Hillary Clinton has released an ambitious plan on mental health, declaring a goal “that within her time in office, Americans will no longer separate mental health from physical health when it comes to access to care or quality of treatment.”
The plan focuses on early diagnosis and intervention—early meaning maternal depression and infant mental health as well as resources in schools and elsewhere in the lives of children and young people—federal support for suicide prevention; improved outcomes in the criminal justice system, where “As many as 1 in every 10 police encounters may be with individuals with some type of mental health problem”; brain and behavioral science research; and housing and job opportunities. Centrally, Clinton’s plan involves integrating healthcare systems and expanding community based treatment, “so that high-quality treatment for behavioral health is widely available in general health care settings” and expanding reimbursement systems for collaborative care models in Medicare and Medicaid.
One of the most important goals for improving mental health care is reaching parity:
The Mental Health Parity and Addiction Equity Act of 2008, which Hillary proudly co-sponsored, requires that mental health benefits under group health plans be equal to benefits for other medical conditions. The Affordable Care Act built on this important law by requiring that insurance plans offered in the individual and small group markets offer mental health coverage as an essential health benefit. But while the right laws are on the books, they are too often ignored or not enforced. Millions of Americans still get turned away when seeking treatment for mental illness, even when the interventions are well-established and evidence-based. A recent report published by the National Alliance on Mental Illness suggested that a patient seeking mental health services is twice as likely to be denied coverage by a private insurer as a patient seeking general medical care.
Clinton’s plan would strengthen monitoring and enforcement to promote the parity the law calls for.
As with any other plan requiring legislative action, a Republican Congress would likely stand in the way of big chunks of this agenda, but it’s also clear that Clinton’s team has thought through what could be accomplished without Congress and is planning accordingly.
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