Could major change be coming to how the United States addresses mental health care?

By Catherine Robertson Souter
November 13th, 2021
mental health changes in US

If New Hampshire Rep. Annie Kuster, along with a bipartisan group of 144 U.S. House lawmakers have their way, major changes could be coming to how the U.S. addresses mental health care.

The Bipartisan Addiction and Mental Health Task Force, co-chaired by Kuster, released a 48-page blueprint in September with an aspirational 66 bills and one resolution designed to address what Kuster’s team calls, “the dual addiction and mental health public health crises that have been exacerbated by the COVID-19 pandemic.”

The plan encompasses a broad range of goals including mental health prevention, treatment, workforce development, health care access, and health parity.

In a statement, Kuster said, “The public health and economic crisis… created new obstacles for those already struggling with addiction and mental health challenges. From ending the cycle of addiction, incarceration, and recidivism … to expanding funding for mental health resources in the wake of COVID-19, the bipartisan bills included in our Task Force Agenda outline meaningful, comprehensive solutions to end the evolving substance misuse epidemic.”

As one of New Hampshire’s two representatives, Kuster is very aware of the drug overdose crisis as the state has long been a focus of national attention for its ongoing opioid addiction crisis. The state saw a slight drop of drug overdose deaths in 2020 but numbers were rising again in 2021.

Nationally, 2021 saw the highest number of drug overdose deaths in the 12 months from February 2020 to 2021, more than 95,000 people according to the CDC. The plan will include a focus on recovery resources, stemming the flow of illegal drugs, ending stigma surrounding addiction, and building resources to better address treatment.

“Overall, the bills have the potential to increase access to recovery resources and build the public health infrastructure needed to address the addiction crisis,” said Katherine McGuire, chief advocacy officer of the American Psychological Association. “With overdose deaths continuing to mount, there’s clearly a lot of work left to do.”

Julie Wolter, Psy.D, chair of the New Hampshire Psychological Association’s Advocacy Committee, was impressed with the scope and wide-ranging support of the plan.

“The NHPA appreciates the comprehensive, bipartisan efforts to address the mental health and substance use crisis,” said Wolter.

The task force, made up of several committees who joined forces to coordinate a more comprehensive plan of action, also hopes to tackle a long list of issues in this legislative year to re-invent mental health care in America.

“I think the range of bills on this list shows how multi-faceted the problem is, and that there’s no one answer that’s going to turn the corner for us,” said Scott Barstow, senior director of Congressional and Federal Affairs for the APA. “We’ve been pleased to work with Congresswoman Kuster and other leaders of the task force on some of this legislation.”

Beyond those specifically addressing addiction, the proposed bills include one for a task force aimed at creating a national strategy to address mental health crises caused by public health emergencies, like the current pandemic.

Another would expand Medicare coverage to include marriage and family therapists and mental health counselors.

A third would establish minority-focused grants to treat maternal mental health and substance abuse.

The proposal also includes bills addressing recovery support; suicide prevention among health care workers; and mental health racial inequalities; and creating grants to provide suicide awareness and prevention training and mental health crisis training for law enforcement and corrections officers.

Additional bills address a wide variety of issues including telehealth, parity, and access to care. Wolter was impressed by the agenda and glad to see the focus on these areas.

“Parity is key as is both audio-only and video telehealth access that is at parity with in-office visits with flexibility in distant and originating sites,” she said. As for access to care, “Sixty-five percent of clinicians who responded in our mental health practice survey say it’s almost always difficult to find a clinician accepting new clients.  It’s especially difficult to find IOP/PHP, Medicare and Medicaid services especially for children, families, and substance use.”

The main concern, she added, will be whether the agenda can get the support it needs.

“It’s an ambitious agenda and success will be determined by ongoing funding,” she said. “We hope it prioritizes provider and patient immediate concerns of workforce shortages, parity, issues with ERISA plans, health equity, and Medicare/Medicaid access to comprehensive treatment options.”

The bills are being introduced by various Democratic and Republican members of the House. Some have already been passed by the House and are awaiting a Senate vote.

The task force, with a goal of taking a huge step forward on addiction and mental health issues this year, plans to continue working with stakeholders and creating additional policy.

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