On Tuesday, February 8, 2022, the Senate Finance Committee started their series of hearings on mental health with Protecting Youth Mental Health: Part I – An Advisory and Call to Action.
This series of hearings will focus on five areas of behavioral health: youth mental health, mental health workforce, parity between mental and physical health, making mental healthcare more seamless, and expanding access through telehealth. The end goal of these hearings is to come up with a bipartisan bill that addresses these five areas.
The Committee will continue to focus on this topic in “Protecting Youth Mental Health: Part II – Identifying and Addressing Barriers to Care,” to take place on Tuesday, February 15th.
In his opening remarks, Finance Committee Chair Ron Wyden (D-OR) provided an introduction to the Committee’s series and outlined the major issues impacting the nation’s mental health today, emphasizing the urgency of the mental health crisis and the need for bipartisan cooperation to develop a comprehensive mental health bill. Wyden’s overall direction for future legislation was to ensure that everyone would be able to get the mental health care they need when they need it.
Ranking Member Mike Crapo (R-ID) also emphasized the importance of bipartisanship in addressing the current mental health crisis, expressing his hope of replicating the success of the Secure Act (2019). Despite this optimism, Crapo highlighted the importance of fiscal integrity in developing the bill. He argued that all provisions within it would have to be fully paid for, and that the Senate must be thoughtful and cautious to avoid exasperating the current fiscal crisis, citing current inflation levels.
In December of last year, U.S. Surgeon General Dr. Vivek Murthy released his advisory, ‘Protecting Youth Mental Health’. In his testimony, Dr. Murthy focused on four components of his advisory: Ensuring everyone’s child has access to high quality, affordable, and culturally competent mental health services; Focusing on prevention, by investing in school and mental health services; Understanding the impact of technology and social media on today’s youth; and Addressing stigma around mental health.
Dr. Murthy claimed that underlining the current crisis is a pervasive stigma around mental health which bars people from seeking the help they need. When asked about Chairman Wyden about how Congress may address this issue, Dr. Murthy said that stigma could not be legislated away, rather, conversation about mental health would have to be opened. He added personal testimonies from political figures and family members would tell today’s youth that they are not alone and would allow them to talk about their own struggles without fear of stigma.
During the question portion of the hearing, Wyden asked Dr. Murthy about his assessment of the current situation with parity. Dr. Murthy said that parity did not exist for many people. He referenced the Biden Administration and HHS’s recent report on coverage gaps, citing the report’s efforts to increase the individuals who are investigating reports, requiring insurance companies to disclose information regarding coverage, and providing technical assistance to states as imperative steps to addressing the coverage gap.
When asked about mental health equity by Senator Bob Menendez (D-NJ), Dr. Murthy pointed out the inadequate representation in the mental health workforce and how this contributes to mistrust and the inadequate access underserved communities have to mental health services. Murthy recommended training institutions be more proactive and invest more in recruitment to diversify the mental health workforce. Dr. Murthy also cited loan forgiveness as a means to recruit minorities into healthcare earlier on in their education.
General Murthy also emphasized the importance of bringing the care to people where are and drew attention to the success of school and community-based programs. Studies have found that, on average, it takes 11 years between the first symptom onset and the provision of first treatment. The Surgeon General said that care closer to home offered a means of more preventative care. Such care, where implemented, whether to address substance use, prevention of unplanned teen pregnancy, and mental health issues showed success while the program itself remained cost effective.
In schools, teachers can serve as a sort of ‘first responder’ to children’s mental health needs and identify issues earlier on. With the American Rescue Plan, schools were given money for mental health services, and Dr. Murthy emphasized the importance of sustaining such services. While recognizing that mental healthcare in schools is important, Dr. Murthy also argued that teachers alone should not be responsible for providing such services, and technical assistance must be provided to schools in order to better implement services.
The impact of technology and social media was another major theme present. In response to Senator Crapo’s question regarding the importance of telehealth in expanding access, Dr. Murthy answered that telehealth had tremendous promise, but ultimately it is a supplement not a substitute. He pointed out, for telehealth to be properly utilized, broadband access would have to be expanded, services would need to be reimbursed adequately, and privacy concerns would need to be addressed. Regarding the roll of social media, Dr. Murthy said that children are currently in a large-scale experiment on the impact of social media. He argued that public health experts should be the ones to analyze the data, not the companies alone, and that such data should be utilized to determine children who are at risk so families can better make decisions for their care.
Last November, the Child Welfare League of America submitted its recommendations to the Senate Finance Committee on how the Committee and country can make critical changes to the nation’s mental health and substance use treatment systems.
