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Editor’s note: Anna Vredenburg is director of health policy at the U.S. Chamber of Commerce.
America’s mental health crisis is firmly ingrained in the national consciousness, and the silver lining of the pandemic’s devastation is the realization that what we did before wasn’t enough.
For American employers, this underscores the need to accelerate investments in workplace mental health.
If you work for a large company, there’s a good chance you have more support available than you did a few years ago: A survey of businesses conducted late last year found that 94% of companies reported that in the past three years they had increased their mental health coverage, expanded access to support, or introduced new workplace programs for mental health and wellness.
Recognising that good mental health is good for workers and good for businesses, employers are dedicating significant resources to addressing the issue. But the need is far from being met. Too many people still find it difficult to access care. There are structural challenges that, if left unaddressed, will continue to impede progress.
Modernizing the mental health care system requires work in three key areas: breaking down barriers to telehealth and virtual care, dramatically expanding the mental health workforce in the short and long term, and integrating mental and physical health care.
The pandemic exacerbated the mental health crisis, initially creating new barriers to care and increasing levels of stress and anxiety for millions of Americans, but paradoxically it has led us toward one solution to address the larger crisis.
Telehealth has expanded rapidly for both physical and mental health services. In March 2020, Congress and the federal government made significant changes to the rules and regulations governing telehealth. The flexibilities supported health care providers faced with an influx of patients and gave patients more flexibility in how they received care.
Once these policy changes went into effect, more healthcare providers were able to offer telehealth from home and telehealth visits could occur across state lines. With more platforms available, healthcare providers no longer needed a pre-existing relationship with the patient. Patients also no longer needed an in-person visit to be eligible for a telehealth appointment. Now, 72% of large companies report that they have recently expanded their telehealth networks or options for their employees.
Pandemic regulations remain in effect and continue to benefit both patients and providers. This is especially true in rural areas where providers and patients may be farther apart.
But these telehealth rules are set to expire at the end of the year, and many Americans could find it even harder to access mental and behavioral health care unless Congress acts to extend them and ensures this access remains available.
Telehealth, including audio only, has the potential to significantly increase the number of people who can receive the help they need, making it essential that flexibility be maintained in the federal regulations governing this practice.
Yet until the supply of mental health service providers increases, access will remain limited. The root cause of the crisis is a mismatch between the number of professionals qualified to help patients and the number of patients who need providers. Nearly three years into the pandemic, 60% of psychiatrists still report they do not have the capacity to take on new patients.
Worryingly, even as demand for care increases, the number of care providers may soon decrease. In 2021, more than 60% of psychiatrists will be over 55 years old, meaning many of our current care providers may soon age out of the workforce. A shortage of professionals to meet the need, both now and in the long term, will not fully address this challenge.
This will require training additional providers, including non-clinical behavioral health providers and primary care providers. In the short term, we need to provide flexibility for licensed health care workers, such as nurses and social workers, to practice to the fullest extent of their qualifications while filling gaps in care with additional community services.
This additional training, especially for primary care providers, could also address the third challenge facing mental health care in America: integrating mental and physical health care. Mental, behavioral, and physical health are complex and often interrelated. Having providers who can address all three, especially when they are linked, can improve patient outcomes.
Integrating mental health and physical health care allows for earlier detection and earlier treatment of mental health issues. In addition to improving patient outcomes, addressing mental health symptoms early, before they become emergencies, can reduce costs for consumers. This also helps reduce the stigma associated with mental health care. Stigma remains a barrier for patients who need mental health services. Eliminating that stigma is another major challenge to breaking down barriers to care.
Currently, the system is failing many people. We have the tools to change it. We have the capacity to address America’s mental health crisis, but policymakers must act. Congress should reauthorize telehealth expansion. Leaders in Washington can join the effort to build America’s mental and behavioral health workforce and support new steps to integrate mental health, behavioral health, and physical health care.
Mental and behavioral health has a significant impact on the lives of nearly every American, and this year Congress should act to strengthen America’s mental health care system.
