Congress Should Pass Consensus, Bipartisan Mental Health Reform Legislation
The American Psychological Association and the American Psychological Association Practice Organization urge Congress to pass comprehensive mental health reform legislation this year. The “Helping Families in Mental Health Crisis Act” (H.R. 2646, introduced by Rep. Tim Murphy, R-Pa., and Rep. Eddie Bernice Johnson, D-Texas) and the “Mental Health Reform Act” (S. 2680, introduced by Senators Lamar Alexander, R-Tenn., Patty Murray D-Wash., Bill Cassidy, R-La., and Chris Murphy, D-Conn., should be the foundation for reform.
Mental disorders affect more than 40 million Americans each year — including roughly 10 million Americans with serious mental illnesses — and these disorders are the leading cause of disability in the U.S. Sadly, there are major gaps in the U.S. mental health treatment system:
- Only 1 in 3 Americans with a mental disorder receive minimally adequate treatment, and nearly 60 percent don’t receive any treatment from a mental health specialist.
- The proportion of all health care spending devoted to mental health and substance abuse treatment is 28 percent smaller today than it was in 1986. State government spending comprises only about half as big a share of such spending as it did then.
- After first onset of a mental disorder, the median delay before first treatment contact is nearly a decade.
- Individuals with serious mental illness are much more likely to be in a jail or prison than in a mental health facility.
Congress should pass legislation based on the Murphy/Johnson and Alexander/Murray/Cassidy/Murphy bills that includes the following provisions of importance to psychologists and their patients with serious mental illnesses:
- Expand the use of health information technology by making psychologists and other mental health providers eligible for financial incentives to implement Electronic Health Records (EHRs).
- Allow limited Medicaid coverage for services provided in institutions for mental disease (IMD).
- Institute consistent reporting on the effectiveness and enforcement of requirements under the Mental Health Parity and Addiction Equity Act, to prevent discriminatory coverage limitations for individuals using mental health and substance use disorder insurance benefits.
- Remove the 190-day lifetime limit on Medicare coverage for services provided in inpatient psychiatric hospitals.
- Help health care providers work with patients and their families by providing resources and training on requirements under the Health Insurance Portability and Accountability Act (HIPAA) for communication between providers, patients and families.
- Increase the number of mental health service providers by authorizing the Minority Fellowship Program, and reauthorizing the Graduate Psychology Education program. The bills would also require HHS to develop a nationwide strategy to recruit, train and increase the mental health service provider workforce.
- Require Medicaid coverage of primary care and mental health services provided on the same day within community mental health centers.
- Prioritize grant funding for the development and dissemination of evidence-based interventions and integrated service programs, and authorize grants for the development of early childhood intervention and treatment programs, and reauthorize grants for jail diversion programs, projects for assistance in transition from homelessness (PATH), the Garrett Lee Smith Act suicide prevention grant program, and comprehensive community mental health services for children with serious emotional disturbances.
In addition to H.R. 2646 and S. 2680, other important mental health reform legislation has been introduced in this Congress. Such bills include H.R. 4435, the “Comprehensive Behavioral Health Reform and Recovery Act,” introduced by Rep. Gene Green, D-Texas.
APA and APAPO look forward to working with members of Congress to pull together ideas from these and other bills into a consensus, bipartisan package that can be enacted this year.