President Biden Elevates Behavioral Health as a Top Administration Priority

Ron Manderscheid, PhD

We all owe President Biden a huge debt of gratitude for elevating America’s behavioral health to a key priority in his first State of the Union address on March 1st. Not only did he put a topic many are unwilling to discuss on the national agenda, he also correctly diagnosed that the behavioral healthcare field currently is in crisis, and he identified the key steps necessary to resolve it. Kudos to you, Mr. President!

The President’s Plan for addressing our behavioral health crisis, including our current opioid use crisis, focuses on three key steps: Expand the behavioral healthcare workforce; improve access to care; and make social environments more supportive, particularly for children and youth. An overview is available at:?see this fact sheet. Below, I present a high-level summary.

Expand the Workforce.?In several blogs, earlier this year, I described the outlines of our workforce crisis in behavioral healthcare. Stated most simply, we currently do not have enough behavioral healthcare providers to reach more than about one in four children or adults who experience a behavioral health issue.

The President will include $700 million in his FY23 Budget for training of behavioral healthcare professionals through the National Health Service Corps, the Behavioral Health Workforce Education and Training Program, and the Minority Fellowship Program. He also will use $225 million in current FY22 funds and propose additional FY23 funding to train a paraprofessional workforce, including community health workers and other health support workers, to bring behavioral health support to underserved communities. Further, he proposes to develop, launch, and support a national peer specialist certification program.

Through the American Rescue Plan, the Administration already has dedicated $103 million to address burnout and strengthen resiliency among healthcare workers. Further, an additional $180 million is being used to develop local capacity to answer crisis calls and implement mobile crisis response teams for the new 988 system, which will be launched in July. The President will build on this investment by requesting an additional $700 million to staff up and shore up local crisis centers.

In related steps forward, the President will propose in the FY23 budget to make the Certified Community Behavioral Health Clinic Program permanent; to grant States funding to expand these facilities for the communities that need them most; to extend funding permanently for Community Mental Health Centers; and to invest $5 million in research for promising treatment models.

Improve Access to Care.?Workforce is not the only factor limiting access to care. Other key elements include insurance coverage, service organization, and service location. President Biden’s Plan addresses each of these.

The President will strengthen the 2008 Mental Health Parity and Addiction Equity Act in his FY23 budget by proposing that all health plans cover robust behavioral healthcare services with an adequate network of providers, including three behavioral health visits each year without cost sharing. He also will propose doubling the funding for integration of primary and behavioral health care; will request that HHS test new payment models that support the delivery of whole person care through integrated programs; and authorize Medicaid reimbursement of inter-professional consultations.

Also, of great concern to the behavioral healthcare community, the President will work with the Congress to ensure coverage of tele-behavioral health care across health plans and delivery of telecare across state lines.

Other related elements of the President’s Plan are intended to bring care where “Americans already live, work, and play.”?The President’s FY23 budget will include $50 million to embed mental health services in non-traditional settings like libraries, community centers, schools, and homeless shelters. American Rescue Plan funds of $160 million already are being used to train and recruit providers for schools, colleges, and universities, as part of the President’s commitment to double the number of school-based mental health professionals. Finally, the VA will expand veterans’ access to same day mental health care. To improve access through navigation, the President proposes building user-friendly, online, treatment locator tools.

Create Healthy Environments.?The President notes that the mental health “crisis is not a medical one, but a societal one.” Thus, he presciently proposes to address the determinants of behavioral health, invest in community services, and foster a culture and environment that broadly promotes mental wellness and recovery.

To begin this important work, the President proposes to increase behavioral health resources for justice-involved populations and to train social and human service professionals in basic mental health skills so that they are prepared to recognize and respond to signs of mental illness and addiction among those that they serve.

For children and adolescents, the President proposes to strengthen children’s privacy and ban targeted advertising for children online; institute stronger online protections for young people; stop discriminatory online algorithmic decision-making that limits opportunities for young Americans; and invest $5 million in FY23 for research on social media’s harms.

Clearly, the President’s Plan is very thoughtful and forward thinking. He deserves our grateful appreciation and our best advocacy efforts to move his agenda through the Congressional legislative process.

March 2, 2022

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