Biden plan would tackle chronic gaps in mental health care

President Joe Biden’s new plan to expand mental health and drug abuse treatment would invest hundreds of millions of dollars in suicide prevention, youth mental health services and community clinics that provide 24/7 access of the week to people in crisis.

Unveiled as part of his State of the Union address, Biden’s plan seeks to bridge the chronic gap in America’s care between illnesses of the body and those of the mind. Health insurance plans would have to cover three mental health visits a year at no additional cost to patients.

But for such a big move, Biden must win the backing of lawmakers from both parties. Mental health and substance abuse are related issues in every congressional district, with rising rates of depression and anxiety in the coronavirus pandemic. Some senior Republicans have expressed support in principle for the administration’s action, but it is too early to say where they will end up.

And let’s give all Americans the mental health services they need, Biden said in his speech Tuesday night. More people can come for help. And full parity between physical and mental health care if we treat it that way on our insurance.

That has been the unrealized goal of federal health care laws dating back nearly 25 years, said Hannah Wesolowski of the National Alliance on Mental Illness. This represents an important agenda that impacts all Americans, Wesolowski said, referring to Biden’s plan.

For months, lawmakers have been showing interest. In the Senate, the Finance Committee and the Health, Education, Labor and Pensions Committee have held hearings with a bipartisan approach. In the House, the Committee on Power and Commerce and the Committee on Ways and Means also held hearings. Those four panels do most of Congress’ work on health care.

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Such sustained attention is rare, advocates say. I can’t remember a time when every jurisdictional committee has held hearings on mental health, said Charles Ingoglia, president of the National Council for Mental Wellness. We have sometimes gone years between hearings dedicated to mental health.

Now the White House is trying to woo lawmakers, weaving threads from the Capitol debate into an ambitious package and adding its own priorities.

I think it highlighted some key areas where we have good work to do, Republican Sen. Lisa Murkowski of Alaska said in her reaction to Biden’s speech.

He spoke about the issue of mental health and what more needs to be done, he added.

Biden’s plan includes a special focus on school-age youth. Children adapted differently to remote learning in 2020, the first year of the pandemic, and those who lacked technological resources were in danger of being left behind. Isolation was hard on teenagers. The White House says Biden’s next budget will require $1 billion to help schools hire counselors, psychologists and other health care workers. The budget will also propose $5 million for research on the effects of social media on children. Supporting bipartisan sentiment in Congress, Biden is calling for the ability of social media companies to collect data on children to be restricted.

The coverage policies of health insurance plans would also receive more attention. The White House says Biden’s budget will require insurers to cover robust behavioral health services with an adequate network of providers. Three free behavioral health visits a year would be part of this.

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

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

The foundation of Biden’s plan is an effort to increase the number of mental health professionals by devoting $700 million to programs that provide training, scholarships and student loan repayment. Expansion of the mental health workforce was a focus of the Senate Finance Committee hearings. Biden also wants to set professional standards for peer counselors, playing an emerging frontline role.

If all goes well, Dr. Megan Ranney says she would expect to see relief at the emergency rooms where she works 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 have to take them to the hospital as a last resort.

The crisis does not happen overnight, Ranney said. Usually it is something that has been burning for a while. And then when it gets bad enough, they have nowhere to go and end up spending days or weeks in the emergency department.

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