Be it resolved: The 118th Congress must keep working on mental health

The 117th Congress wrapped up 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 lack of adequate mental health infrastructure have led 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 epidemic levels, with high death rates driven by potent 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 and 64% of youth feel the world is more stressful now than when their parents were their age.Americans are impacted by these challenges, regardless of their party, location or background.

Representing providers and people affected by mental illness, the American Psychiatric Association and the National Alliance on Mental Illness have identified areas where the administration and Congress can build on the momentum from 2022.

• There are not enough psychiatrists and other mental health clinicians to meet demand, with more than 150 million Americans living in a Mental Health Provider Shortage Area. Last year Congress provided 100 graduate medical education (GME) slots designated for psychiatry. But this should be seen as a down payment toward erasing the workforce shortage. Congress should also consider strengthening the use of peer support specialists and providing loan repayment to psychiatrists to practice in Health Professional Shortage Areas like the current program for substance use disorders.

• The 988 Suicide and Crisis Lifeline became available nationwide last July, providing millions of Americans’ with access mental health emergency care. Since the new number came online, demand has increased 40 percent over the previous year. We need to increase  awareness, as 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 wraparound 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 insurance coverage for mental health and substance use care should be equitable to coverage for other health conditions. However, enforcement remains a challenge. Congress should increase enforcement.
• At the outset of the pandemic, Congress had the foresight to loosen restrictions on patients’ access to telehealth services and it served as a lifeline for many seeking mental health and substance use disorder treatment. The effectiveness of telehealth is clear, including patient satisfaction, clinical efficacy, and access in underserved areas. Congress has extended Medicare’s current flexibilities until 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 authorized grants and technical assistance for primary care physician practices to implement integrated care and we encourage Congress to further incentivize its adoption.
• Research is crucial to discovering more precise diagnostics and innovative treatment options for people with mental health conditions. Mental illness remains a 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 things, 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 improvement is needed in access to mental health care, and Congress can help. The new Congress has an 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 stand committed to working with members of the 118th Congress to make progress in addressing our nation’s mental health crisis.

Saul Levin, M.D., M.P.A, is a psychiatrist and Chief Executive Officer and Medical Director of the American Psychiatric Association (APA). Prior to assuming this role in October 2013, Dr. Levin led the District of Columbia Department of Health (DOH). Daniel Gillison, Jr.  is Chief Executive Officer of the National Alliance on Mental Illness (NAMI).  Prior to his role at NAMI, Mr. Gillison was executive director of the American Psychiatric Association Foundation (APAF).