Our country is at a crossroads. Millions of Americans are reporting increased rates of anxiety, depression, substance use and suicides. The shared trauma brought on by the pandemic, a national reckoning around systemic racism and our broken approach to mental health have all laid bare the need for change.
As we roll up our sleeves for vaccines that protect our bodies, we must demand that the nation’s leaders do more to protect our minds.
President Biden has a long history of support for increased access and equity for mental health care. Now that he’s in the White House, he must put pen to paper and realize the meaningful changes for mental health care that he envisioned.
Then-former Vice President Biden told the audience at the 2018 Global Summit on Mental Health Culture Change, “We need to ensure [people] have access to health care providers in rural areas or [in places with] few medical facilities, and we need to ensure that insurance policies include mental health.”
Now, Biden — with solid support from the Congress — can do just that. Inseparable, the national mental health nonprofit that I founded in 2020 following the loss of my brother to depression, is calling on the administration and Congress to address three urgent priorities to improve mental health care for all Americans.
First, we must increase access to help. To put it simply, there’s a huge treatment gap between those who need help and those who receive it. Less than half of the people in America who need treatment for mental health issues receive the care they need — that’s more than 26 million people left untreated. For those with health insurance, navigating the mental health care system can be confusing and services are often not included in coverage as they should be. For those without insurance coverage, access to mental health services can be financially out of reach, creating an additional barrier to seeking treatment. For people of color, LGBTQ people, veterans, those suffering from postpartum depression and Native Americans, the need for care can be even greater.
Closing the treatment gap and increasing access to care includes addressing affordability, expanding insurance coverage, integrating mental health into primary care and building a much bigger, culturally and linguistically competent workforce.
Second, the administration should increase investment in prevention and early intervention — this means focusing mental health education and resources on young people, giving them the tools they need to cope from an early age. Half of all mental illness presents before age 14. In 2018, suicide was the second leading cause of death for ages 12 to 18 and college-age youth. As the pandemic rages on, learning patterns are being disrupted for children of all ages, increasing social isolation and putting children at an increased risk with less access to support. In 2020, there was a 24 percent increase in emergency room visits for mental health reasons for kids aged five through 11 and more than a 30 percent increase for kids between ages 12 and 17. We need urgent investments in prevention and early intervention to give every child in America a chance for a hopeful, healthy future.
Comprehensive school mental health systems have been proven to create positive, nourishing school climates by ensuring students have access to support systems and vital, age-appropriate mental health and wellbeing knowledge and skills from K-12. Investments in prevention and early intervention with children and adolescents will strengthen resiliency and also create significant savings down the line.
Finally, the Biden administration and the Congress must put an end to the criminalization of mental illness and addiction. Mental health and addiction are some of the only medical conditions that we routinely criminalize in the United States. A conservative estimate says 900,000 people with mental illness end up in our jails every year. To put that into perspective, the Los Angeles County jail is the largest mental health provider in the country. That’s unacceptable.
It’s time we prioritize treatment over punishment for people with mental illnesses. The administration should work with lawmakers to develop a federal strategy for the decriminalization of mental health and reform of crisis response systems.
To achieve better mental health care access and equity will require action from all agencies of government, a holistic “whole of government” approach similar to what the Biden administration is doing around climate change. Mental health cannot simply be left to Health and Human Services (HHS); rather, it’s a critical issue that must be addressed by the Department of Labor (DOL) through employee insurance coverage mandates; Veterans Affairs (V.A.), which needs to receive more resources to meet the overwhelming needs of veterans and service members in crisis; the Department of Education (DOE) through promoting school mental health to help young people take ownership over their mental health and address substance use from a young age; and every agency that holds a stake in the fight for American wellness.
To that end, the president’s newly-appointed Cabinet heads, including at the HHS, DOL, among others, make clear this administration's firm commitment to improved mental health care.
Health care policy in this country must reflect the simple reality that the health of our bodies is inseparable from the health of our minds. The Biden administration not only has the power but also the moral imperative to tackle the mental health crisis head on. Now, it just needs to decide it wants to.
Bill Smith is the founder of Inseparable, a leading mental health advocacy organization.