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Senate begins work on bipartisan mental health package

Experts call for provisions to boost the mental health workforce and crisis treatment

Sen. Patty Murray, D-Wash., has asked HHS Secretary Xavier Becerra for a plan for after the Supreme Court decision, but said she recognizes there are limits to what can be done federally.
Sen. Patty Murray, D-Wash., has asked HHS Secretary Xavier Becerra for a plan for after the Supreme Court decision, but said she recognizes there are limits to what can be done federally. (Caroline Brehman/CQ Roll Call file photo)

Top senators on an influential health committee indicated at a hearing Tuesday that they plan to work on a bipartisan mental health and substance use package this year.

The COVID-19 pandemic has seen record numbers of drug overdose deaths and rises in the number of individuals reporting symptoms of anxiety and depression. Experts have renewed calls for increased resources for children’s mental health, expanding access to mental telehealth and broadening the continuum of care for individuals in crisis situations.

Bipartisan interest has been brewing for a significant legislative package to address growing mental health needs. Senate Finance Committee leaders began work on their own bipartisan package last fall and are expected to unveil their next steps Feb. 8 in their own hearing on youth mental health with Surgeon General Vivek Murthy. Finance leaders had aimed to put together a bipartisan mental health proposal by the end of last year.

The House Bipartisan Addiction and Mental Health Task Force released its own bipartisan package of 66 bills in September. And the House Ways and Means Committee will hold its own mental health hearing on Wednesday.

Senate Health, Education, Labor, and Pensions Chairwoman Patty Murray, D-Wash., renewed calls at the hearing Tuesday for a comprehensive mental health package.

“If we’re going to respond to the behavioral health issues the pandemic has made worse, it’s clear we have to build on these efforts. That will take legislative action,” she said. “My goal is to work with ranking member [Richard M.] Burr to fold these priorities into a larger package that makes progress on many of these issues that we’re going to hear about today.”

Sen. Lisa Murkowski, R-Alaska, who filled in as ranking member for Burr, R-N.C., echoed Murray’s push for working across party lines.

“While there is a lot that divides us these days, mental health and substance abuse are areas where we are finding true bipartisan consensus. And I hope we can build a legislative package that addresses these issues head-on,” she said.

Murkowski previewed a bill she will introduce later this week that would protect Coast Guard members from being discharged for seeking mental health treatment. She and Sen. Jacky Rosen, D-Nev., also plan to introduce a separate bill that would fund school mental health programming through Substance Abuse and Mental Health Services Administration grants.

Additional concerns

Witnesses highlighted several policies related to workforce and treatment that they say should be included in the legislation the committee plans to consider this year. 

Mitch Prinstein, chief science officer at the American Psychological Association, called on Congress to allow trainees in psychology to be reimbursed under Medicare, similar to medical residents.

“Doctoral interns in psychology have an average of over 700 hours of independent direct patient care experience, more than most medical residents, and we can mobilize thousands of mental health care workers quickly,” he said.

Michelle P. Durham, vice chair of education in the department of psychiatry at Boston Medical Center and the Boston University School of Medicine, highlighted concerns about treatment silos, with providers who may only want to work with substance use issues or mental health issues rather than both.

“That adds complexity when people want to go for care and they have to go to many different providers to get the treatment that they need,” she said.

This comes as the need for treatment has increased exponentially.

“In my over 10 years at BMC academic medical center in New England’s largest safety net hospital,  I’ve never seen our mental health care services stretched so far beyond their capacity as they are now,” she said.

Murkowski echoed the witnesses’ focus on workforce issues.

“My hope is that we build out a package of focus on mental health and really key in on the workforce issues because I think we recognize that in all our states, we are sorely, sorely lacking,” she said.

Increasing crisis care, especially related to suicide prevention, was another major theme.

A three-digit suicide hotline – 988 – rolls out in July, and Sen. Tammy Baldwin, D-Wis., a lead lawmaker in getting the designation passed by Congress, asked what next needs to be done before the number change is in effect nationwide.

“988, as we know, is the starting place,” said Jennifer D. Lockman, CEO of Centerstone Research Institute, who called for making sure mobile crisis systems are well-equipped and maintained to make sure there is diversion from emergency departments. 

Sara Goldsby, director of South Carolina Department of Alcohol and Other Drug Abuse Services, also called on Congress to elevate substance use disorders as a core focus.

Claire Rhyneer, a mental health youth advocate from Alaska, said she experienced a difficult and dark period and experienced self-harm a few years ago, before becoming an advocate for other youth experiencing mental health issues.

“I’m more than an anecdote,” she said, adding she has heard from many friends who have experienced suicidal ideation. “We need to support school counselors, station social workers in schools, fund wellness programs, and introduce mental health curriculums into health classes where they belong.”

Murray ended the hearing by saying she plans to work with Murkowski and the rest of the committee on learning more about the causes that lead to suicide deaths. She said there needs to be an understanding that this cannot be a taboo topic.

988 is not yet active. If you or someone you know is facing a suicidal crisis, please call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to be connected to a trained counselor.