diagnoses are no more likely than their matched controls (individuals with no psychiatric diagnosis) to commit violence in the community. (See also the National Coalition on Mental Health Recovery’s fact sheet on mental health and violence: http://www.ncmhr.org/downloads/Research-on%20people-with-mental-health-diagnoses-and-violence%204-16-2014.pdf)

Co-existence of gun violence and psychiatric diagnosis is not proof of a causal link: In other words, the presence of a psychiatric diagnosis in someone who has committed gun violence may be completely and utterly unrelated (or, at least, not a primary motivating factor) to their actions in a given situation.

In theory, one could do a study of any two characteristics or qualities and measure them up against violent acts. For example, how many people who commit gun violence have brown hair, or have worked at a fast food restaurant at some point in their life? Any trend identified could mean there’s a real relationship between the two. Or, it could be that those qualities are actually linked to yet another factor that is the real predictor, or merely evidence of the prevalence of brown hair or the likelihood of holding a fast food job at some point in one’s life.

Given the growing frequency by which psychiatric diagnoses are doled out, it should be none too surprising that some people who commit violent acts also fit this category. However, a growing body of research indicates that causal links have been identified between violence and substance abuse, but not particularly with mental health. (Fazel, et al, 2009.)

There is no evidence that the ‘go to’ interventions proposed by legislation like the Murphy Bill would have stopped most of the recent gun violence: Proponents of restrictive and regressive mental health legislation are quick to capitalize on tragedy, and even to bus in distraught family members and victims of violence to testify about the horrors they’ve been through, pulling on the heartstrings of all in hearing range. Their stories are valid and they have every right to be sharing them. But what aren’t we being told?

Rarely is anyone asked to clearly explain how regressive mental health laws would have changed what happened. At best, broad and sweeping statements are made with little or no supporting evidence.

There is a reason for this: In so many cases, it wouldn’t have changed a thing. Why? Most such mental health policies focus on getting (or forcing) people into services, but in many instances held up as example, the person in question was already in treatment.

At least one individual in question (Cho, 2007) was already ordered into forced outpatient treatment (a particularly controversial and force-laden measure that Representative Tim Murphy emphasizes in all of his proposed legislation) before he engaged in a mass shooting.

There is evidence that the ‘go to’ interventions proposed by legislation like the Murphy Bill will have no impact on gun violence, or could even make it worse: There is currently no well-founded research to suggest that measures like outpatient commitment laws are effective at reducing hospitalization or violence, especially when separated out from the impact of an influx of quality services that are voluntary. Meanwhile, there are a growing number of studies suggesting that conventional interventions like psychiatric medication can make manifestations associated with psychiatric diagnosis worse over time, and can even increase the risk of violence.

For example, one long-term study (Harrow, 2011) of people diagnosed as psychotic found that medicated individuals had significantly worse outcomes in every area observed including anxiety, cognitive function, and what were seen as psychotic symptoms.

Few would disagree that the mental health system is broken, but why would we want to invest more dollars in blindly emphasizing (and even forcing) treatments that at least appear to be counter-productive for so many people and could potentially even raise the risk of violent outcomes?

The ‘go to’ interventions proposed by legislation like the Murphy Bill violate people’s civil rights in a way that would be seen as flatly unacceptable were any other group to be targeted in that manner: In reviewing literature on risk for gun violence, several predictive factors are listed including age (Farrington, 1986), gender (Brennan and Moore, 2009), race (Nielsen et al, 2005), and location (Ousey and Augustine, 2001). Yet, imagine the public outcry if legislation were introduced to restrict people’s civil liberties (such as the Murphy bill seeks to do around the right to privacy, to be in community, to make personal choices about interventions, etc.) based on being a young black man from a particular neighborhood?

And, the outcry would be justified – even in a situation where (unlike with psychiatric diagnosis) the research appears to actually point in a particular direction – because these results fail to consider so many other societal factors (racism, poverty, trauma, environmental violence, etc.), because they cannot be translated into ‘treatment plans’ at the individual level without doing far more harm than good, and because these are many of the freedoms upon which our very country was founded.

Focus on psychiatric diagnosis is often a manipulation to steer us away from a focus on gun control:

Every day, a reported 297 people (187,476 per year) in the United States are shot. Just under a third of them die as a result. Among those who die of a gunshot, over 11,000 are declared to have been murdered. (Brady Campaign, 2015.) Only an estimated 440 (4%) of those murders will have been committed by someone who also has a psychiatric diagnosis, and for how many people that psychiatric diagnosis played a factor in their actions is entirely unknown.

