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In his State of the Union address, President Biden announced an ambitious plan to address the country’s mental health needs and presented it as an issue of bipartisan support.
“Let’s provide all Americans with the mental health services they need. More people to turn to for help and full parity between physical and mental health care if we treat it that way in our insurance.”
On Tuesday, the White House also released a fact sheet detailing the government’s strategy. It aims to address a mental health crisis that has been brewing for years but has only been made worse by the pandemic.
The plan focuses on ways to strengthen system capacity and connect people in need of assistance to a continuum of care. It includes measures to expand the mental health workforce, efforts to establish a crisis response system to support the launch of the 988 crisis line in July, a focus on children’s mental health and proposals to encourage insurance companies to improve their behavioral health coverage .
“We’re really excited about this focus,” Schroeder Stribling, president and CEO of the advocacy group Mental Health America. “We have long needed a bold national strategy and we are just delighted to see the Government seize this opportunity. That was a long time coming.”
This is the first time since the Carter administration that the federal government has shown such significant leadership in tackling mental health, says psychiatrist and former director of the National Institute of Mental Health, Dr. Thomas Island.
“I think this is an important moment,” he says. “The federal government has largely abandoned mental health policy [and] Services to the States. Essentially, the federal government has been in action for 41 years, and Biden’s comments and this factsheet put her back at the center of mental health action.
Insel’s and other advocates’ excitement extends to the details of the initiatives laid out by the White House.
But they say the plan’s success depends on congressional support for regulations and funding proposals outlined by the government.
It is particularly important, says Stribling, that the legislature think about long-term financing. “This cannot be a one-time intervention at the federal level,” says Stribling. “This must be a sustained and broad-based response.”
The mental health impact of the pandemic, adds Stribling, “is going to have a very long tail. And we have to remember that before the pandemic, we already had a mental health crisis. We’re talking about tackling decades of declining mental health in our country.”
Still, the president’s focus on the mental health crisis — and recent signs of bipartisan support for tackling it — is very encouraging, Insel says: “I think for the first time in a very, very long time we’ve got both the White House and also interest and impetus for Congress, as the President said, to deal with mental health.
Here are five highlights of the plan that proponents find promising.
1. Focus on children’s mental health
In his Tuesday night speech, Biden placed particular emphasis on addressing the mental health needs of children “whose lives and education have been turned upside down during the pandemic.”
The plan proposes several efforts to curb the harmful effects of social media on children, including asking Congress to ban excessive data collection from children and advertising aimed at them. It also proposes expanding early childhood and school services to prevent young children’s mental health problems from getting worse.
The focus on children’s mental health is historic and necessary, says Dr. Tami Benton, President-elect of the American Academy of Child and Adolescent Psychiatry. “Prevention is the most effective and least expensive way to prevent the onset of mental illness,” says Benton.
2. Mental health workforce development
The Biden plan emphasizes the need to build a pipeline of skilled mental health professionals and cites a “serious shortage” of providers. “I think this commitment to the workforce is extremely important and it will take time,” says Insel, whose new book cure outlines the flaws in the mental health care system and efforts to address them.
However, he notes that the plan proposes around $1 billion in new investment in the effort in the next budget, for measures like training, scholarships and loan forgiveness to encourage people to enter the field.
Benton was impressed by a proposal to train and support paraprofessionals so they would be better able to help with mental health, i.e. “people who are already in contact with vulnerable individuals such as social workers or child welfare workers” – as well as the Creation of certifications for peer specialists. This would be “a very different way of recognizing who is responsible for our nation’s mental health.”
“It’s a way to get our communities involved. It’s a way to destigmatize mental health and it’s a way to expand the workforce in ways we haven’t talked about before,” she says.
3. Ongoing funding for community behavioral health centers
For several years, the federal government has offered grants to fund community mental health clinics — places where people can get 24-hour care for mental health and drug use in their local community. Now the administration wants to finance this permanently in the next budget.
“This is a long-term investment to create a state-funded community mental health network. We really haven’t had that since the 1970s and 1980s,” says Insel. “It’s a huge, huge change.”
4. Support for crisis preparedness
This summer, the new Mental Health Crisis Hotline will be launched – dial 988. The Biden administration has already committed $180 million to help staff crisis call centers and support local crisis response. Now she’s proposing more resources for local crisis center staff and a “crisis care continuum: someone to call, someone to respond, and a place for every American in crisis to go.”
“The hotlines and crisis-based services would be such an addition to many of the families that come here to seek emergency care,” Benton says. Crisis patients could potentially avoid going to the emergency room, she says, if they have someone to talk to who can help them understand the problem they’re facing, access resources, or even go to their house. to defuse a crisis.
“There is a large evidence base that supports the effectiveness of these interventions,” she says. “It’s great to see an investment and again educating people where they are and keeping families together and in their homes.”
5. Make sure your insurance covers mental health
Since 2008, federal law has required health insurers to cover mental illness at the same level as other health conditions. But enforcement has been left to the states, Insel says, and patients often struggle to get the mental health care they need. The Biden administration says it wants to require all health plans to cover “robust behavioral health services.”
“It’s another great example of the federal government moving forward,” says Insel. A specific requirement from the White House is “that every person with commercial insurance receive three behavioral health visits per year at no additional cost. That’s quite a big step forward,” added Insel.