Congress Addresses Bills With Mental Health Impact

In another legislative development, APA is supporting a bill in the Senate that would create several new programs to improve access to mental services in rural areas. The Rural Mental Health Accessibility Act (S 859), introduced by Sen. Craig Thomas (R-Wyo.) in May, would authorize several million dollars in grants to be awarded to eligible entities to:

• create community education programs to reduce the stigma and misinformation surrounding mental health,

• create interdisciplinary training programs in universities for providers of mental health care and primary care,

• study the effectiveness of mental health services delivered via telehealth technologies, and

• develop 20 demonstration projects to provide mental health services to children and the elderly.

APA’s Division of Government Relations persuaded Thomas to drop family therapists and mental health counselors from the definition of mental health professionals in an earlier draft version. The bill now refers only to psychiatrists, clinical psychologists, clinical social workers, and clinical nurse specialists. The bill had eight cosponsors at press time.

Another bill Congress will consider would prohibit discrimination based on sexual orientation. This addresses an unfinished civil rights issue, emphasized Sen. Edward Kennedy (D-Mass.) in July when he reintroduced a bill that would bar employers from singling out gays, lesbians, and bisexuals for unfair treatment in the workplace. Rep. Christopher Shays (R-Conn.) introduced a companion measure in the House.

The bills would level the playing field for gays, lesbians, and bisexuals in the workplace by explicitly prohibiting employment discrimination against them. Sexual orientation is not a protected category under the employment discrimination section of the 1964 Civil Rights Act, leaving gays and lesbians without legal remedies in federal courts, though a number of states and municipalities have enacted such protections within their jurisdictions.

Title 7 of the 1964 Civil Rights Act applies only to race, color, religion, sex, and national origin.

The 2001 Employment Non-Discrimination Act (ENDA) would prohibit discriminatory practices by public and private employers, employment agencies, labor organizations, training programs, and associations. All aspects of employment discrimination are covered including hiring, firing, promotion, layoffs, job advertisements, recruitment and referrals, retirement plans, and compensation.

ENDA would give gay and lesbian employees the right to file a complaint with the Equal Employment Opportunity Commission (EEOC) within 180 days of the discriminatory incident. The EEOC would then pursue the case or refer it to federal court, according to Nancy Buermeyer, deputy director for legislation of the Human Rights Campaign, an advocacy group for gays, lesbians, and bisexuals based in Washington, D.C.

Jack Drescher, M.D., chair of the APA Committee on Gay, Lesbian, and Bisexual Issues, told Psychiatric News, “This is a very important bill because it guarantees that people have protection from being discriminated against based on their sexual orientation. Gay and lesbian individuals are frequently mistreated at work and have no protections or legal recourse, which is antithetical to creating a safe working environment.”

The bills have bipartisan support in Congress, though not enough to guarantee passage. As of August 15 there were 181 House cosponsors and 41 in the Senate.

The Senate bill (S 1284) and House measure (HR 2692) would exempt employers with fewer than 15 employees, the military, and religious groups.

Proponents of the legislation are optimistic that the large number of cosponsors in the House will be able to overcome strong opposition by the Republican leadership. When the legislation was first introduced in 1996, the House version was blocked from getting to the floor and the Senate bill fell one vote short of passing, Buermeyer told Psychiatric News.

The HRC believes federal legislation is necessary because of widespread harassment and discrimination in the workplace against gays, lesbians, and bisexuals. HRC issued a report in July that illustrates this point with more than 130 documented cases of employment discrimination that occurred nationally in the last decade. The report describes case after case of physical and verbal abuse and job dismissals. According to the HRC, this is just the tip of the iceberg because many more incidents go unreported.

The HRC also maintains federal legislation is necessary to provide uniform standards instead of the current patchwork of state and local protections. Eleven states and the District of Columbia have laws prohibiting employment discrimination based on sexual orientation in the public and private sector. Another 10 states ban this form of employment discrimination in the public sector only, according to the HRC.

In addition about 30 cities and counties have enacted laws banning public and private employers from discriminating against individuals on the basis of gender identity, sexual orientation, or “affectional preference.” Another four cities limit this type of discrimination to public employers.