Following President Joe Biden's discussion of mental health priorities in his State of the Union (SOTU) Address, the Biden administration last week released its five-point plan to tackle current shortcomings of mental health care.
The plan will focus on strengthening the capacity of the U.S. mental health system and improving accessibility to care networks.
According to Hannah Wesolowski of the National Alliance on Mental Illness, Biden's plan "represents an important agenda that impacts every American."
"I think this is an important moment," said Thomas Insel, a psychiatrist and the former director of the National Institute of Mental Health. "For the most part, the federal government has ceded mental health policy [and] services to the states. Essentially, the federal government has been missing in action for 41 years, and Biden's comments and this fact sheet bring it back into the center of the action for mental health."
Still, experts believe the success of the administration's plan will largely depend on the level of congressional support for the regulations and funding proposal.
In particular, Schroeder Stribling, president and CEO of Mental Health America, emphasized how important it will be for lawmakers to support long-term funding. "This cannot be a one-time intervention from the federal level," she said. "This must be a sustained and broad-based response."
The Covid-19 pandemic's impact on mental health "is going to have a very long tail," Stribling added. "And we need to remember that we had a preexisting mental health crisis before the pandemic. We're talking about addressing decades' worth of declining mental health in our country."
However, Biden's focus on mental health—along with recent signs of bipartisan support for addressing it—are very encouraging, Insel said. "I think for the first time in a very, very long time, we have both White House and congressional interest and momentum for, as the president said, taking on mental health," he added.
1. Address the mental health needs of children
During his SOTU, Biden emphasized the mental health needs of children, "whose lives and education have been turned upside down" during the pandemic.
Biden's plan proposes multiple efforts to curb the harmful effects social media can have on kids, including asking Congress to ban excessive data collection from children and advertising geared toward them. In addition, the plan proposes expanding early childhood and in-school services that help prevent the progression of mental health problems among young children.
According to Tami Benton, the president-elect of the American Academy of Child and Adolescent Psychiatry, the administration's focus on children's mental health is historic and necessary. "Prevention is the most effective and most cost-effective way to prevent the onset of mental illness," Benton said.
2. Grow the mental health workforce
In addition, Biden's plan emphasizes the importance of building the pipeline of qualified mental health professionals, citing a "severe shortage" of providers. "I think this commitment to the workforce is hugely important, and it is going to take time," Insel said.
Separately, Benton said she was impressed with the administration's proposal to train and support paraprofessionals to be better equipped to handle mental health issues.
"It's a way to engage our communities. It's a way to destigmatize mental health, and it's a way to really expand the workforce in ways that we haven't talked about before," Benton added.
3. Implement permanent funding for community behavioral health centers
For many years, the federal government has offered grants for funding community mental health clinics that give people access to 24/7 care in their local community for mental health and substance use issues. In the plan, the administration proposes making funding for these facilities permanent in the next budget.
"That'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," Insel said. "That's a huge, huge change."
4. Increase support for crisis care
To date, the Biden administration has provided $180 million for staffing crisis call centers and local crisis response. Under the new plan, Biden proposes allocating more funds to help staff local crisis centers and a "crisis care continuum: someone to call, someone to respond, and somewhere for every American in crisis to go."
"The crisis lines and crisis-based services would be such an addition for many of the families who are coming in to seek emergency care," Benton said. "It's great to see an investment and, again, training people where they are and keeping families together and in their homes."
5. Require all health plans to cover mental health services
In addition, the Biden administration said it wants to require all health plans to cover "robust behavioral health services."
"This is another great example of the federal government stepping up," Insel said. Specifically, the White House requested "that every individual with commercial insurance will get three behavioral health visits per year without a copay. That's a pretty big step forward," Insel added. (Alonso-Zaldivar, Associated Press, 3/3; Chatterjee/Wroth, "Shots," NPR, 3/2; Rodriguez, USA Today, 3/2)
The Covid-19 pandemic is rapidly increasing the need for behavioral health services. But there are significant gaps and barriers that stand in the way of people getting the help they need. Download our take to learn how health systems can prioritize addressing the immediate needs of both staff and patients, especially those with preexisting behavioral health needs or comorbid conditions.
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