A bill which has been criticized as discriminatory and unnecessary by state and national mental health professionals will go to a vote on the House floor Wednesday. Its companion bill, S.B. 1556, passed by a vote of 27-5 in the Senate in February.
The legislation causing such a stir, House Bill 1840, reads, “No counselor or therapist providing counseling or therapy services shall be required to counsel or serve a client as to goals, outcomes, or behaviors that conflict with a sincerely held religious belief of the counselor or therapist; provided, that the counselor or therapist coordinates a referral of the client to another counselor or therapist who will provide the counseling or therapy.”
Officials with the American Counseling Association (ACA), Tennessee Counselors Association (TCA), American Foundation for Suicide Prevention, Tennessee Association of Marriage and Family Therapists, Tennessee Equality Project and others are strongly opposing it, calling it “Hate Bill 1840.” On Monday, they lobbied publicly in Nashville and launched a media campaign against it saying “Businesses won’t come to a state that discriminates” and “Your religious beliefs could disqualify you from getting the help you need. Tell your House Rep. HB1840 is wrong!”
They said the effects on mental health, business and healthcare funding for the state could be detrimental.
“Passing this legislation is not only morally wrong and a dangerous precedent, but could also result in costly unintended consequences for Tennessee, including for the hundreds of thousands of state residents who rely on accessible and professional counseling services,” said Art Terrazas, Director of Government Affairs at The American Counseling Association. “As we’ve seen in states across the country, including most recently North Carolina and Georgia, discriminatory bills are bad for business. Bills like H.B. 1840 hurt both the economic strength of the states in which they are passed, and, most importantly, the people victimized under the laws. Tennessee can’t afford Hate Bill 1840.”
Terrazas said the bill would legalize discrimination in counseling and would strike down the ACA Code of Ethics that was created to protect the public and to ensure its right to healthcare regardless of age, culture, identity, sexual orientation or socioeconomic status.
“It puts the government between citizens and their therapists,” said Terrazas.
Lisa Henderson, Licensed Professional Counselor and president-elect for the TCA said this interference with an existing, vetted policy is one of their major concerns with the legislation.
“The Code of Ethics was open to public comment prior to its induction,” said Henderson. “Prior to this bill being brought forward, there was no concern brought to our board. It went straight into bill format, so this climate of distancing ourselves from the people with whom we disagree is counterproductive.”
Terrazas said the bill was created by lobbying efforts of the Family Action Council of Tennessee (FACT) and the Alliance Defending Freedom. It was introduced by Republican Senator Jack Johnson into the Senate and by Republican Representatives Dan Howell and Curtis Johnson into the House.
In 2014, the ACA Code of Ethics was amended to include “Counselors refrain from referring prospective and current clients based solely on the counselor’s personally held values, attitudes, beliefs, and behaviors.”
The addition to the ACA code came about after a ruling in the 6th Circuit Court of Appeals in Ward v. Polite, which upheld the right of a Christian counselor to refer a gay/lesbian client if the therapy sought required the counselor to affirm same-sex marriage in violation of her beliefs. FACT argues the bill is not an anti-gay bill, as it has been criticized, and that it would actually provide better care to those clients.
Proponents believe H.B. 1840 not only puts counselors in the awkward position of affirming lifestyles or decisions with which they disagree, but it disservices the clients by interacting with counselors who cannot sympathize.
Dianne Bradley, director of the Counseling Education Program in Franklin, Tenn., said the bill is a solution in search of a problem.
“The Code of Ethics developed by our profession already allows us to make referrals,” Bradley said. “I am a Christian, and if I do not feel comfortable, as a clinician in this situation, I seek consultation with another professional. Sometimes, a referral is necessary, and the profession and Code of Ethics already provide for ethical, prudent and respectful means of making referrals.”
A Carter County mental health provider, Frontier Health, which provides counseling to service personnel, students, locals and residents of area domestic violence shelters, among others, also stands in opposition to the bill.
“At Frontier Health, we have a strong non-discrimination policy and no one who is interested in treatment is denied services,” said Dr. Teresa Kidd, Frontier Health president and CEO. “We do not believe that H.B. 1840 is necessary legislation.”
With consideration to the variety of strongly held religious beliefs, opponents questions the breadth of the definition for causes of referral under the new legislation.
“The limits of determination of sincerely held religious beliefs reside with the therapist, and that’s a problem because that could be anything,” said Barney Self, president of the Tennessee Association of Marriage and Family Therapists. “….This bill is totally and completely fear-driven. It does not address a need that exists. Nothing has ever been brought before the board to address this. They are doing collateral damage to people, perhaps unintentionally, which is why it has been titled the Hate Bill.”
Opponents believe the breadth of the definition of strongly held religious beliefs could mean untimely referral for clients including unwed mothers, suicidal teens or interracial couples.
Christopher Sanders, executive director of the Tennessee Equality Project (TEP), said their primary concerns are for lesbian, gay, bisexual and transgender (LGBT) residents of rural areas who might be denied services because of a counselor’s religious beliefs.
“If a counselor is able to turn away LGBT clients, maybe that client has to go several miles to get a counselor who will see him or her, and some don’t have access to transportation or funding,” said Sanders.
He said the fact that many minors cannot drive to further assistance is cause for even greater concern. Sanders referenced a Tennessee Department of Education report on bullying in public schools, which found that eight out of 10 LGBT youth reported being bullied. Though an amendment to HB 1840 was proposed so that it would not apply to minors seeking counseling for bullying, that amendment did not pass in the House Health Committee.
“We are extremely concerned about youth access to healthcare,” said Sanders.
Mental health professionals already have a system for referring clients, which Self argues is both ethical and effective. He said processing referrals on the basis of religious differences could be traumatic for the clients involved, and it could cause accreditation to come into question.
“I don’t see any problem with the factors already in place,” said Self. “I’ve found this whole process to be very hurtful, damaging and risky for the state.”
House Rep. Timothy Hill of Carter County voted in favor of the legislation going to a full vote, but did not provide details as to why. He said the substantive debate will take place on the floor.