The Efficacy of the Helping Families in Mental Health Crisis Act of 2016 in Improving Conditions for the Mentally Ill and Increasing Access to Mental Healthcare Nationwide
Matthew D. Lovesky
Class ID: AB-F1742
University of Florida
Abstract
This paper explores modern mental health issues and the various methods that the government of the United States has used to improve these issues. These include the Helping Families in Mental Health Crisis Act of 2016, which was passed as H.R. 2646 in the House of Representatives. The H.R. 2646 improves community crisis response systems, the mental health workforce, early intervention services, the integration of health and mental healthcare, and evidence-based and seemingly efficient practices of assisting the mentally ill. It also helps to combat and prevent suicide, clarify health privacy laws and increase reporting on mental health parity. The H.R. 2464 is not perfect and still leaves issues unresolved. While it does improve access to, and the quality of, mental healthcare, it fails to address issues of incarceration of the mentally ill. Additionally, the Act does little to assist uninsured individuals with mental disorders. Since they still lack insurance, they also lack access to mental healthcare. This paper examines the Helping Families in Mental Health Crisis Act of 2016 itself from the website of the U.S. Congress. It also examines a report entitled The State of Mental Health in America 2017 from the Mental Health America Incorporation, detailing the issues regarding mental health in modern American society. Finally, it uses an article entitled “A Closer Look at Mental Health Reform Legislation” from the National Alliance on Mental Illness to consider the issues that the H.R. 2646 addresses from the report.
The Efficacy of the Helping Families in Mental Health Crisis Act of 2016 in Improving Conditions for the Mentally Ill and Increasing Access to Mental Healthcare Nationwide
The issues of access to mental healthcare and the quality of mental healthcare have long been present in the United States, but recently they have reserved a spot in the societal and political limelight of this nation. It is likely that this is due to deinstitutionalization, which, for many reasons, was a great progression in the field of mental health and proper healthcare. It increased humane treatment of the mentally ill and provided better, more accurate healthcare and treatment. On the contrary, it gave rise to many new issues that the U.S. must now conquer. The mentally ill now face issues with substance use, access to mental healthcare and insurance, and many other systemic obstacles. The United States, Congress specifically, struggles to find a comprehensive solution to the issues regarding mental health but has made some progress with the passing of H.R. 2646 in the House of Representatives. It greatly improves the lives of the mentally ill by providing them with more accessible mental healthcare and ensuring that the necessary members of our society are able to properly care for them. This includes law enforcement officials and mental health professionals such as psychiatrist, psychologists, and social workers. The passing of H.R. 2646, however, did not solve every issue. It still leaves the uninsured without access to proper mental healthcare. It also fails to implement programs to facilitate the transition of the mentally ill in and out of incarceration facilities. The H.R. 2646 is a tremendous improvement for the mentally ill in America; however, it still lacks many necessary changes that need to be made in order to fully address every issue regarding mental health and to provide individuals with mental disorders with the full, comprehensive treatment that they require.
Issues with Mental Health Care
The issue of access to, continuity of, and quality of mental healthcare have long been issues in the United States. Fortunately, our nation has made progress with the passing of the H.R. 2646. This bill made tremendous improvements to mental healthcare for all those requiring it, and for those that provide it. Although it did much good to benefit our society, the bill still lacks some important qualities that would help to bring our nation’s mental healthcare system to near perfection.
Insurance Issues
Improving the mental healthcare system of the United States has taken time and still has a long way to go. This is, in part, due to the fact that healthcare seems to be a partisan issue in Congress when it should not be. It is even more difficult for them to come to a consensus on the specific issue of mental healthcare, giving rise to many issues within the mental healthcare system. For example, states have different policies regarding insurance, making it difficult for clients to access proper care in their states and when crossing borders.
Access to Healthcare. Individuals also face issues acquiring care for mental health illnesses when they are uninsured. According to the report, The State of Mental Health in America 2017, by Nguyen and Davis (2017), 17% of adults with a mental illness do not have health insurance that covers the treatment they require. It also reports that one out of five adults with a mental illness do not receive the care they need whether they have health insurance or not (Nguyen & Davis, 2017). This lack of access to healthcare creates many problems. It is more likely for an individual with a mental illness who does not receive proper treatment to end up in a prison or jail than a person with the same mental illness who does receive care. States with the lowest recorded access to mental healthcare also have higher rates of incarceration (Nguyen & Davis, 2017). When it is very difficult for a person to obtain mental healthcare, they often end up in the criminal justice system because of their mental illness and its manifestations. Furthermore, over half of the individuals that are currently incarcerated have a mental illness, and most do not receive treatment while in prison or jail (Nguyen & Davis, 2017). It is not the fault of the individual, but rather the fault of our nation’s mental healthcare system.
