At a Senate appropriations subcommittee hearing, the former Missouri Department of Mental Health’s Medical Director, Dr. Joe Parks testified to the many challenges behavioral health providers face. The issues raised by Dr. Parks, including workforce shortages, inadequate reimbursements, and the integration of primary care and behavioral health, have all been discussed at earlier BHECON forums in Missouri and other states. The hearing demonstrated that across the country providers are facing the similar challenges and that these challenges are gaining federal attention on Capitol Hill.
A Senate appropriations subcommittee convened a hearing on mental health treatments and services on Wednesday. The hearing featured testimony from National Council members, Dennis Freeman and David Johnson, and staff, Joe Parks, who presented recommendations for improving the nation’s mental health care system. The hearing signaled Congressional members’ interest in supporting mental health funding, particularly in rural and underserved areas.
Unmet Mental Health Needs
Half of individuals in the U.S. with behavioral health needs are not receiving any treatment, according the National Council’s Medical Director, Joe Parks. Dr. Parks and other hearing witnesses noted the cause of this treatment gap is a lack of capacity throughout the behavioral health system. To aid in meeting this growing demand for services, Dr. Parks called for a greater investment of federal resources in SAMHSA’s block grants, Certified Community Behavioral Health Clinics (CCBHCs), electronic health records and facility renovations for community mental health clinics.
The ability of behavioral health care providers to meet the demand for services is also dependent upon a strong behavioral health workforce. Dr. David Johnson with Navos Mental Health Solutions and Dr. Dennis Freeman with Cherokee Health Systems both testified to the struggles they face as providers in finding qualified mental health professionals. According to Dr. Parks, workforce shortages are caused by inadequate Medicaid rates providers receive, ultimately inhibiting providers’ ability to offer competitive salaries to employees.
Importance of Medicaid Expansion
Dr. David Johnson shared his experience with Medicaid expansion in Washington state, where 30,000 newly-eligible Medicaid enrollees received addiction care in the last year. Dr. Johnson also pointed out that the expansion population–individuals receiving health care for the first time–have tapped into other resources impacting their health, such as housing, employment, and care coordination. The potential elimination of Medicaid expansion would hurt providers and shift costs onto states, hospitals, and law enforcement, Dr. Johnson warned.
Innovations in Mental Health Care: CCBHCs and Integration
From both the witness panel and subcommittee members, there was a focus on innovative methods of treating mental illness. Dr. Dennis Freeman of Cherokee Health Systems shared how his patients receive behavioral health care in the primary care setting because primary care is the “front door to the health care system,” for most patients. Dr. Parks discussed the emerging and growing role of CCBHC’s to provide comprehensive care that meets the behavioral and physical health care needs of consumers.
Subcommittee Chairman Sen. Roy Blunt (R-MO) asked the panel how technologies like telehealth could be used to improve mental health treatment access in rural areas. The witnesses agreed that telehealth is an important tool for seeing patients in hard-to-reach areas and makes service delivery more efficient by eliminating travel time.
Criminal Justice Response: Mental Health First Aid
Knowing how to appropriately respond to an individual with mental illness is the number one concern of police officers across the country, according to Chief Donald De Lucca, President of the International Association of Chiefs of Police. Chief De Lucca urged the committee to provide more funding for training law enforcement in de-escalation techniques to prevent individuals with mental illness from entering the criminal justice system. Chief De Lucca explained how valuable trainings like Mental Health First Aid (MHFA) and Crisis Intervention Team (CIT) are to police departments looking to improve their responses to individuals experiencing a mental health crisis.
Chairman Blunt wrapped up the hearing by saying “Coverage is important, but coverage without access is not solving the problem,” implying that Congress needs to not only ensure that Americans have health care coverage, but that there needs to be an adequate number of providers available to serve them. For more on the hearing, watch the recording and access witness testimony here.