Taking a Stand for Access & Intervention this Mental Health Month
May is Mental Health Month — 31 days dedicated to raising awareness for, and breaking down stigma against, the tens of millions of Americans who will experience a mental health or substance use disorder each year.
Last week, we shared information about how policymakers can improve America’s mental health and addiction care systems by investing in prevention — but that’s just one piece of the puzzle.
While nearly one in five Americans — tens of millions of people — will experience a mental health or substance use condition in any given year, less than half will receive any treatment. The need for affordable, quality treatment couldn’t be more urgent. Roughly 116,000 Americans die each year from suicide and overdose, and the cost of untreated mental illness is estimated to be at least $444 billion each year.
We can’t afford to lose one more life to stigma and inaction. Policymakers must ensure all people with mental health conditions, including serious mental illnesses (SMI), substance use disorders, and eating disorders, have timely access to affordable treatment and services that treat the mind and the body.
Mental health is health
For far too long, many Americans have been forced to suffer in silence due the restrictive cost of treatment for their mental illness or substance use disorder. Even now, 11 years after the passage of the Mental Health Parity and Addiction Equity Act of 2008 (Federal Parity Law), complex insurance and managed care schemes result in the unequal coverage of mental and physical health care, forcing many of the people to pay for their mental health services out of pocket.
Federal and state governments should fully enforce the Federal Parity Law, which requires insurers to cover treatment for mental health and addiction no more restrictively than treatment for illnesses of the body, such as the flu, diabetes, or heart disease. This includes enforcing coverage equity in government sponsored plans like Medicare and Medicaid.
Don’t Deny Me, an initiative lead by Mental Health for US coalition leader The Kennedy Forum, offers consumers a way to make their voice heard and pressure elected officials, insurance commissioners, and attorneys general to enforce this critical law. Check out their website to learn more about parity and how you can play a role in making it a reality for us all.
Supporting America’s mental health workforce
One major barrier to mental health care in America is a shortage of qualified providers. According to the National Association of Community Health Centers, 95% of community health centers have at least one clinical vacancy. Even more shocking, 60% of U.S. counties do not have a single practicing psychiatrist. If we want to improve the quality of mental health and addiction care in America, then our leaders need to get serious about addressing this workforce shortage.
It’s time for policymakers to ensure there are enough inpatient and outpatient resources across the country to provide needed care to a broad array of patients. Expanding the use of Certified Community Behavioral Health Clinics (CCBHCs), for example, is a great way Congress can address the mental health workforce shortage while making enhanced services available in community settings. Additionally, now more than ever, providers must have the freedom to use telemedicine and other digital tools to provide care for their patients. We don’t know what the post-coronavirus world will look like yet, but we must be prepared to address the mental health needs that will arise out of this crisis.
Emergency intervention during crises
Mental health and addiction crises, which can include psychotic episodes, suicidal ideations, or overdoses, are situations that many individuals and families living with mental illness or addiction may experience. However, our systems often aren’t set up to help families and communities safely navigate them when they occur.
Too often, people with these illnesses are treated like criminals instead of receiving help. Someone experiencing a psychotic episode, for example, may not understand a law enforcement officer’s orders and would therefore seem non-compliant. However, trainings like the one endorsed by CIT International could help the officer recognize the crisis and intervene appropriately (or better yet, these interventions could be done by a specialist). Policymakers must prioritize public health policies that support these and similar initiatives.
First and foremost, the National Suicide Prevention Lifeline Network and the nation’s crisis centers must be funded by federal, state, and local entities to meet current needs and future demand. Additionally, policymakers should invest in improved community crisis services — such as mobile crisis units, crisis hotlines, and the use of non-law enforcement transportation — and focus on providing care and supportive services rather than engaging law enforcement.
If law enforcement must be involved, the responding officers, as well as the community and other first responders, should be equipped with the tools they need to help those affected by mental illness and addiction, including:
- The overdose reversal medicine, naloxone, which should be made available in every community setting, including workplaces, libraries, community centers, train and metro stations, universities, and schools.
- Training to recognize when someone is experiencing a mental health crisis or symptoms of SMI and how to de-escalate such situations.
- Information about community resources that are available to people living with mental illness and addiction.
Decriminalize diseases of the brain
In any given year, 65% of the U.S. prison population lives with an active substance use disorder. Additionally, there are 1.2 million people living with a mental illness sitting in jail or prison. Rather than directing these individuals — often non-violent offenders convicted of low-level offenses like jaywalking, disorderly conduct, or trespassing — towards the treatment and services they need, our society places them behind bars.
As a matter of human rights, we should not criminalize diseases of the brain and warehouse those in need of treatment in jails and prisons. We must expand crisis intervention teams, increase the use of drug and mental health courts, and make medication-assisted treatment (MAT) available to those currently incarcerated. Finally, policymakers must abolish mandatory minimum sentencing — an antiquated practice that brings a high cost at low return and diverts more mental health and addiction patients away from treatment and into prisons and jails.
Educating our communities
Whether we know it or not, we all have a role to play in caring for our communities, neighbors, friends, and family. That’s why all of us — emergency services personnel, first responders, teachers and school administrators, primary care professionals, students, and other members of the community — should be educated about the signs of mental illness and available resources through trainings such as Mental Health First Aid and Ending the Silence.
Policymakers can incentivize the public’s participation in these programs to ensure every community is equipped with the knowledge and resources to effectively respond in the case of emergency. These training programs allow us all to recognize the signs when someone is struggling or may be living with any SMI at any stage, know how to reach out, and where to refer for professional help when needed. As with all mental health supports and services, these training programs should be culturally and linguistically competent to provide the best care to each community.
Mental Health for US is a nonpartisan, educational initiative focused on elevating mental health and addiction to national policy conversations by empowering grassroots advocates and improving candidate and policymaker health literacy. The Mental Health for US coalition is comprised of 95+ organizations from around the country dedicated to uniting the American people to make systemic, long-term change with civic engagement tools and resources. For more information, visit www.mentalhealthforus.net.
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