We are building a big tent vision that will address mental health for all people and populations in America. Together we'll beat the crisis and create a flourishing future that puts people first.
People want change but have hesitation — how? There are questions as to how effective treatments are, how they are administered, and demand for a more human-centered approach to care.
While more innovation is certainly needed, current treatments are effective, we can save lives tomorrow, and lifestyle focused interventions are part of the plan.
The best psychiatric medicines are as effective as any of the top 10 most effective drugs in the country. Some talk therapies such as IGT-P are looking like one of the most cost-effective forms of improving well-being we have. Rehabilitative community centers and some neurotherapeutics are also effective yet are rarely covered by insurance.
The problem is that care is rarely delivered as it should be. The best care includes multiple treatments, carefully timed, and paired targeted lifestyle changes — just like we see with physical health. For mental health, though, this care is rarely the case.
Mental health has been neglected in America for over a century and we've failed to build the basic infrastructure to deliver our care right.
If we want to end the crisis, we must fix our care system but also adopt a whole-person, population health approach. Community, meaning, lifestyle changes, educating life skills in our youth and much more.
The mental health crisis is like a house on fire — and with mental health care the way it is, it's like we haven't even built the fire department. Strong societies take care of the sick. We must fix (build) the system.
While there is more research and innovation to be done, we know more than enough to improve outcomes. Therapy, medications, neurotherapeutics, and urgent care facilities can save lives tomorrow. There are three buckets we can invest in right now.
Our lack of investment into behavioral health centers has created an unjust pipeline of sick Americans into jails and homelessness. It's costing us billions— and thousands of lives.
• Incentivize crisis response lines and trauma-informed 24/7 mobile crisis teams nationwide
• Pass the Medicaid Reentry Act
• Further fund and expand the CCBHC model
• Implement fully the 988 number and response driven by healthcare
• Integrate crisis response within 911
• Incentivize inpatient, crisis stabilization programs, sub-acute care, and respite care
• Federally expand online “bed boards” for psychiatric beds
• Require police training to recognize symptoms - MHFA, LEAD, CIT
• Incentivize hospitals to achieve zero suicides, overdose
• Require local justice systems, including law enforcement, to develop diversion plans with MH/SUD providers
• Provide universal access to proven, trauma-informed treatments
• Implement broad-based diversion efforts across the continuum of sequential intercepts for people with MH/SUD to prevent arrest and incarceration
Insurance companies do not treat mental health equally. They drive up costs and create disparities of access with our most vulnerable communities. This is illegal and we must hold insurers accountable.
• Fed. law mandating equal reimbursement of telehealth medicine
• Ensure collaborative care reimbursement is adequate
• Require medical determinations to align with GASC
• Eliminate Medicaid lifetime caps on inpatient coverage of 190 days
• Require private health plans to cover FDA-approved medication
• Remove limitations to MATs
• Eliminate restrictions on SUD care
• Require all Fed. plans to reimburse FDA-cleared digital therapeutics
• Require insurers to cover the full range of intermediate mental health and addiction services, including residential care, intensive outpatient, and partial hospitalization services
• Create DOL annual report card rating parity compliance
• Require MACPAC to assess IMD expansions, recommend expansion
• Amend ERISA via DOL to impose fines on group plans
• Federal funding for random annual audits and review of all consumer complaints
• Health plans must publicly report denial rates, appeals, and reimbursements
• Eliminate Medicaid exclusion of people in jails/prisons
Our children are suffering and we can help them. Our schools need more mental health professionals, mental health first-aid training, and life skills like decision-making, self-management and relationship skills.
• Amend Head Start Act to include Trauma-informed programs
• Fund grants for schools that can’t afford therapists
• Enhance on-site health centers to handle mental health issues
• Medicaid waivers or coverage for school screenings
• Add mental health interventions to DOE What Works Clearinghouse
• Loan repayment for school MH providers
• Expand Medicaid billing to include school-based mental health services, including telehealth
• Full funding of IDEA - Individuals with Disabilities Education Act
• Require staff mental health first-aid training
• Require adoption of evidence-based life skills education for K-12
• Require K-12 health education to include mental health education
• Require school districts to adopt family engagement plans
• Require annual well-being checks for all students and staff in K-12
• Ratio of students to school psychologists (1:500) social workers (1:250) counselors (1:250)
• Amend the Elementary & Secondary Education Act to make well-being programs allowable uses of Title 2 funding
• State legislation for school climate surveys, adopting anti-bullying policies, anti-discrimination policies, excused absences for mental health, and suicide prevention programs
Fixing the care system and improving treatment is essential, but we must acknowledge that the root cause to so much of our crisis is that our society puts profits and money over people. In the name of GDP and market growth, people are squeezed and separated from meaningful and healthy lives. In an attempt to keep up, people lose much of what constitutes a life well-lived. In these vulnerable states, when difficult life events hit us, our mental health slides farther than it should. It shouldn't be that way.
