Chair DeLauro Statement at the Mental Health Emergencies: Building a Robust Crisis Response System Hearing

The following are remarks of Congresswoman Rosa DeLauro (D-CT), as prepared for delivery, at the Mental Health Emergencies: Building a Robust Crisis Response System hearing:

Over the past few years and all across our country, we have seen far too many instances in which local police have had to deal with individuals suffering from mental health crises or behavioral issues when what these individuals really need is medical treatment or a mental health provider. But due to a lack of mental health resources or teams better equipped to handle these situations, police are often the first, and only services to arrive at the scene.

But there is something we can do about it! Recently the City of New Haven announced a new program, which is the focus of one of my Community Project requests this year. This program, the New Haven Community Crisis Response Team would divert 9-1-1 calls involving someone experiencing a mental health crisis or behavioral issue to social services and dispatch specially trained social-worker led teams to address calls related to homelessness, mental health and substance abuse disorder instead of police. This program will significantly reduce the need for New Haven Police Department and EMS responses to incidents that are not of a criminal or health emergency nature. And we are seeing more models like this around the country, which we will talk about today.

The issue of mental health and substance use was already a growing concern in this country before the COVID-19 pandemic. But the isolation, the school closures, the economic anxiety, job losses, and challenges to obtaining childcare or paid time off have only exacerbated these already existing problems and created new barriers to treatment. According to the American Psychiatric Association, people from racial/ethnic minority groups are less likely to receive mental health care even without the additional barriers posed by the pandemic. For example, in 2015, among adults with any mental illness, 48 percent of whites received mental health services, compared with 31 percent of blacks and Hispanics, and 22 percent of Asians.

Earlier this year we had a hearing of this subcommittee on these growing problems and today we are looking at how we can strengthen the mental health crisis response system so that mental health providers across this country can respond to mental health emergencies rather than law enforcement.

Mental illnesses are serious medical conditions. And without treatment, these conditions can result in a diminished capacity for coping with the ordinary demands of life.

Untreated mental illness can escalate to a crisis situation where a family member, friend, or someone in the community feels they have no choice but to call 911 – which inevitably leads to situations in which law enforcement are responding to what is actually a mental health emergency.

Meanwhile, for the individual, arrest can cause unnecessary trauma, which can make their long-term recovery more difficult. This can lead to high rates of incarceration or even more tragic outcomes, including needless death – particularly for black or brown people.

According to the Treatment Advocacy Center: one in ten police responses involves an individual with a mental health condition. One in five incarcerated individuals lives with a mental health condition. And one in four individuals killed by police had a mental health condition.

Which is especially tragic because most police want to do their jobs well – they just do not always have the tools or training necessary to respond to a mental health emergency.

Part of the problem here is that the behavioral health system has been underfunded for years. We need to make treatment more available to everyone who needs it and ensure crisis services are available to anyone.  No one should go to jail when what they really need is mental health treatment.

In recent years, we have made efforts to address this shortfall. We have made serious investments in our police departments and crisis intervention programs. And we will continue to do so.

The Affordable Care Act significantly expanded access to Medicaid, which in many States is the most important source of coverage and funding for behavioral health services. And the American Rescue Plan gave an additional financial incentive to expand Medicaid for the 14 states that have not yet done so and allows states to use Medicaid funds to support the expansion of mental health mobile crisis teams.

In addition, last year we increased overall funding for the Substance Abuse and Mental Health Services Administration (SAMHSA) by $133 million – for a total of $6 billion. We also increased funding for Mental Health Services Block Grants by $35 million and created a 5 percent set-aside within the block grant specifically focused on crisis services. And over the past year, in three separate emergency bills, we have provided more than $8.6 billion to a variety of programs to address the mental health impacts of the pandemic.

Meanwhile, President Biden’s fiscal year 2022 budget blueprint would double funding of the Mental Health Services Block Grant to $1.6 billion - an increase of $825 million.

And while we have not seen the full budget yet, according to the administration’s blueprint it is clear they are proposing additional funding for partnerships between mental health providers and law enforcement, as well as suicide prevention activities.

Similarly, SAMHSA has put out a roadmap for robust crisis care services that can divert people experiencing a mental health crisis from the criminal justice system into mental health treatment.  

Another important tool in our toolbox is the rollout in July 2022 of 988 as the new three-digit number for the National Suicide Prevention Lifeline. 988 will be a dedicated number for people experiencing a mental health crisis to call and access lifesaving resources. It will function as an alternative to 911 and allow individuals in crisis to receive help immediately and a mental health response can be dispatched if necessary.

Many communities are implementing model programs where mental health providers respond to mental health emergencies, ensuring individuals with health care training are dispatched to address these situations and freeing up police resources for where they are most needed.

There are a range of different approaches communities can take, with different levels of police involvement – or no police involvement – depending on the mental health resources available in the community. The New Haven Community Crisis Response Team in New Haven is just one of many examples of how these programs can be developed. And I am greatly encouraged to see how many other Members have submitted requests across the Labor H and CJS subcommittees for crisis intervention projects including crisis response teams, mental health co-responders, and 911 diversion projects. But it is absolutely crucial that we train police to deal with mental health emergencies. Crisis Intervention Team (CIT) programs create connections between law enforcement, mental health providers, hospital emergency services and individuals with mental illness and their families.

One thing these models have in common is they all bring different stakeholders together – mental health providers, hospitals, law enforcement, people with mental illness and their families. We need to engage everyone.

If someone’s illness has escalated to the point of a crisis situation, the system has already failed them. How we respond to that crisis can be a turning point in someone’s life – it can lead to lifesaving treatment, or if we fail, unnecessary incarceration or even more tragic, irreversible outcomes.

That is why I am looking forward to hearing from our witnesses about what we can do to expand access to mental health crisis services, different models around the country, and how we can encourage more communities to think about changing the way they respond to mental health emergencies.