Quality of Healthcare. Each individual requires different care, and sometimes healthcare for mental illness is incomplete. Physicians can fail to provide the necessary treatment and services; mental illness may go undiagnosed, untreated, or improperly treated in many individuals. Physicians and mental health professionals need more training in this area. Patients also face difficulty accessing proper care after they have received a diagnosis due to systemic barriers. These include lack of insurance or inadequate insurance. There can also be a lack of treatment providers because not all insurances are accepted universally. Individuals without acceptable insurance plans can be denied or forced to pay expensive bills for treatment. In addition, there can be a lack of necessary treatment types. Sometimes the treatment is not immediately available to the individual. These issues delay treatment, block access to physicians, and inhibit access to medications. In a recent report, approximately 56.5% of adults with a mental illness could not receive proper treatment for a combination of the reasons listed above (Nguyen & Davis, 2017). Youth in the United States are more likely than adults to be insured, but this does not mean that mental healthcare is covered under their insurance. According to the report, 64.1% of youth suffering from major depression did not receive treatment (Nguyen & Davis, 2017). The quality of health insurance and mental healthcare require improvement.
Mental Health Workforce. A major necessary improvement to the mental healthcare system pertains to the individuals that operate it. There is only one mental healthcare provider per 529 individuals (Nguyen & Davis, 2017). These providers include psychiatrists, counselors, psychologists, and therapists among others. Currently there are only 51,403 psychiatrists out of 479,346 total active specialized physicians (Kaiser Family Foundation, 2017). There are even less mental health professionals who are specialized (i.e. child psychiatrists), so it is difficult to find treatment for specialized cases.
Solutions of H.R. 2646
The passing of the Helping Families in Mental Health Crisis Act of 2016 in the House of Representatives was a huge improvement for mental healthcare. It improves services, members and standards of the mental health workforce. It also works to prevent suicides and promote early intervention services. Most importantly, it helps to merge mental healthcare with general healthcare to create an effective method of treatment.
Improving Services and the Workforce
The Helping Families in Mental Health Crisis Act of 2016 improves crisis response services and supports the mental health workforce. It allows individuals with mental illnesses to get help before their condition worsens. The act provides grants for improving services that immediately respond to psychiatric crises. It ensures that professional members of society such as law enforcement officials and first responders are properly trained to work with the mentally ill. The members of the mental health workforce are also now better trained and prepared to deal with patients who have mental health related issues. It allows for an increase in pediatric mental health professionals as well as liability protections for volunteers in the mental health field so that more professionals may now provide services.
Suicide and Intervention. The bill does a great deal to combat suicide and promote early intervention and prevention of mental illness and suicide. It specifically targets suicide in schools, universities and communities and especially among youth. It extends preexisting suicide prevention services listed under the Garret Lee Smith Memorial Act to include more individuals in order to increase access to help. Furthermore, it promotes awareness for substance use disorders which have a strong correlation with mental health issues. Finally, it places the National Suicide Prevention Lifeline into federal statute so that it may remain a resource. It especially promotes programs that support mental health in infancy and early childhood to catch the problems early and hopefully provide preliminary care before the condition worsens.
Comprehensive Healthcare and Services. The H.R. 2646 strongly supports the legal integration of mental healthcare with general healthcare. Now individuals receive care that treats the entire person rather than just a single condition, and many mental health and substance use services can be billed to Medicaid. With about 20 million individuals enrolling in various insurance programs after the passing of the Affordable Care Act, it is essential that these individuals have equal access to healthcare and treatments especially those that face mental health issues (Young et al., 2014). Mental health can no longer go unsupported by insurance policies, and thankfully it will not be for those with Medicaid.
Improving the Legality of Mental Healthcare. The H.R. 2646 clarifies laws so that mental health professionals and patients know their rights. It also adds a training program to better educate physicians and insurance professionals on the laws of the Health Insurance Portability and Accountability Act of 1996. Most importantly, it ensures that health insurance plans must properly cover mental health and substance use conditions. Finally, it requires that the Assistant Secretary for Mental Health and Substance Use be a mental health professional so that he or she is well informed on the mental healthcare system and the patients that it treats. Legally, the H.R. 2646 has greatly improved the treatments and services for the mentally ill.
Remaining Issues and Solutions
Though the Helping Families in Mental Health Crisis Act of 2016 has made incredible improvements for mental healthcare, it fails to address incarceration. Many individuals with mental illnesses face incarceration at some point in their lives. When in prison and jail, only some individuals receive care for their conditions; many others go unnoticed.
Solutions to Incarceration Issues
In order to better facilitate the incarceration of the mentally ill, the nation must first invest in diversion methods, such as mental health courts and pre-booking diversions. These allow for mentally ill individuals in legal trouble to be referred to other resources. These resources include treatment for an illness that may be out of their control. We must also ensure the continuity of healthcare for individuals once they have been either incarcerated or released. Individuals can lose treatment when incarcerated or receive treatment while incarcerated and lose that treatment when they are released. This includes loss of medications which is extremely dangerous for individuals who rely on medication as a treatment. Transitional support systems are necessary for incarcerated individuals with mental illnesses. The government must also invest in research on the correlation between mental illness and incarceration to find a solution to the growing problem. Investing in treatments can greatly reduce the rate of incarceration for the mentally ill. It is essential that the issue of incarceration is addressed early on where it matters most: in schools. This is especially important for students with disabilities who are already predisposed for behavioral misconduct in school and, later in life, incarceration. It is essential to use intervention services, screenings, and community resources in schools so that children are supported throughout their lives and avoid incarceration.