The Senate Finance Committee held a hearing on June 15 titled, “Mental Health Care in America: Addressing Root Causes and Identifying Policy Solutions.” Throughout the hearing, witnesses and committee members identified barriers to accessing mental health services and solutions to address these concerns, including increasing and diversifying the mental health workforce, increasing access to telehealth services, integrating the primary care and behavioral health care systems, addressing substance use disorders, providing funding for crisis intervention programs, and ensuring the well-being of health professionals.
In his opening statement, Chairman Ron Wyden (D-Ore.) stated, “Every American must have mental health care when they need it. The shameful reality is, the United States does not come close to meeting that bar today.”
He identified three challenges the committee can address in a bipartisan fashion: creating a larger mental health workforce, expanding mental health care coverage, and reducing the racial inequities in mental health care. Wyden also highlighted some recent progress, including the permanent expansion of mental health care services via telehealth and the funding in the American Rescue Plan (P.L. 117-2) for the CAHOOTS program to allow health professionals to act as first responders when there is a 911 call related to someone experiencing a mental health crisis.
Ranking Member Mike Crapo (R-Idaho) noted, “Unfortunately, the COVID-19 pandemic has highlighted – and exacerbated – the mental and behavioral health challenges we continue to confront. … While many are returning to their pre-pandemic lives, we should not be content to allow our mental health care delivery system to revert to its pre-pandemic ways.” Crapo added he is looking forward to working with Wyden to build on recent policies that have modernized and expanded access to telehealth coverage.
Several senators and witnesses voiced their support for how the expansion of telehealth services has increased access to mental health services and provided solutions to address remaining barriers to care. Sens. John Thune, (R-S.D.) and Bill Cassidy, MD, (R-La.) mentioned their recently introduced bill that would remove a statutory requirement for Medicare beneficiaries to be seen for an in-person visit within six months of receiving mental health services through telehealth.
Michelle Durham, MD, MPH, assistant professor of psychiatry, Boston University School of Medicine and Associate Director, Global and Local Center For Mental Health Disparities, Boston Medical Center, agreed with removing the requirement, referring to it as an “unnecessary barrier to getting care.” Durham and Well Being Trust Chief Strategy Officer Benjamin Miller, PsyD, also called on Congress to permanently expand the temporary flexibilities that allow Medicare beneficiaries to access telehealth services through audio-only calls.
In her opening remarks, Durham provided solutions to concerns about the current mental health care workforce. She stated, “Increased Medicare Graduate Medical Education (GME) funding for psychiatry residency slots can help increase the physician workforce. Increased funding for loan forgiveness programs for those who work in underserved areas can help alleviate the $250,000 of debt that the average medical student has accumulated by the time their residency education is completed. The need to pay off medical school loan burden is also likely to cause physicians to pursue practice in more affluent areas, adversely impacting access to care for lower-income populations.”
During his comments, Sen. Mark Warner (D-Va.) referred to the importance of addressing provider well-being and urged his colleagues to pass the Dr. Lorna Breen Health Care Provider Protection Act (S.610, H.R. 1677), which the AAMC supports [refer to Washington Highlights, May 27].