Mental illness is a medical problem but our solutions must go beyond medicine. We must rebuild our communities and put people first.
GDP and other economic measures were not designed to assess the well-being of citizens. We need a new measurement that tells us how we are doing as people and accounts for our mental health. This new measurement should be one of the main ways we evaluate progress as a society.
Gross Domestic Well-Being can be this measurement. GDW is a bipartisan idea already utilized around the world in multiple countries such as the United Kingdom.
The creation of GDW would create a clear intention in our society that people matter. GDW could be used to incentivize institutions and businesses to improve human well-being, not just their profits. This small change would help us to alleviate the stressors that exacerbate and stoke the mental health crisis.
We are calling upon the federal government to establish a "New Measurements of Well-Being Commission."
This commission will research what the development and implementation of a new measurement would be — and make concrete recommendations for Congress to begin that process.
Our policies and visions are based on two widely cited and supported documents: the Unified Vision and the "Healing the Nation" by the Well-Being Trust. View more essential aspects of our vision below.
To achieve optimal outcomes through prevention, we must identify illnesses early by having a targeted focus on screening children, youth, and families.
• Provide routine MH/SUD screenings via PCPs and schools
• All delivery sites should screen for social needs
• Require federal agencies to adjust IADLs for psychiatric impairments
• Include MH/SUD screening in crisis response
• Create consistent processes/standards for ensuring people receive precise diagnoses and personalized interventions
• Provide long-term care for children exposed to violence/trauma
We must hold our health systems accountable to evidence-based standards of care, measuring progress, and improving outcomes.
• Promote measurement-based care and value-based financing
• Eliminate the use of “fail first” policies for medication therapies
• Develop evidence-based standards of care by 3rd party experts without incentives
• Implement quality measures to reduce disparity
• Incentivize evidence-based interventions for severe MH/SUD
Inappropriate incarceration of people with SMI wastes millions and traps people in sickness. People should be receiving care not sitting in jail.
• Create federal incentives for MH screening in the federal judicial system
• CMS should clarify how Medicaid funds can be used for screening in justice settings
• Federal penalties for no screening or bad care
• Federal gov. should fund correctional officer training in mental health supports
• Incentivize jail systems to have automated enrollment into Medicaid upon release
• Support problem-solving courts
• Incentives for reducing preventable arrests
We need to increase the number and diversity of mental health and substance use disorder providers. This will reduce costs and improve outcomes.
• Require payers to reimburse peer support and community health workers
• Offer loan repayment for recent grads to take on Medicaid/Medicare patients
• Eliminate barriers for child psychiatrists to get HRSA loan repayment
• Increase investment into development programs: GME, GPE, BHWET, Minority Fellowship
• Include cultural competence and trauma-informed care in training
We must address the historical injustices that have exacerbated racist and discriminatory policies, and culturally insensitive treatments that disproportionately impact the mental health of people of color.
• Include race, ethnicity, and language data in all MH/SUD intake
• Develop screening & treatment responsive to culture and race
• Address ACEs - focus on racism/ discrimination to reduce resulting MH/SUD
• Include training to reduce health disparities, including anti-racist and anti-discrimination
Many groups require targeted interventions and policy change such as pregnant and postpartum women, unhoused individuals, indigenous, veterans, LGBTQ+ people, immigrants, farmers, and AAPI. We commit to their well-being.
• Extend CMS changes to VHA (Veterans)
• Comprehensive services and education on signs of risk for when Veterans return
• Extend all health insurances changes to IHS and sovereign tribes (Indigenous)
• Medicaid for women up to one year postpartum mandatory eligibility (Mothers)
• Codify comprehensive non-discrimination protections for LGBTQ+
Federal policy can support employers to create mentally healthy workplaces that grow the economy, increase productivity, and promote well-being.
• The DOJ should issue guidance on ADA compliance for mental health
• OSHA funding for suicide and mental health training in the workplace & limit unfair liability
• Incentivize small employers with at-risk populations to adopt evidence-based policies
Achieve optimal outcomes through prevention, early identification and intervention, with a targeted focus on children, youth, and families.
• Fund a network of quality improvement organizations that support collective impact in communities for population health
• Incentivize new consumer technologies that support well-being and evaluate impacts
• The development of Gross Domestic Well-Being could set in motion a wave of community change