How Do We Fix America’s Mental Health Care System?
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At the end of February at the Newseum in Washington, D.C., the Hill hosted a event on the economic and human consequences of policies that limit access to treatment to mental health services. The event, entitled Fixing America’s Mental Healthcare System, featured policy leaders in a discussion about limited access to treatment for people living with mentally illness.
The event included a keynote interview with Senator Chris Murphy (D-Conn.) and Congressman Tim Murphy (R-Pa.), followed by a case study presented by Dr. Seth Seabury, of the USC Schaeffer Center for Health Policy and Economics and a panel discussion with four leaders in the mental health care movement.
In light of the significance of the Patient Protection and Affordable Care Act, the overall goal of the event was to discuss the gaps that still exist in America’s mental health care system and possible actions we as a the nation could take to close them.
Editor-in-chief of the The Hill, Bob Cusak, gave opening remarks and introduced Sen. Murphy and Rep. Murphy who then discussed the key challenges with the current mental health system, many of which they hoped to rectify with proposed legislation. The most critical issue regarded the treatment and approach to mental illness—how it is often treated as an attitude problem as opposed to a medical condition.
Rep. Murphy stated that only a small fraction of the nearly $130 billion appropriated by the federal government for mental health finds its way down to families or communities. “We do not have to wait for another tragedy to pass this bill,” Sen. Murphy declared.
Following the interview Sen. Murphy and Rep. Murphy, Dr. Seabury presented a case study on findings related to Medicaid access and restrictions on psychiatric drugs. He noted that costs are cut through prior authorization, a procedure that requires a prescriber to obtain permission to prescribe a medication prior to prescribing it, and step therapy restrictions, the practice of starting drug therapy for a medical condition with the most cost-effective and safest drug, then progressing to other more costly or risky therapy. However, the cost savings did not improve outcomes and were not beneficial to the actual people receiving medication.
Seabury argued that removing these restrictions would benefit those living with mental illness and would not harm federal government spending.
The panel discussion with four mental health experts closed the event. Here is a brief summary of what each of the experts had to say:
Matt Salo, Executive Director of the National Association of Medicaid Directors, supported the implementation of comprehensive mental health reform, but was wary of federal expenditures. He stated that the federal government would consider providing more integrated mental health care only if the costs were low.
Allen Doederlein, President of the Depression and Bipolar Support Alliance, described the benefits of integrating his personal experience when advocating for patient-centered therapy. Doerdelein’s experience suggested that a peer-specialist who has experienced a patient’s hardships firsthand could provide more effective methods of treatment, leading to more successful recovery.
Dr. Ron Manderscheid, Executive Director of the National Association of County Behavioral Health and Developmental Disability Directors, believes that the public needs to change its language when discussing mental health. He stressed the importance of early mental illness identification, since early targeting can lead to quicker recoveries.
Dr. Azfar Malik, the CEO and Chief Medical Officer of CentrePoint Hospital, emphasized the lack of focus on mental health among health care professionals. In the field, Dr. Malik has been forced to prescribe ineffective medications to people simply because of prior authorization and step therapy regulations currently in place.
While the event itself wasn’t able to implement an immediate plan of action to solve the situation that we are still faced with, it did offer up a few excellent ideas that set the table to come up with a solution. With each suggestion, the federal government and American public has hope of filling the gaps and providing comprehensive mental healthcare in the near future.
Teaser photo courtesy of The Hill. The Hill's Bob Cusack, Sen. Chris Murphy (D-Conn.), and Rep. Tim Murphy (R-Pa.) makes a keynote speech during a policy briefing entitled "A Discussion on Fixing America's Mental Healthcare System" sponsored by Takeda Pharmaceutical, Lundbeck and The Hill at the Newseum in Washington, D.C., on Thursday, February 26, 2015.