Hillary Clinton has just released a plan would treat mental health care with the same priority as physical health care. It’s a well-thought-out, comprehensive policy that deserves attention and support. And, according to some observers, it actually has a chance of becoming a reality. Unfortunately, the announcement of the plan came in the midst of the media clamor over Donald Trump’s bogus trip to Mexico and his hate-fueled immigration speech.
Clinton’s plan calls for some very important changes to the way mental health care is currently addressed in the American healthcare system, where it has long been a neglected stepchild.
In broad terms, according to the Clinton website, the plan would
Promote early diagnosis and intervention, including launching a national initiative for suicide prevention.
Integrate our nation’s mental and physical health care systems so that health care delivery focuses on the “whole person,” and significantly enhance community-based treatment
Improve criminal justice outcomes by training law enforcement officers in crisis intervention, and prioritizing treatment over jail for non-violent, low-level offenders.
Enforce mental health parity to the full extent of the law.
Improve access to housing and job opportunities.
Invest in brain and behavioral research and developing safe and effective treatments.
More specifically, the big-ticket item in Clinton’s plan is, according to the Washington Post,
…$5 billion for community health centers providing substance abuse and mental-health treatment as well as traditional medical care…To address a shortage of mental-health professionals, meanwhile, she would encourage telemedicine, among other things. Clinton also proposed pumping up the budget for basic scientific research, some of which would be diverted into studying the brain.
There’s no doubt that these priorities merit attention. According to a government study, about 1 in 5 adults — or 43.6 million people — had a mental illness in 2014, with nearly 10 million of those experiencing a serious condition, such as schizophrenia or bipolar disorder. The same study said that 2.8 million adolescents had a major depressive episode during the past year.
Unfortunately, conventional payment systems have shortchanged mental-health care. While the Affordable Care Act [Obamacare] made some significant changes in requirements for mental health coverage, there is much room for improvement. The good news, for example is that,since 2014, health insurance companies offering individual and small-group plans can no longer deny enrollment or charge higher premiums to people with medical histories of behavioral/mental health disorders. Also under the ACA, individual and small–group plans are required to cover ten essential health benefits with no annual or lifetime dollar limits. Mental health and addiction treatment are among the essential health benefits. Nor can these plans offer mental-health benefits that are less favorable than the benefits for medical/surgical care.
But the National Alliance on Mental Illness published a report in 2015 detailing problems with access to behavioral health providers, and limited coverage for some brand-name drugs, particularly anti-psychotics, says healthinsurance.org. .The report also notes that health insurance companies are still more than twice as likely to deny authorization for mental health care, compared with authorization for general medical care.
Clinton’s plan, says the Washington Post, “emphasizes using the federal government’s role as a major payer in the health industry to encourage the integration of mental-health care into medical practices.”
As for practicality, Clinton’s plan is not just another pie-in-the-sky idea with no hope of implementation. The Washington Post notes that…
Congress has over the past several years put serious effort into reforming the federal government’s mental-health efforts, producing — but not yet passing — a slew of bills with bipartisan backing. This is one of the few issues on which lawmakers may be able to agree, even in a severely divided Washington, over the coming months. The House, in fact, has already passed a bill. Ideally, the Senate would pass its own reform before next year. But, if lawmakers fail to send a bill to President Obama — always a high likelihood given Congress’s slow pace — the next president should enter the policy debate, pressing for lawmakers to finally pass something.
As far as I can tell, there’s no parallel proposal from the Republican nominee, whose candidacy has been, essentially, a policy-free zone [until recently, when he doubled-down on an outrageously hateful, xenophobic immigration “plan.”]
For those of us seeking a President who has actual policy ideas designed to help people, and who is willing to do the work necessary to bring them to life, Hillary Clinton’s mental healthcare plan is very reassuring. I’m voting for the policy wonk.