The last significant expansion of community mental health services in the United States happened in 1963, when the population was less than 190 million people. Since then, providers have not kept pace with population growth. And then came the coronavirus pandemic.
The Kaiser Family Foundation reported last September, “In response to growing mental health concerns during the pandemic, 67% of schools reported increasing mental health services offered to students.” But they haven’t increased staff to meet the demand: “Fewer than half of schools (41%) reported hiring new staff to focus on students’ mental health and well-being since the pandemic began.”
The problem goes beyond school budget constraints. KFF explained, “Among the 88% of schools that did not strongly believe they could effectively provide mental health services to students in need, the most reported limitations involved mental health provider shortages – 61% cited insufficient staff coverage and 57% cited a lack of access to providers.” The shortage of providers isn’t new, but with demand skyrocketing, the problem has become acute.
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The Post reported on the critical shortage of mental health care last October: “This summer, Massachusetts General Hospital had a staggering 880 people on its wait list for psychiatric services. The list had grown so large that the hospital issued an unusual plea to its physicians: Stop referring psychiatry patients for non-urgent care.”
This is why Sen. Robert P. Casey Jr. (D-Pa.), chair of the Senate subcommittee on children and families, and then-Sen. Rob Portman (R-Ohio) introduced legislation last summer to add resources for mental health services for children. In a similar vein, Sen. Patty Murray (D-Wash.), chair of the Senate Health, Education, Labor and Pensions Committee, and since-retired senator Richard Burr (R-N.C.), announced bipartisan legislation “to reauthorize, improve, and expand federal mental health and substance use disorder programs.”
While those legislative efforts expired at the end of Congress’s last term, school professionals continue to sound the alarm. And lawmakers are listening.
Last week a small bipartisan group of House members including Reps. Suzanne Bonamici (D-Ore.), Brian Fitzpatrick (R-Pa.) and Susan Wild (D-Pa.) introduced legislation that would “require coordination between federal agencies to develop best practices” for suicide prevention and training for educational professionals themselves. It would also provide resources for public awareness campaigns to destigmatize mental health care as well as “direct support to educators and school staff members by establishing programs to promote mental health among the education professional workforce; and promote accountability for federal resources for new programs.”
States are also pursuing mental health care shortages. The Wall Street Journal reports: “Governors and lawmakers in a number of states are pushing for billions of dollars in funding increases for mental health this year, as Republicans and Democrats alike say that a shortage of available services has reached crisis levels. The budget proposals seek to address the nationwide scarcity of mental-health workers, the mental-health needs in schools and growing demand for emergency services.”
Even MAGA Gov. Greg Abbott in Texas wants to spend more on mental health, and a bill to double mental health spending in the state is gaining momentum in the GOP-dominated state legislature. Meanwhile, a number of states have entered into an interstate counseling compact allowing professionals to practice in any of its members.
It’s true that Republicans and Democrats cannot agree on much at the federal level. But expanding access to mental health care might be the sort of issue even churlish Republicans wouldn’t block. (In the modest gun safety legislation that passed last year, lawmakers included millions of dollars for mental health and drug intervention programs.)
To be certain, it will not be easy to convince House Republicans to spend money on anything. But they are interested in “clawing back” unused pandemic money, estimated to be about $500 billion. If some of that could be redirected toward mental health spending, especially in schools, a compromise might be in the offing.
President Biden was able to achieve a number of items on his unity agenda from 2022, including expanded care for veterans exposed to burn pits in the Iraq and Afghanistan wars; more funding to fight cancer; and more resources to battle opioid addiction in rural communities. In a preview Tuesday morning of his State of the Union address, White House advisers explained how the president would build on each of these, including attention to online practices that target children (negatively affecting their mental health), expanding access to providers and policing insurance carriers to ensure they cover mental health services as required by law.
Who knows? Perhaps even the House Republicans are capable of addressing a real problem with federal resources.