Blog
Q&A with Policy Experts at NatCon24: Improving Behavioral Health Access Through Policy
Current Behavioral Health Landscape
nonfatal overdose-related emergency department visits in 2022
overdose deaths in 2022
suicide deaths in 2022
of adults with mental illness do not receive treatment
of drug overdose deaths had at least one potential opportunity for intervention in 2022
individuals who died from overdose who could have been helped
calls anticipated to the 988 Suicide & Crisis Lifeline in 2025
Staggering statistics like these above illustrate the current behavioral health landscape, and it’s clear that more action is needed to reduce such high rates of crisis. In April, Vatsala Kapur, VP of External Affairs at Bamboo Health, hosted a fireside chat at NatCon24 with Kendall Hussey, Senior Policy Adviser at Akin. The discussion focused on navigating advocacy in behavioral health through policy.
Check out the top takeaways from their discussion below (edited for length and clarity) for insights from Kendall on improving the behavioral health landscape from a policy perspective.
Q: Many of America’s behavioral health challenges are bipartisan issues with engagement on both sides of the aisle. Can you tell us more about why and how Congress is acting in the behavioral health space?
A: The evolving nature of the opioid epidemic is a crucial catalyst for legislative movement since prescription drugs are no longer the primary culprit. With fentanyl now driving most overdoses, Congress has been tasked to address new challenges within the behavioral health sector. Some of the challenges affecting access to care that Congress has been focusing on:
- Workforce shortages affecting access to care: Most of the country lives in a mental health workforce shortage area. In some states, over 700 mental health professionals are needed to alleviate this issue and ensure staff are available to address rising behavioral health care demands.
- Financial impediments due to low reimbursement rates: The economic burden further exacerbates the situation, as reimbursement rates from payers, primarily Medicaid and Medicare, remain inadequate.
- Pervasive stigma surrounding mental health treatment: Patients continue to face significant stigma within medical settings and accessing appropriate treatment. Integrating substance use education into the medical academic curriculum, improved community engagement to reduce stigma, maintaining behavioral health telehealth flexibilities, and increasing the pipeline of peer support specialists into care settings are all policies Congress is considering. Despite bipartisan acknowledgment of the youth mental health crisis, marked by a substantial increase in cases, overcoming stigma and ensuring comprehensive care for this vulnerable demographic remains a priority for Congress. The younger population is the future of our country, and there’s broad bipartisan support focused on improving their overall mental health.
Congress has also supported initiatives such as certified community health clinics, which have proven effective in reaching those in need. Furthermore, efforts to combat the opioid crisis encompass both law enforcement measures and strategies for treatment and recovery. Recent developments, including the final 42 Part 2 rule released earlier this year and the introduction of innovative programs like the Innovation in Behavioral Health model, underscore a concerted effort to provide holistic support to individuals, integrating medical, behavioral, and social needs.
Q: Can you share more about some of the innovations in the Medicaid space related to wrapping behavioral health into the Medicaid program to support financial sustainability for these efforts? Why does this matter? And how can states get more engaged with their Medicaid programs to advance treatment access?
A: Despite the challenges posed by a divided government, states have leveraged Medicaid Section 1115 waivers to enact significant reforms, showcasing bipartisan efforts to address pressing issues.
California has emerged as a trailblazer in utilizing the Section 1115 waiver to expand access to crucial services, setting a precedent for other states. Similarly, Oklahoma pursued Medicaid coverage and reimbursement for substance use disorder (SUD) and severe mental illness (SMI) services, demonstrating a commitment to improving mental health care access across party lines.
Washington State is implementing a system to track the availability of inpatient and crisis stabilization beds, which underscores a proactive approach to crisis intervention and management. Meanwhile, Montana’s innovative model, building upon its Medicaid expansion demonstration, integrates behavioral health services with housing assistance, addressing the complex needs of individuals diagnosed with mental health disorders. Notably, this includes providing incentives for reentry services for justice-involved populations.
Q: Could you share more about the SUPPORT Act and how it fits into this conversation on expanded behavioral health access?
A: In 2018, Congress passed its first SUPPORT Act in response to the opioid epidemic, which provided significant funding for various initiatives and substance use disorders. Unfortunately, it expired last year. Given its centrality to funding for behavioral health, we hope there is momentum for SUPPORT Act reauthorization this year.
Q: What do audiences need to know about funding for the 988 Suicide & Crisis Lifeline?
A: We’re seeing a lot of bipartisan activity with 988. Both the Administration and Congress have made significant investments to support 988. Recently, the House Energy and Commerce Committee Republicans released a letter asking the U.S. Government Accountability Office (GAO) to investigate how 988 funding is being used. The Committee found that less than half of the obligated funds had not been expended to date. We foresee further Congressional oversight as an opportunity to improve the outcomes of the 988 program, which continues to have strong bipartisan support.
Q: Can you speak a little more on the federal crisis and the policy debate around the approach to 988 from the law enforcement side?
A: It’s a tricky area. Law enforcement is often the first to respond during a crisis, which can cause further stigma. Of course, in the behavioral health space, trust is a critical element in connecting individuals to long-term treatment. It will be critical for lawmakers to work across both chambers and relevant committees of jurisdiction to find workable solutions that address the needs of individuals in crisis and their community response.
Q: In terms of coalition-building and advocacy, what else could we be doing as a healthcare community to advance the critical work of behavioral health providers?
A: I hope you can come to Washington, D.C. and use your voice. Please advocate for your priorities so that your programs get funded. It is your Representatives’ job to listen to you and highly encourage any advocacy efforts in this area. At this point, we’ve got to get creative regarding coalition building; everybody needs to be involved. Everyone must work towards one goal, whether it’s law enforcement, parents, teachers, doctors, mental health and behavioral health professionals. By being aligned, we build strength in numbers. When Congress knows they have the bulk of the stakeholders supportive and involved, they will respond to that powerful momentum. One recent example is TikTok: I’ve never seen a bill move so fast, and that was very much driven by what Members of Congress were hearing from parents and their children about the uses of that platform. So, things can get done if we push Congress hard enough.
If you missed Bamboo Health at NatCon24 this year, contact us to continue this discussion or meet us at an upcoming conference.
