APA Praises House Passage of Legislation to Address Nation’s Mental Health Crisis

APA yesterday applauded the passage of the Restoring Hope for Mental Health and Well-Being Act (HR 7666) by the House of Representatives, calling the bill “an important step to expeditiously address the nation’s mental health crisis.”

In addition to reauthorizing federal programs that promote access and coverage to behavioral health and substance use disorder services, APA noted in a news release that HR 7666 includes several provisions that are high priorities for APA:

• Parity: Eliminates the parity opt-out for non-federal governmental health plans and provides funding for state insurance departments to enforce and ensure compliance with the mental health parity law.
• Collaborative Care: Supports uptake of the evidence-based Collaborative Care Model via grants to primary care practices to better integrate behavioral health care into primary care settings.
• Crisis Services: Directs funding through the Substance Abuse and Mental Health Services Administration (SAMHSA) for 988 Lifeline implementation and supports state implementation of the lifeline through technical assistance and coordination.
• Workforce Equity Investments: Makes crucial investments in the behavioral health care workforce by reauthorizing and increasing authorized funding for SAMHSA’s Minority Fellowship Program.

A summary of the bill notes that the bill also “expands access to opioid and other substance use disorder treatments and recovery support services. For example, the bill (1) eliminates a provision that generally requires individuals to be addicted to opioids for at least a year before being admitted to an opioid treatment program, and (2) promotes access to high-quality recovery housing.”

“Our nation faces an unprecedented mental health crisis among people of all ages, one that has been exacerbated by the pandemic and continuing acts of mass violence. At the same time, more than one million Americans have lost their lives to drug overdoses over the past two decades, devastating their families, our communities, and nation as a whole,” a statement from the White House noted. “To ensure we have a mental health and substance use care system that works for everyone, investments to shore up these systems are essential.”

The bill will now move to the Senate. APA encourages members to contact their senators to ask for their support in passing this bill.

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APA Praises Passage of Legislation to Address MH Problems, Burnout Among Health Care Professionals

APA joined five leading physician groups yesterday in commending the passage of the Dr. Lorna Breen Health Care Provider Protection Act (HR 1667). The legislation establishes grants to prevent and reduce suicide, burnout, and mental and behavioral health conditions among health care professionals. Having passed both the House and Senate, the bill now heads to President Joe Biden’s desk for signature.

The Dr. Lorna Breen Health Care Provider Protection Act is named in honor of Lorna Breen, M.D., an emergency room physician who was working on the front lines when COVID-19 first emerged in New York. Breen died by suicide in April 2020.

“Research shows that physicians in the U.S. face higher incidence of suicide than almost any other profession, and the COVID-19 pandemic has exacerbated personal hardships as physicians continue caring for patients, themselves, and their families,” wrote APA, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians, and the American Osteopathic Association in a statement. “The passage of the Dr. Lorna Breen Health Care Provider Protection Act is timely and critical to ensuring our nation’s ability to respond to the mental health needs of physicians and other health care professionals.”

Sen. Tim Kaine (D-Va.) introduced the bill in July 2020. Co-sponsoring the legislation were Sens. Todd Young (R-Ind.), Jack Reed (D-R.I.), and Bill Cassidy, M.D. (R-La.) and Reps. Susan Wild (D-Pa.) and David McKinley (R-W.Va.).

According to a news release, the Dr. Lorna Breen Health Care Provider Protection Act will

• Establish grants for health profession schools, academic health centers, hospitals, and other institutions to help them train health workers in strategies to prevent suicide, burnout, and mental health conditions, including substance use disorders, among health care professionals.
• Seek to identify and disseminate evidence-informed best practices for reducing and preventing suicide and burnout among health care professionals and training health care professionals in appropriate strategies to promote their mental health.
• Establish a national evidence-based education and awareness campaign targeting health care professionals to encourage them to seek support and treatment for mental health and substance use disorders and stigma associated with seeking care for these conditions.
• Establish grants for health care professionals and professional associations for employee education, peer-support programming, and mental health treatment.
• Establish a comprehensive study on the impact of the COVID-19 pandemic on the mental health of health care professionals.

The legislation also directs the Department of Health and Human Services (HHS) to study and develop policy recommendations to remove barriers to accessing care and treatment and identify strategies to promote resilience, according a congressional summary of the bill.

“We’re … pleased that this bipartisan, bicameral legislation supports research on health care professionals’ mental and behavioral health, including how best to heal from the pandemic’s detrimental impact on the health care community,” APA and the five physician groups wrote. “Amid a public health emergency, this is more important than ever.”

For related information, see the Psychiatric News article “APA Applauds Passage of COVID-19 Relief Package.”

