The State of America’s Mental Health System

Yesterday, the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing assessing the state of America’s mental health system. Chairman Tom Harkin (D-IA) and Ranking Member Lamar Alexander (R-TN) welcomed two panels of witnesses to discuss mental health in America and how to improve access to mental health services for individuals with mental illnesses and/or disorders. In his opening statement Chairman Harkin acknowledged that the hearing was long overdue as the HELP committee hasn’t held a hearing on mental health since 2007. He also explained the stigma associated with mental illness, which he referred to as the nation’s silent epidemic. Citing recent statistics, he pointed to the fact that most mental health conditions begin by adolescence. Harkin went on to talk about the need for mental health parity by clarifying that although the Mental Health Parity and Addiction Equity Act (MHPAEA) was enacted over four years ago, the Obama Administration has yet to issue a final rule. Alexander, newly elected to his post as Ranking Member, expressed his hope for the bipartisan fashion in which he expected to be able to work with the Chairman and described his role in the hearing as being one of a listener first and foremost. He said his goal of the hearing was to learn who needed help, who provided that assistance, and how the federal government could help facilitate that process.

The first witness to testify before the committee was Pamela Hyde, Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA). She testified to the prevalence of mental illness and substance use disorders, gaps in treatment, and the need for more training of mental health professionals.  She also lauded the Administration’s recent efforts to change the conversation regarding mental health in this country. During question and answer she was asked by the Chairman and others to clarify when the Administration would release the final rule on mental health parity to which she noted that the process was ongoing.

Dr. Thomas Insel, Director at the National Institute of Mental Health offered testimony on the research associated with improving the quality of care provided to those with mental illness. He focused on serious mental illness which he said affects about 1 in 20 Americans. He echoed the Chairman’s comments that chronic illness begins early in life, but went on to say that these disorders are treatable. He was asked by the Chairman to talk about the use of antipsychotic medications for children and the long-term effects associated with these medications. Insel said there are real concerns because the use of these drugs for children is increasing and the side effects, especially when used long term, are more adverse. He said the larger issue still, is the rate of adolescents with serious mental illness who are not getting properly diagnosed or treated.

While the first panel focused on the federal efforts to address mental health, the second panel focused on local and community-based mental health providers. Common themes among this panel included solutions to help with early identification of mental illness, service integration, the need for increasing funding and removing barriers to mental health services and treatments.

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