How Biden plans to address chronic mental health gaps?

(Washington DC) — President Joe Biden’s new plan to expand mental health care and drug abuse treatment would pump hundreds of millions of dollars into suicide prevention, youth mental health services and community clinics that provide 24/7 access to those in crisis.

Biden’s plan, unveiled as part of his State of the Union address, seeks to narrow America’s chronic gap in care between diseases of the body and that of the mind. Health insurance should cover three mental health visits per year at no additional cost to patients.

But for such a big move, Biden will need the support of lawmakers from both sides. Mental health and substance abuse are linked issues in every congressional district, with depression and anxiety rising amid the coronavirus pandemic. Some high-ranking Republicans have expressed support for government action in principle, but it is too early to say where they will end up.
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“And let’s give all Americans the mental health care they need,” Biden said in his address Tuesday night. “More people can turn to for help. And full parity between physical and mental health care when we deal with that in our insurance.”

That’s the unrealized goal of federal health care laws that are nearly 25 years old, said Hannah Wesolowski of the National Alliance on Mental Illness. “This represents an important agenda that touches every American,” Wesolowski said, referring to Biden’s plan.

Legislators have been signaling interest for months. In the Senate, the Finance Committee and the Health, Education, Labor and Pensions Committee have held hearings with a dual focus. The Energy and Trade Committee and the Roads and Means Committee also held hearings in the House of Representatives. Those four panels do most of Congress’ health care work.

Such sustained attention is rare, proponents say. “I don’t recall any relevant committee holding hearings on mental health,” said Charles Ingoglia, president of the National Council on Mental Well-being. “Sometimes we’ve spent years between special hearings on mental health.”

Now the White House is trying to lure lawmakers out, weave threads from the Capitol Hill debate into an ambitious package, and add its own priorities.

“I think he highlighted a few key areas where we have good work to do,” Alaska Republican Senator Lisa Murkowski said in response to Biden’s speech.

“He spoke about the issue of mental health and what else needs to be done,” she added.

Biden’s plan includes a special focus on school-age youth. Children adapted differently to distance learning in 2020, the first year of the pandemic, and those without technological means were in danger of falling behind. Isolation was difficult for teenagers. The White House says Biden’s upcoming budget will ask for $1 billion to help schools hire counselors, psychologists and other health professionals. The budget will also propose $5 million for research into the effects of social media on children. Biden supports the bipartisan sentiment in Congress and calls for curbing the ability of social media companies to collect data on children.

Health insurance coverage policies would also receive more attention. The White House says Biden’s budget will ensure insurers “cover robust behavioral health services with an adequate network of providers.” Three free behavioral health visits per year would be part of that.

In July, the government will launch a new suicide prevention hotline number: 988. Biden’s plan calls for nearly $700 million to bolster local crisis centers that can handle follow-up. The idea is to tackle basics like hours of operation and staffing in preparation for an expected increase in calls when three-digit dialing goes into effect.

The plan also calls for an experimental program to be made permanent that has expanded access to 24/7 mental health and substance abuse. It’s called Certified Community Behavioral Health Clinics, modeled after federally funded health centers that have become a foundation for basic medical care in low-income communities. The behavioral health centers rely on peer counselors who have survived their own trauma to lift others out of crisis. The approach has twofold support.

Supporting Biden’s plan is an effort to increase the number of mental health professionals by spending $700 million on training programs, scholarships and repayment of educational loans. Growing the mental health workforce has been a focus of the Senate Finance Committee hearings. Biden also wants to establish professional standards for peer counselors and take on an emerging frontline role.

When it all comes together, Dr. Megan Ranney says she should expect relief for the emergency rooms where she practices in Providence, Rhode Island. People with mental health and substance abuse problems would have more ways to get help before things get out of hand and the police or a family member has to take them to the hospital as a last resort.

“The crisis doesn’t happen overnight,” Ranney says. “It’s usually something that’s been smoldering for a while. And when things get bad enough, they have nowhere to go and spend days or weeks in the emergency department.”

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