New Recommendations to Improve US Mental Health Policy Released

Megan Brooks

January 30, 2020

A framework and policy report from the nonprofit organization Well Being Trust lays out actionable solutions to improve mental health and well-being for Americans, its authors say.

Healing the Nation: Advancing Mental Health and Addiction Policy includes more than 50 recommendations and specific steps federal policy makers can take now to advance mental health.

"For decades, federal policy has largely treated mental health as an afterthought, and despite best efforts, we have yet to see a robust policy agenda that elevates the importance of mental health alongside physical health," Benjamin Miller, PsyD, chief strategy officer for Well Being Trust, told Medscape Medical News.

"On the heels of continued poor mental health and well-being across the country, it was important to bring mental health to the top of the nation's agenda," said Miller.

The report provides a policy framework that focuses on health, judicial, and educational systems; workplace and unemployment; and the whole community.

The framework highlights segments of the population affected by the mental health and addiction crisis.

"For our country to make a meaningful and long-lasting impact on what matters to people, we need to address needs in a comprehensive, culturally relevant, and community-focused manner," Miller said. "The action guide offers a vision for mental health that integrates these critical services into community and clinical spaces," he noted.

The report calls on the federal government to do the following:

  • Ensure that hospital payment models and quality programs encourage a mental health assessment at every interaction as a vital sign — not only during wellness visits. This should include integrating screening and treatment into episode-based payment models for health conditions for which there are frequent mental health comorbidities, such as cardiovascular diseases, cancers, and pulmonary diseases.

  • Create incentives for policy reforms that improve school culture and/or student mental health and provide additional financing for schools that implement effective strategies that reduce disparities in belonging and safety for students who identify as LGBTQ, including specialized services for suicide prevention.

  • Make Medicaid coverage for women up to 1 year post partum a mandatory eligibility category for coverage and include measures of screening and effective coordination of care for maternal behavioral health in hospital incentive programs for care transitions and quality/safety.

  • Ensure that the Indian Health Service and the Veteran's Health Administration are engaged in the same reform efforts as the Centers for Medicare & Medicaid Services (CMS) for mental health and increase funding to build capacity.

  • Make it impermissible that any information related to the seeking of mental health treatment be used in any aspect of immigration enforcement and provide funding to disseminate this information to immigrants and for education about the availability of mental health services as part of immigration services.

  • Provide long-term funding for states to continue programs such as Money Follows the Person and the Balancing Incentive Program to ensure that people with intellectual and developmental disabilities and mental health conditions have consistent access to comprehensive, high-quality services and support outside of institutional settings.

  • Allow Medicaid funds to reimburse for the education of housing authorities concerning the risks of housing insecurity and what resources are available to meet those needs.

  • Create incentives in funding programs for municipalities that have created effective policies or strategies for ensuring access to affordable housing.

  • Increase incentives for individuals to join the mental health workforce and for training programs to actively recruit and effectively train diverse individuals to meet underserved needs and provide more culturally competent care.

  • Create a seed fund that supports primary care providers, especially Federally Qualified Health Centers and Rural Health Centers, in developing the necessary capacity to begin seeking sustainable reimbursement for integrated mental healthcare services (which could be effectively paired with parity initiatives).

"Healing the Nation offers a new vision for mental health. The framework, the solutions are there ― it's time for federal officials to act," Andy Slavitt, former acting administrator of the CMS and board chair of the nonprofit group, United States of Care, said in a release.

The full report is available online.

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