Department of Government Affairs Prepared by Nuala Moore, Dep. Dir. Gov’t Affairs Kristin K. Ptakowski, Dir. Gov’t Aff. and Clinical Pract. 1.800.333.7636 or nmoore@aacap.org

1st Session 109th Congress 109-1 February 14, 2005

AACAP member action is needed to oppose legislation that, if enacted, could stifle efforts to support state and local efforts to identify children and adolescents with mental illnesses. The bill, entitled the Parental Consent Act, H.R. 181, was introduced in the House by Rep. Paul (R-TX) and would prohibit the use of federal funds for mental health screening. Rep. Paul introduced the bill in response to the New Freedom Commission on Mental Health’s recommendations for increased screening. The bill and some communications circulated in the House to support it allege that the Commission has proposed mandatory screening of all children. This is not true. In fact, the Commission emphasized the need for full parental involvement in all decisions relating to the mental health of their children. The New Freedom Commission report is available at www.mentalhealthcommission.gov.

Additionally, the bill includes language that is discriminatory towards psychiatry, mental illness, and particularly, medications used to treat children. The following is an excerpt from the bill’s findings section: “(5) Because of the subjectivity of psychiatric diagnosis, it is all too easy for a psychiatrist to label a person's disagreement with the psychiatrist's political beliefs a mental disorder.” The bill also includes distortions of the Surgeon General’s 1999 report on Mental Health and the DSM IV.

The APA and the AACAP sent a letter to all members of the House and Senate on February 10 that dispels the misinformation about screening and the New Freedom Commission, and points out the discriminatory language towards mental illness and mental health professionals in H.R. 181. All AACAP members are asked to contact their Representatives to request their opposition to this bill.

ACTION: H.R. 181 has nineteen House cosponsors. These include: Reps. Ron Paul (R-TX), Henry Hyde (R-IL), Jo Ann Davis (R-VA), Tom Feeney (R-FL), Scott Garrett (R-NJ), Virgil Goode (R-VA), Mark Kennedy (R-MN), Gil Gutknecht (R-MN), Thaddeus McCotter (R-MI), Jeff Miller (R-FL), and C.L. “Butch” Otter (R-ID), Thomas Tancredo (R-CO), Roscoe Bartlett (R-MD), Duncan Hunter (R-CA), Randy Neugebauer (R-TX), Michael Simpson R-ID), Zach Wamp (R-TN), Charlie Norwood (R-GA) and Mike Pence (R-IN). If your House Representative is on this list, please contact them immediately to request that they withdraw their support for H.R. 181. Call 1-202-224-3121 to reach the Capitol Switchboard, and ask for your representative’s office. When connected to the office, ask for the Health Legislative Assistant. If you leave a voicemail message, include your name and phone number. The following are sample message points:

• I am a practicing child and adolescent psychiatrist in (your county) and I am calling to ask Rep._____ to oppose or (if your rep. is cosponsor of the bill) withdraw his/her support for H.R. 181, the Parental Consent Act, because the bill is unnecessary and discriminatory towards mental illness and the field of psychiatry (refer to the underlined quote from the first paragraph of this alert).
• The bill alleges that the President’s New Freedom Commission on Mental Health recommended mandatory screening of all children. This is false. The Commission emphasized the need for full parental involvement in all decisions relating to the mental health of children.
• I agree that mental health screenings for children must include parental consent, but this is already a required procedure in screening programs, so federal legislation is unnecessary.
• I am concerned that H.R. 181 will lead to fewer children with mental illnesses being identified due to its negative characterization of mental illness. Children with untreated mental illness are at high risk for school failure, substance abuse and entrance into the juvenile justice system.
• As a child and adolescent psychiatrist, I am dedicated to improving the quality of life for children, adolescents and their families struggling with mental illness and I ask you to oppose H.R.181, legislation that attacks my medical profession.

FY 2006 Budget Recommends Cuts for Mental Health Services
Under the Bush administration’s fiscal year 2006 budget recommendations released this week, the National Institute of Mental Health (NIMH) would receive a modest funding increase and the Substance Abuse and Mental Health Administration (SAMHSA) would be slated for a significant cut in funding. The Administration’s budget numbers are used as a guideline for the House and Senate Appropriations Committees; although, the final funding levels negotiated between the House and Senate are often different from the original numbers, as the chart below indicates. SAMHSA’s CMHS is slated for a cut in funding from $862 million in 2005 to $837 million in 2006. The cut is absorbed by CMHS’s Programs of Regional and National Significance (PRNS). PRNS programs include the School Violence Prevention initiative, which would be cut by almost a third. The Children’s Mental Health Services Program would receive an inflation adjustment of $17,000 and new State Improvement Grants (SIG’s), which will be used for reforming state mental health systems, are slated for a funding increase of $6 million.

FY 2006 Administration Mental Health Research and Services Budget (in Billions or Millions)
Program	FY2005 Final	FY2006 Adm. Request	Increase/ Decrease	AACAP Recommendations
Nat’l Inst. of Mental Health (NIMH)	$1.412B	$1.418B	+ $6 Billion	$1.496B
Center for Mental Health Services (CMHS)	$901.3M	$837.3M	- $64.1M	$982.4M
Children’s Mental Health Program	$105.2M	$105.2M	+ $17,000 Thousand	$114.7M
Programs of Regional & Nat’l Significance	$274.3M	$210.2M	- $64.1M	$299.1M
State Improv. Grants (SIG’s)	$19.8M	$26.0M	+ $6.2M	$21.6M

FDA Gets Funding Increase; Children’s GME and School Mental Health Cut
The following are some other key health and youth programs and how they fared in the Administration’s budget:

• The Food and Drug Administration would receive for an overall increase of 4.5 %. This includes a $5 million increase for the Center for Drug Evaluation and Research.
• The Children’s Hospitals Graduate Medical Education program receives a funding cut of 33%. Child and adolescent psychiatry training programs are eligible for this funding.
• The Elementary and Secondary School Counseling Improvement program, one of the key sources of funding for school-based mental health programs, would receive no funding at all. This program was also eliminated in last year’s Administration budget, but congressional appropriators restored its funding. The AACAP will work to ensure that funding is restored.

If you have questions or comments, please call 1.800.333.7636 ext. 127 or 126 or e-mail Nuala Moore at nmoore@aacap.org. If you visit Washington D.C., or attend a meeting in the area and would like to talk to your legislators, please contact the AACAP for help in making appointments, securing background material and using talking points.