What Medicare Expansion Would Mean for Equitable Mental Health Services
At first glance, the title Marriage and Family Therapist (MFT) does not immediately communicate that one is qualified to provide mental health services to a diverse population. However, this is indeed the case. MFTs, such as I, are trained and qualified in the behavioral health management of a myriad of mental health complexities. Furthermore, studies have repeatedly shown just how effective MFTs are in treating these disorders.
This is good news for individuals who want to receive treatment from a mental health provider with extensive training that includes a focus on the family system. That is, unless you are one of the 63 million individuals whose healthcare costs are covered by Medicare. Unlike Medicaid and commercial payers who recognize MFTs as eligible providers, Medicare does not.
This is problematic for the following for three reasons:
1) Increasing limited access to mental health providers for those most in need — the older adult population.
2) Compounding the U.S. mental health crisis.
3) Driving up Medicare expenses.
What is most interesting is that the federal government currently recognizes psychiatrists, psychologists, mental health clinical nurse specialists, clinical social workers, and MFTs as core mental health professionals. However, MFTs continue to not be recognized by Medicare. Why is this the case? It’s not immediately clear, but as an MFT and an individual who cares about the aging population, I’m inclined to advocate for expanded funding so that mental health services can be accessible to the millions of Americans in need.
The Older Adult Population Needs our Help More Than Ever
Mental health is a public health crisis, particularly for older adults. According to the Center for Disease Control, 20% of people age 55 years or older experience some type of mental health condition, be it depression, anxiety, or another common mental health complexity. To exasperate this further, the World Health Organization predicts that the U.S. population over 60 years of age will nearly double, from 12% to 22%, by 2050. If that’s the case, then it’s fair to argue that the demand for mental health services will increase if there is no behavioral health intervention. This is disheartening, especially with the sheer number of qualified MFTs ready to help.
MFTs are Rigorously Trained and Well-Positioned
In the United States, MFTs must have graduate training (a Master’s or Doctoral degree); complete two years of post-graduate, supervised, clinical practice; and pass a national exam to practice as licensed clinicians. Despite having equivalent or greater education and training as other similar professions, the lack of Medicare recognition prevents MFTs from providing mental health services to the aging adult population. This creates a shortage of qualified mental health professionals. However, passing the newly created Mental Health Access Improvement Act would immediately make over 200,000 licensed mental health professionals, including MFTs, eligible to treat older adults.
Two hundred thousand may not sound like a lot. However, let’s consider this from a different perspective. As of 2021, approximately 37% of Americans live in mental health shortage areas. Two-thirds of these shortage areas are in rural or partially rural settings, with one-fifth of these inhabitants being Medicare recipients. The silver-lining, MFTs are far more prevalent in rural areas than any practitioner recognized by Medicare. Essentially, passing the Mental Health Access Improvement Act will significantly impact these historically underserved communities by increasing access to mental health services for all individuals across the lifespan.
What You Can Do to Help
As Director of Clinical Programs for evolvedMD and a leader in integrating behavioral health services in modern primary care, I must advocate for equitable mental health access. Professionals like myself have been lobbying for coverage for quite some time. To date, over 30 bills have been introduced to legislation that include MFTs as eligible providers under Medicare, none of which have gained needed traction. However, I believe we are on the cusp of change as The Mental Health Access Improvement Act was created earlier this year. This legislation, if passed, will finally bring much-needed mental health coverage for individuals across the country.
Whether you’re an MFT, a caregiver for an aging family member, or someone who recognizes the mental health needs of the American population, I encourage you to join me in taking action. You can do this by sending a message to Congress urging them to support the inclusion of MFTs as Medicare providers here.
