Meeting the mental health needs of our nation’s most vulnerable
This op-ed originally appeared in the San Francisco Examiner.
When it comes to better care for mental health patients, well-intentioned legislation hasn’t been a panacea. A 2008 federal law required most insurance policies to cover mental and physical health equally, but study after study shows we have a long way to go to achieve mental health parity.
Now, Congress is once again trying to remedy the nation’s ailing mental health system and finally meet the needs of some of the nation’s most vulnerable citizens.
The far-reaching 21st Century Cures Act, which President Barack Obama signed Tuesday, is far from perfect. The biggest winners, critics have noted, will likely be drug companies and medical device makers who will have fewer regulatory roadblocks in getting their products to market. But in a last-minute bout of legislative maneuvering, congressional leaders tacked on sweeping mental health reforms that offer an important first step in helping the estimated 13 million Americans who live with a serious mental illness.
The bill reauthorizes — and in some cases boosts — funding for mental health research and treatment with hundreds of millions of dollars going to initiatives that would include helping train more caregivers, expanding efforts to diagnose mental illness in students and keeping nonviolent mentally ill offenders out of jail. It would also establish stakeholder boards to better analyze and coordinate federal mental health programs and authorize the president to appoint a new assistant secretary for mental health and substance abuse to administer those programs.
Perhaps most importantly, the bill would put the onus on Washington to verify that insurers are abiding by mental health parity laws. That has proven to be a challenge. A report published last month by the National Alliance on Mental Illness found that respondents were nearly twice as likely to have difficulty finding a therapist willing to take their insurance than other types of medical specialists.
Long waits for care are commonplace throughout the mental health care industry. Understaffing forces patients to wait weeks, even months for therapy appointments. More than 3,000 California Kaiser Permanente mental health professionals represented by the National Union of Healthcare Workers are now in discussions with Kaiser about how to change this with the goal of making Kaiser the model for mental health care. Kaiser has already committed to hiring 500 additional clinicians statewide.
A mental health czar as envisioned in the new legislation could be a champion for at last achieving parity. But questions remains whether President-elect Donald Trump will put someone in place — and demand the funds — to get the job done. It’s hard to be optimistic given that his choice for health secretary, Rep. Tom Price, R-Georgia, wants to repeal Obamacare, privatize Medicare and rollback Medicaid, which pays for about one-quarter of the nation’s mental health treatment.
If Trump and the Republicans are serious, however, there is a blueprint for finally getting mental health treatment its equal due in our healthcare system. It just happens to be authored by Hillary Clinton — and inspired by Vermont Sen. Bernie Sanders. During the presidential campaign, Clinton proposed a parity plan that included randomly auditing health care providers to detect violations, preventing insurers from concealing any practices for denying mental health care and creating a simple process for patients and providers to report parity violations.
Sal Rosselli is president of the National Union of Healthcare Workers, which represents 13,000 California caregivers, including more than 3,000 Kaiser Permanente mental health clinicians.