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APA Praises Congress for Funding Mental Health Programs for FY 2019

APA today praised Congress for funding several mental health programs through the passage of HR 6157, a bill which includes funding for the departments of Defense, Labor, Education, and Health and Human Services through the end of September 2019.

The spending package includes funding for the following:

• Substance Abuse and Mental Health Services Administration (SAMHSA): $5.7 billion ($584 million increase)
• National Institutes of Health (NIH): $39.1 billion ($2 billion increase), including $429 for the BRAIN Initiative (Brain Research through Advancing Innovative Neurotechnologies)
• Curbing the opioid epidemic: $3.8 billion ($206 million increase)
• SAMHSA Minority Fellowship Program: $13.2 million ($500,000 increase) through SAMHSA’s Center for Mental Health Services, Center for Substance Abuse Treatment, Center for Substance Abuse Prevention

The bill passed in the House on Wednesday by 361-61, a week after the Senate passed an identical measure by a vote of 93-7. The bill was presented to President Donald J. Trump on Thursday.

“We thank members of Congress from both parties for prioritizing mental health care—including treatment for and prevention of substance abuse—in the FY 2019 Defense-Labor-HHS funding package,” said APA President Altha Stewart, M.D., in a statement released by APA. “The commitment to mental health care shown in these appropriations will advance critical research on psychiatric disorders and improve care for the millions of Americans living with mental illness and substance use disorders.”

“Mental health and substance use treatment are critical to our nation’s well-being,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A., in a statement. “Our members were vocal about the need to fund the Minority Fellowship Program and we thank the members of Congress who worked with us to secure and expand funding for this critical program.”

(Image: David Hathcox)

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APA Calls for Senators to Reject Flawed American Health Care Act, Offers Priorities for Moving Forward

APA and the American Psychological Association this week called on the Senate to “avoid major flaws” in the American Health Care Act (AHCA) and craft a bill that would result in more people having coverage for mental health and substance use treatment.

In a letter to Senate Majority Leader Mitch McConnell (R-Ky.) and Senate Minority Leader Charles Schumer (D-N.Y.) dated June 6, the two mental health associations expressed their reservations with the House bill passed May 4.

“We strongly oppose the American Health Care Act, as recently passed by the House. According to the Congressional Budget Office, the AHCA would result in 14 million more people uninsured in 2018 than under current law, and 23 million more people without insurance by 2016,” wrote APA CEO and Medical Director Saul Levin, M.D., M.P.A., and American Psychological Association CEO and Executive Vice President Arthur C. Evans, Ph.D. “Millions more would lose access to treatment, with mental health and substance use services no longer being covered under their benefit package. This is the wrong direction for our country.”

Levin and Evans called on the Senate to retain Medicaid eligibility for Americans below 138 percent of the federal poverty level and to retain the current Medicaid financing structure, without the use of per capita caps or block grants.

“Low-income and uninsured adults have sharply higher rates of serious mental illness as those with insurance and higher incomes,” they wrote. “Medicaid expansion has been particularly helpful in addressing the opioid epidemic, as illustrated by the 700 percent increase in use of substance use treatment services among Kentucky beneficiaries after the state expanded its Medicaid program, and Medicaid’s coverage of 37 percent of spending on buprenorphine in New York.”

The opioid epidemic illustrates the danger of capping federal Medicaid payments, they said. “Private insurance payments for opioid abuse and dependence services increased by 1,375 percent between 2011 and 2015 (from $32 million to $446 million),” they wrote. “Under a system of Medicaid per capita capped payments, tens of thousands of individuals struggling with opioid addiction would have been denied Medicaid coverage and treatment, and thousands more would have died. … States already have significant flexibility in tailoring their Medicaid programs, and can be provided more flexibility without capping federal payments.”

Levin and Evans urged the Senate to also continue to require plans to cover an essential health benefits package that includes mental health and substance use disorder services and behavioral health treatment, and to prohibit insurers from charging higher premiums for people with pre-existing conditions. Further, the pair emphasized the importance of continued investment in research and programs, including retaining the Prevention and Public Health Fund.

“Our nation cannot afford to go back to the days when insurers selectively enrolled individuals to avoid financial responsibility for needed services. Nor can we afford to return to viewing mental health and substance use services as optional,” the leaders wrote. “Rather, we must further reduce the uninsured rate, develop integrated systems of care, and continue to foster an environment in which health plans compete on how efficiently and effectively they can provide services.”

Write Your Senators and Urge Them to Start Over on AHCA

APA members are urged to contact their senators to express opposition to the AHCA and instruct the Senate to set aside the House bill and start over on new legislation that does not put at risk health care for people with mental health/substance use disorders. To make such communication quick and easy, visit the APA Advocacy Center.

(Image: Mikhail Kolesnikov/Shutterstock)