Committee calls for creating a 'care continuum' to meet unmet needs of patients with serious mental illness
A federal committee tasked with recommending ways the federal government can help provide more mental healthcare says the system is ill-equipped.
The Interdepartmental Serious Mental Illness Coordinating Committee established under the 21st Century Cures Act reported to Congress on Thursday that there aren't enough psychiatric beds and community-based alternatives to hospitalization, and that more first responders need training to deal with the mentally ill and that there should be universal screening for mental illnesses and substance use disorders.
"It is crucial to provide access to evidence-based mental health care before people experience negative outcomes," said Dr. Elinore F. McCance-Katz, assistant secretary for mental health and substance use and chair of the ISMICC. "Our health care system can do better, and the federal government can marshal its resources to help make that happen."
The ISMICC was one of a number of provisions included in the 21st Century Cures Act that focused on improving mental healthcare access, including a requirement that insurers provide the same level of coverage for behavioral healthcare services as they do for physical health.
Congress has asked several times for progress on the law. Yesterday, some lawmakers lamented the lack of funding available to implement many of the most significant provisions that aimed to fix a broken system.
"I hope that the public sees this as really a sea change in the focus on severe mental illness on the federal level," said John Snook, executive director for the Treatment Advocacy Center and a member of the committee that drafted the report to Congress. "For too long, there just wasn't a focus on the crisis that families were experiencing every day."
More than 10 million adults in the U.S. were living with a serious mental illness in 2016, and more than 7 million children and youth experienced a serious emotional disturbance.
A disproportionate number of adults with severe mental illness live with poor access to social supports, in poverty, and have higher rates of co-morbid physical health conditions like heart disease and diabetes compared to the general population. As many as 2 million such adults are incarcerated every year. While there, only one in three receive treatment.
The committee's report found the biggest barrier to be the shortage of behavioral healthcare professionals. There are shortages of psychiatrists within 96% of U.S. counties. Overall, their number has decreased by 10% between 2003 and 2013.
One of the goals of the committee was to develop ways to improve the system in order for it to provide a "continuum of care." Recommendations toward that end included making mental health screening and early intervention a national standard for children, eliminating the use of solitary confinement and restraints, and training all first responders on the best ways to work with a person they encounter whose experiencing severe mental illness.
Approximately 35% of adults with mental illness in 2016 did not receive treatment, according to the report. The committee called for greater access to treatment like cognitive behavioral and dialectical behavior therapies. The report also recommended providing additional resources toward addressing substance use disorders among those with severe mental illness SMI, where only 12% out of the estimated 2 million living with both conditions received treatment for both in 2016.
Approximately 35% of adults with mental illness in 2016 did not receive treatment, according to the report. The committee called for greater access to treatment like cognitive behavioral and dialectical behavior therapies.
Snook said the committee will discuss how to turn the report's findings into actionable policy decisions.
"That will be the measure of success whether or not these just end up as smart ideas on a shelf or if they actually change the way we provide the level of care throughout the country," Snook said.
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