On March 23, the Senate Health, Education, Labor, and Pensions Committee held a hearing on federal mental health and substance use disorder programs titled, “Strengthening Federal Mental Health and Substance Use Disorder Programs: Opportunities, Challenges, and Emerging Issues.” This served as a follow-up to the committee’s Feb. 1 hearing, “Mental Health and Substance Use Disorders: Responding to the Growing Crisis,” [refer to Washington Highlights, Feb. 4].
In her opening statement, Committee Chair Patty Murray (D-WA) discussed the profound impact of the COVID-19 public health emergency on the nation’s collective mental health. She noted a sharp increase in the rate of overdose deaths ascribed to drugs such as fentanyl, methamphetamine, and cocaine and emphasized the critical role that mental health and substance use professionals play in providing lifesaving care. Murray further observed that the pandemic has imposed incredible stress on the nation’s behavioral health workforce, thereby exacerbating provider shortages and limiting access to care. She expressed the committee’s intention to finalize bipartisan legislation to reauthorize, improve, and strengthen federal programs addressing mental health and substance use disorders. She concluded, “I look forward to hearing from our witnesses today about the steps we can take to bolster the efforts of those on the frontlines of our mental health and substance use disorder crises.”
Committee Ranking Member Richard Burr (R-NC) stressed the role of social isolation in driving the nation’s current mental health crisis. He noted that the past two years have seen a marked uptick in the rate of anxiety, depression, and mental health-related emergency department visits among the nation’s young people. Burr observed that the committee has authorized or reauthorized over 40 different federal programs to address mental health and substance use disorders since 2016 and stressed the need to evaluate and improve existing programs. He also emphasized the importance of engaging local communities through public-private partnerships to identify innovative solutions to the mental health crisis saying, “Sometimes this requires thinking outside the box. We saw communities pull together during the pandemic to come up with solutions that worked – and we need the same spirit and ingenuity for this challenge.”
The committee heard from Miriam Delphin-Rittmon, PhD, assistant secretary for mental health and substance use at the Department of Health and Human Services and administrator of the Substance Abuse and Mental Health Services Administration (SAMSHA). In her testimony, Delphin-Rittmon outlined SAMSHA’s key near-term priorities, including preventing overdose deaths, improving access to suicide prevention and crisis care, promoting the behavioral health of youth and children, integrating physical and behavioral health care, and finally, using performance measures, data, and evaluation to inform the agency’s decision making. She further outlined the agency’s recent actions to advance these goals, including the creation of a new Office of Recovery, the establishment of a new suicide crisis support system, and the expansion of evidence-based integrated behavioral health models, such as Certified Community Behavioral Health Clinics. Delphin-Rittmon further described the agency’s grant-making initiatives to expand access to evidence-based substance use disorder treatment and harm reduction services, as well as promote the mental health and well-being of young people, tribal populations, adults with serious mental illness, and pregnant and post-partum individuals.
The committee also heard from Carole Johnson, administrator of the Health Resources and Services Administration (HRSA). Johnson highlighted two key mental health programs pending reauthorization: (1) the Screening and Treatment for Maternal Depression and Related Behavioral Health Disorders program, which empowers maternal health care providers to screen for and address behavioral health conditions in the perinatal population, and (2) the Pediatric Mental Health Care Access program, which integrates behavioral health services into pediatric primary care through telehealth. Johnson also emphasized HRSA’s ongoing efforts to strengthen and diversify the nation’s behavioral health workforce, including graduate medical education programs such as the Children’s Hospitals Graduate Medical Education Program and the Teaching Health Center Graduate Medical Education Program, as well as loan repayment programs such as the National Health Service Corps. She noted, “HRSA programs play an important role in growing and training the behavioral health workforce and creating supports and incentives to help encourage providers to practice in the communities that need them most.”
The committee also heard from Joshua Gordon, MD, PhD, director of the National Institutes of Mental Health (NIMH) within the National Institutes of Health (NIH). Gordon described how basic science research supported by the NIMH is the foundation for new and innovative clinical treatments for mental and behavioral health conditions. In addition, Gordon described the NIMH’s intention to collaborate with federal agencies to disseminate evidence-based preventative and therapeutic interventions for mental and behavioral health, such as the collaborative care model. The AAMC previously endorsed the collaborative care model, which was first developed at the University of Washington Advancing Integrated Mental Health Solutions (AIMS) Center, in a response to the Senate Finance Committee request for information on behavioral health [refer to Washington Highlights, Nov. 19, 2021].
Finally, the committee heard from Nora Volkow, MD, director of the National Institute on Drug Abuse (NIDA), also within NIH. Volkow emphasized the importance of NIDA-supported research in developing evidence-based prevention and treatment strategies for substance use disorders. Volkow described how the agency has leveraged telehealth to expand access to treatment for opioid use disorders for historically marginalized and hard-to-reach populations.
The committee plans to use the testimony received at this hearing to inform the development of a future bipartisan legislative package, which Murray anticipates will be introduced this summer.