Addressing the Nation’s Mental Health Crisis

CEOs of the nation's 14 leading mental health advocacy organizations have created a roadmap to address America’s mental health crisis, which has worsened due to COVID-19. Since the onset of the pandemic, depression symptoms have tripled, overdose deaths have increased in 40 states, and 25% of young adults struggle with suicidal ideation. The crisis "requires immediate action by the new administration, as well as state and local governments in all 50 states,” said Daniel Gillison, Jr., co-convenor and CEO, National Alliance on Mental Illness.

The coalition's mental health proposal calls for prioritizing mental health care while addressing social and economic conditions that disproportionately affect people of color and the poor, resulting in inadequate and inequitable access to effective, humane treatment. 

The following some recommendations specific to health payers:

• Eliminate fail first policies for medication therapies
• Include licensed mental health and addiction clinicians equal to other licensed health professionals in medical/surgical networks
• Fix rate deficiencies that drive licensed behavioral health clinicians out of insurance-based care
• Enact a federal parity law that prohibits discrimination against telehealth and mandates equal reimbursement. Also, include access to audio-only care as an option given inequitable access to broadband
• Require that all health plans’ medical necessity determinations are consistent with generally accepted standards of care for a mental health/substance use disorder
• Apply the Mental Health Parity and Addiction Act to all public and private payers 
• Increase funding for the Dept. of Labor’s parity enforcement of ERISA plans 
• Eliminate all restrictions on substance use disorder care, including limitations on providers prescribing medication-assisted treatment and telehealth limits
• Ensure that states and the federal government are requiring compliance with the Mental Health Parity and Addiction Act and are requiring health plan transparency about benefit design and application
• Enforce standards to eliminate non-quantitative treatment limitations 
• Ensure that Collaborative Care reimbursement rates support universal access to measurement-based care
• Incentivize evidence-based interventions for severe mental health/substance use disorder and co-occurring disorder treatment
• Promote measurement-based care and value-based financing

Several ideas can be implemented quickly, such as bringing telehealth into schools, community centers, and prisons; fast-tracking the new 988 National Suicide Prevention Lifeline for immediate access on mobile carriers; engaging a diverse mental health care workforce, and expanding access to peer support groups and community-based programs.