Given all that, it makes complete sense that the Consortium for Risk-based Firearm Policy (2013) asserts the following: ”Strategies that aim to reduce gun violence by focusing…on restricting access to guns by those diagnosed with a mental illness are unlikely to reduce the overall rate of gun violence in the US.”

It seems undeniable that, where gun violence is concerned, a focus on mental health legislation is little more than a distraction from the much deeper societal issues at hand, and is keeping us from taking a hard look at some of the changes that may be needed to actually save lives moving forward.

People with psychiatric diagnoses are the most obvious scapegoats when a scapegoat needs to be found. They have an already well-established ‘bad reputation’ in the media and so the public readily accepts them as the ones to blame. Their experiences are often misunderstood and typically seen as ‘other’ or separate from the rest of the population, so pointing the finger in their direction requires no real change or effort on the part of the average citizen. They also lack the major lobbying forces of the gun and pharmaceutical industries. It’s the easy choice. But not the right one.

Our society is fractured, and many of us are hurting and scared. Doing nothing is not an answer, but further fracturing through scapegoating, discrimination, and force is likely to breed violence all on its own. We need change that is thoughtful, not reactionary. We need willingness to be bold and courageous in response to the real ills of society. We need truth, and we need to acknowledge once and for all that focusing on psychiatric diagnosis in the face of so much gun violence is not the answer we seek.

Sera Davidow is a mother, an advocate, an activist and a filmmaker who devotes much of her time to the Western Massachusetts Recovery Learning Community (http://www.westernmassrlc.org). She entered the mental health system as a teenager and cites “non-compliance” as part of what saved her from a very different path that surely would not have included the freedom she now enjoys from all psychiatric labels and medications.

It is time for all of us to act on the Murphy Bill. Now!!

By Larry Drain, Hopeworks Community

The Murphy Bill will be marked up in subcommittee in a couple of days. What happens in that meeting will substantially affect whether or not the Murphy Bill will become the Murphy Law. Your voice matters. Those supporting the Murphy Bill are well organized and verbal. Either our voices will be heard or our silence will be heard. It is on us.

Below is a list of all the contact information you will need to make it easier for you to be effective.

Consider the following guidelines:

  1. Share this post with everyone you know and ask them to do the same. Numbers do matter.
  2. If your legislator is on the list below, contact them.
  3. Contact the Energy and Commerce Committee, especially the chairs, Rep. Pallone and Rep. Upton if at all possible. Contact information is at the bottom of this boast.
  1. If you can contact one Democratic member, please do so. Many of them signed the letter opposing the bill in its current form. Voice your support and encouragement. Contact information is below.
  2. Use whatever means of communication you feel most comfortable with — but communicate.
  3. If you have friends, consider having an email or phone party with them. Group efforts will matter.
  4. Tell your story. Explain how one or two items of the Murphy Bill will affect you. Personal stories matter. Keep it to one or two items. You need to be able to say it in 3 or 4 minutes tops.
  5. Make sure you tell them what you want them to do. “My name is ____ and I am calling to ask Rep.____ to oppose the AOT provisions of the Murphy Bill. I have concerns with other provisions also….. I (your story)….
  6. If you call, keep it to 3-4 minutes tops. Be organized and prepared. They will be polite to you.
  7. If you post on Facebook, try to keep it to 3-4 paragraphs tops. Do not be belligerent or accusatory. Try to share your personal stake in the bill.
  1. If you use Twitter, make one point per Tweet. Share links to more in depth points.
  1. If you email staff, be clear and personal. Thank them for their time. Again, be brief and focused. Share links to other material if you like.



Doris Matsui – CA6(D) – 202-225-7163
facebook: http//www.facebook.com/doris.matsui
Chief of staff: julie.eddy@mail.house.gov

David Loebsack – IA2(D) 202-225-6576
facebook: http//www.facebook.com/DaveLoebsack
CS staff: eric.witte@mail.house.gov

Paul Tonko – NY20(D) – 202-225-5076
facebook: http//www.facebook.com/reppaultonko
CS staff: clinton.britt@mail.house.gov

Joseph P. Kennedy – MA4(D) – 202-225-5931
facebook: http//www.facebook.com/CongressmanJoeKennedylll
CS staff: gregory.mecher@mail.house.gov

