The 117th Congress ended in December with a bipartisan funding package that advanced the nation’s mental health care system. As the new Congress begins, addressing mental health remains one area of bipartisan agreement and focus. And more action is desperately needed as the country faces a growing mental health emergency.
The lingering effects of the pandemic and the lack of adequate mental health infrastructure have brought us to a crisis point. Mental health care is expensive and difficult to access for people across the country due to structural and regulatory barriers. Substance use disorders are at an epidemic level, with high death rates caused by powerful drugs like fentanyl. The youth mental health crisis is growing, and the Surgeon General has called for urgent action. People are feeling higher levels of stress than this time last year, with 64% of young people feeling that the world is more stressful now than when their parents were their age. Americans are affected by these challenges, regardless of their pastime, location, or background.
Representing service providers and people affected by mental illness, the American Psychiatric Association and the National Alliance on Mental Illness identified areas where the administration and Congress can build on the 2022 momentum.
- There are not enough psychiatrists and other mental health practitioners to meet the demand, with more than 150 million Americans living in an area with a shortage of mental health providers. Last year, Congress provided 100 graduate medical education (GME) slots for psychiatry. But this should be seen as an advance to erase the labor shortage. Congress should also consider strengthening the use of peer support specialists and providing loan repayment for psychiatrists to practice in areas of health care shortages, such as the current substance use disorder program.
- 988 Suicide and Crisis Lifeline became available nationwide last July, providing millions of Americans with access to emergency mental health help. Since the new number went online, demand has increased by 40 percent over the previous year. We need to raise awareness, because only 14 percent of Americans were familiar with the 988 line (in October). While 29 states have increased funding for crisis services, only five have passed legislation to sustainably fund call centers and support services, such as mobile crisis teams and crisis stabilization centers. Congress can support these efforts with increased grants and technical assistance.
- Many people are protected by mental health parity law—meaning that insurance coverage for mental health and substance use care should be equal to coverage for other health conditions. However, implementation remains a challenge. Congress needs to increase enforcement.
- At the start of the pandemic, Congress had the foresight to loosen restrictions on patient access to telehealth services and served as a lifeline for many seeking treatment for mental health and substance use disorders. The effectiveness of telehealth is clear, including patient satisfaction, clinical efficiency, and access to underserved areas. Congress extended current Medicare flexibilities through December 2024, but should remove uncertainty and make many telehealth flexibilities permanent.
- Evidence supports the clinical benefits of integrating behavioral health with primary care. Congress recently approved grants and technical assistance for primary care physician practices to implement integrated care, and we encourage Congress to further encourage its adoption.
- Research is critical to discovering more accurate diagnostics and innovative treatment options for people with mental health conditions. Mental illness remains the leading cause of disability in this country. Increased funding for the National Institute of Mental Health is urgently needed for research to improve treatment and reduce mental health disparities.
Our nation is divided on many issues, but Americans want and desperately need help accessing care and treatment for mental health and substance use disorders. Nearly 8 in 10 Americans agree that access to mental health care needs to improve, and Congress can help. The new Congress has the opportunity to fully address this issue and improve the lives of millions of children, adults and their families by supporting these much-needed investments. We are committed to working with members of the 118th Congress to make progress in addressing our nation’s mental health crisis.
Saul Levin, PhD, MPA, is a psychiatrist and the chief executive officer and medical director of the American Psychiatric Association (APA). Prior to assuming this role in October 2013, Dr. Levine led the District of Columbia Department of Health (DOH). Daniel Gillison, Jr. is the Chief Executive Officer of the National Alliance on Mental Illness (NAMI). Prior to his role at NAMI, Mr. Gillison was the Executive Director of the American Psychiatric Association Foundation (APAF).