Saul Loeb – Pool/Getty Images
In his State of the Union address, President Biden announced an ambitious plan to address the nation’s mental health needs, presenting it as an issue with bipartisan support.
“Let’s give all Americans the mental health services they need. More people they can turn to for help, and full parity between physical and mental health care if we treat them this way.” way in our assurance.”
On Tuesday, the White House also released a fact sheet that details the administration’s strategy. He is seeking to deal with a mental health crisis that has been going on for years, but has only been made worse by the pandemic.
The plan focuses on ways to build system capacity and connect people who need help to a continuum of care. It includes measures to expand the mental health workforce, efforts to establish a crisis care response system to support the launch of the 988 hotline in July, a focus on children’s mental health and proposals to push insurance companies to improve their behavioral health coverage. .
“We’re really excited about this direction,” said Schroeder Stribling, president and CEO of advocacy group Mental Health America. “We’ve needed a bold national strategy for a long time, and we’re just thrilled to see the administration seizing this opportunity. It’s been a long time coming.”
This is the first time since the Carter administration that the federal government has taken such leadership on mental health, says psychiatrist and former director of the National Institute of Mental Health, Dr. Thomas Insel.
“I think this is an important moment,” he said. “For the most part, the federal government has ceded mental health policy [and] state services. Essentially, the feds have been missing for 41 years, and Biden’s comments and this fact sheet bring him back to the center of mental health action.”
The enthusiasm of Insel and other advocates also extends to the details of the initiatives laid out by the White House.
But they say the plan’s success hinges on congressional support for the regulations and funding proposals outlined by the administration.
It’s especially important, Stribling says, that lawmakers consider long-term funding. “It can’t be a one-time intervention from the federal level,” Stribling said. “It must be a sustained and large-scale response.”
The impact of the pandemic on mental health, adds Stribling, “is going to have a very long tail. And we have to remember that we had a pre-existing mental health crisis before the pandemic. We’re talking about coping with decades of decline mental health in our country.
Still, the president’s focus on the mental health crisis – and recent signs of bipartisan support to address it – are very encouraging, Insel says: “‘I think for the first time in very, for a very long time, we’ve had both the White House and Congress interest and momentum in, as the president said, tackling 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 upbringings have been turned upside down” during the pandemic.
The plan proposes several efforts to reduce the harmful effects of social media on children, including calling on Congress to ban the excessive collection of data about children and advertising that targets them. It also proposes expanding early childhood and school-based 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 cost-effective way to prevent the onset of mental illness,” Benton says.
2. Strengthen the mental health workforce
The Biden plan emphasizes the need to build a pool of trained mental health professionals, citing a “serious shortage” of providers. “I think that commitment to the workforce is extremely important and it’s going to take time,” says Insel, whose new book, Healing describes failures in the mental health care system and efforts to address them.
But he notes that the plan proposes about $1 billion in new investment in the effort in the next budget, for measures such as training, scholarships and loan forgiveness to encourage people to enter the field.
Benton was impressed with a proposal to train and support paraprofessionals to be better able to help with mental health issues, meaning “people who are already in contact with people vulnerable such as social service workers, child protection workers” – as well as the creation of certifications for specialist peers. It would be “a very different way of seeing who is responsible for our nation’s mental health.”
“It’s a way to engage our communities. It’s a way to de-stigmatize mental health, and it’s a way to really expand the workforce in a way that we’ve never talked about before. “, she says.
3. Make funding for community behavioral health centers permanent
For several years, the federal government has provided grants to fund community mental health clinics – places where people can get 24/7 care for mental health and addictions in their local community. Now the administration wants to put permanent funding for these in the next budget.
“It’s a long-term investment to create a federally funded community mental health network. We haven’t had that since really the 1970s and 1980s,” says Insel. “It’s a huge, huge change.”
4. Support crisis care
This summer will see the launch of the new mental health crisis hotline – accessible by dialing 988. The Biden administration has already provided $180 million to support crisis call center staffing and support local response to crises. Now it’s proposing more funding to staff local crisis centers and a “continuum of crisis care: someone to call, someone to answer, and somewhere to go for every American in crisis.”
“Distress lines and emergency services would be such an addition for many families coming in for emergency care,” Benton said. Patients in crisis could potentially avoid going to the ER, she says, if they have someone to talk to who can help them understand the issue they’re facing, access resources or even get to home to diffuse a crisis.
“There is a broad evidence base supporting the effectiveness of these interventions,” she says. “It’s great to see an investment and again, training people where they are and keeping families together and in their homes.”
5. Make sure insurance covers mental health
Since 2008, a federal law requires health insurers to cover mental illness at the same level as they cover other health problems. But enforcement has been left to states, Insel says, and patients can 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.”
“This is another great example of federal government intervention,” Insel says. A specific request from the White House is “that each person with commercial insurance get three behavioral health visits per year without co-payment. That’s a pretty big step forward,” Insel adds.