Bobby Rush – IL1(D) – 202-225-4372
facebook: http//www.facebook.com/Congressmanbobbyrush
CS staff: stanley.watkins@mail.house.gov

Diana DeGette – CO1(D) – 202-225-4431
facebook: http//www.facebook.com/DianaDeGette
CS staff: lisa.cohen@mail.house.gov

Janice Schakowsky – IL9(D) – 202-225-2111
facebook: http//www.facebook.com/janschakowsky
CS staff: cathy.hurwit@mail.house.gov

Kathy Castor – FL14(D) – 202-225-3376
facebook: http//www.facebook.com/USRepKathyCastor
CS staff: thomas.phillips@mail.house.gov

Jerry McNerney – CA9(D) – 202-225-1947
facebook: http//www.facebook.com/jerrymcnerney
CS staff: nicole.alioto@mail.house.gov

Ben Ray Lujan – NM3(D) – 202-225-6190
facebook: http//www.facebook.com/RepBenRayLujan
CS staff: angela.ramirez@mail.house.gov

Yvette D. Clarke NY9(D) – 202-225-6231
facebook: http//www.facebook.com/repyvetterdclarke
CS staff: shelley.davis@mail.house.gov

Eliot Engel NY16(D) -202-225-2464
facebook: http//www.facebook.com/RepEliotEngel
CS staff: william.weitz@mail.house.gov

Lois Capps CA24(D) – 202-225-3601
facebook: http//www.facebook.com/loiscapps
CS staff: sarah.ethington@mail.house.gov

G.K. Butterfield NC1(D) – 202-225-3101
facebook: http//www.facebook.com/congressmangkbutterfield
CS staff: troy.clair@mail.house.gov

John Sarbanes MD3(D) – 202-225-4016
facebook: http//www.facebook.com/RepSarbanes
CS staff: jason.gleason@mail.house.gov

Peter Welch VT(D) – 202-225-4115
facebook: http//www.facebook.com/PeterWelch
CS staff: bob.rogan@mail.house.gov

John Yarmuth KY3(D) – 202-225-5401
facebook: http//www.facebook.com/congressman-John-Yarmuth-KY-3/214258646163
CS staff: julie.carr@mail.house.gov

Kurt Schrader OR5(D) – 202-225-5711
facebook: http//www.facebook.com/repschrader
CS staff: paul.gage@mail.house.gov

Tony Cardenas CA29(D) – 202-225-6131
Facebook: http//www.facebook.com/repcardenas
CS staff: virginia.zigras@mail.house.gov
Joseph Pitts (Chair Health Subcommittee) PA16 (R)
Twitter: @RepJoePitts
Facebook: https://www.facebook.com/CongressmanJoePitts/
CS staff monica.volante@mail.house.gov

Gene Green (Ranking Democrat) TX29 (D)
Twitter: @RepGeneGreen
Facebook: https://www.facebook.com/RepGeneGreen/?fref=ts
CS staff rhonda.jackson@mail.house.gov

Joe Barton TX (R) – 202-225-2002
Twitter: @RepJoeBarton
Facebook: https://www.facebook.com/RepJoeBarton/?fref=ts
CS staff: ryan.thompson@mail.house.gov

John Shimkus IL(R) – 202-225-5271
Twitter: @RepShimkus
Facebook: https://www.facebook.com/repshimkus/?fref=ts
CS Staff: craig.roberts@mail.house.gov
LD staff: greta.joynes@mail.house.gov
Michael C. Burgess TX(R) – 202-225-7772
Twitter: @michaelcburgess
Facebook: https://www.facebook.com/michaelcburgess/?fref=ts
CS Staff: kelle.strickland@mail.house.gov
Cathy McMorris Rodgers WA(R) – 202-225-2006
Twitter: @cathymcmorris
Facebook: https://www.facebook.com/mcmorrisrodgers/?fref=ts
CS staff: david.peluso@mail.house.gov
Morgan Griffith VA(R) – 202-225-3861
Twitter: @RepMGriffith
Facebook: https://www.facebook.com/RepMorganGriffith/?fref=ts
CS staff: kelly.lungren@mail.house.gov
Frank Pallone NJ(D) Ranking Democrat on subcommittee
Twitter: @FrankPallone
Facebook: https://www.facebook.com/RepFrankPallone/?fref=ts
CS staff: jeff.carroll@mail.house.gov


Larry Drain is author of Hopeworks Community, a blog about mental health, advocacy and social justice. He is a long time advocate in Tennessee.