Here are just a few of the mental health initiatives that the Biden Administration appears poised to pursue, according to policy watchers and influencers.
- Increased federal enforcement of an Affordable Care Act mandate that insurance companies put mental health care on par with all other health care.
- Heightened oversight of short-term insurance policies that President Trump supported, but critics derided as “junk insurance” because they did not cover mental illness or behavioral, substance abuse and similar disorders.
- More federal support to help municipalities join a nationwide emergency 988 call line — signed into law in 2020 by Trump — aimed at lowering suicide rates, police intervention in emergencies involving persons with mental illness and handling other mental health crises.
- Urging Congress to approve $4 billion to help the Substance Abuse and Mental Health Services Administration (SAMSHA) and the Health Resources and Services Administration (HRSA) expand services as the pressures of COVID-19 have prompted record numbers to people to seek mental and behavioral health care.
“They have not been direct about what they plan to do; they are mainly trying to collect info … and move aggressively against what Trump did regarding (rolling back) Medicaid and the ACA,” Andrew Sperling, legislative affairs director for the National Alliance on Mental Illness (NAMI), told me a few weeks before President Joe Biden’s inauguration.
Sperling and others who’ve conferred with the White House on what to do about mental health care said some things are understandably unknown, especially given Biden’s pressing focus for now on the pandemic and related issues, including rolling out coronavirus vaccines and stimulus checks and dealing with rising hunger and a worsening housing crisis. That proposed $4 billion for mental and behavioral health is No. 43 of 47 major budgetary priorities in the White House’s American Rescue Plan released in late January.
Nevertheless, mental health advocates do have their wish lists and projections of what may come.
“We are likely to see a greater interest in workplace mental health because of the huge toll the pandemic has taken on workers,” said Paul Gionfriddo, president and CEO of Mental Health America.
The pandemic has taken a toll on seriously mentally ill persons living in group homes or other congregant housing. Data on Covid’s impact isn’t systematically kept, NAMI’s Sperling said.
“People with serious mental illness in those settings, even before the pandemic, already were facing big challenges.” He said. “This group has more diabetes, heart disease, respiratory disorders than the general population. They’re at high COVID risks based on those facts.”
He added, “But when you live with 10 other people, who also have schizophrenia, it’s hard to self-isolate, to quarantine … There has been no data on who’s died in congregate settings, which are not licensed by the state and not tracked and are very loosely regulated.”
NAMI also will continue its push for waivers, enacted during the coronavirus pandemic, for audio-only telehealth sessions that have been especially critical to patients in regions without sufficient internet access. The alliance has been lobbying Congress and the Centers for Medicare & Medicaid Services (CMS) on that issue.
NAMI’s leader hopes that within his first 90 days in office, Biden will lay out how he plans to broaden so-called crisis stabilization efforts that lessen the contact law enforcement officials have with people in the midst of a psychotic break or other mental health trouble. “There is a growing momentum and recognition of the need to do things differently,” said Angela Kimball, NAMI’s national director of advocacy and public policy. “We’re seeing the racial disparities and the fact that persons with serious mental illnesses are being shot in the streets.”
Achieving those and other assorted goals will require, she added, that CMS and related federal agencies hire more workers with a full understanding of mental health and addiction issues, not just expertise in government budgets and funding.
- Mental Health for Us, a coalition of mental and behavioral health-focused nonprofits, conducted this Q&A with then-candidate Biden before the 2020 election.
- American Psychological Association statement on Biden’s positions on mental health.
- Over the years, with mixed success, various states have pushed for stricter licensing of group homes for persons with severe mental illness. What’s happening where you report?
- Privately owned telecommunications companies will be levied fees to pay for those federally mandate 988 hotlines. How far along are state regulatory agencies in setting up those fees? How much time will it take? How will those regulations and fees vary, state by state?