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Charles Ingoglia, MSW

President and CEO of the National Council for Behavioral Health

Ignoring Behavioral Health Care Needs Harms Patients and Communities

June 25, 2020 | From the CEO | Comments
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Chuck Ingoglia, President and CEO, National Council for Behavioral Health

Behavioral health often goes unnoticed.

Even though mental illness and substance use disorders are less visible than many physical illnesses, they are no less painful and no less serious. They simply are unseen.

Ironically, behavioral health care organizations also go unnoticed. Our nation’s response to the COVID-19 pandemic provides evidence of this painful truth.

The federal government has worked hard to help our nation’s health care providers cope with the tragic consequences of the pandemic. That rapid federal response has equipped hospitals with life-saving resources to battle a deadly virus that continues to ravish our country. But lawmakers have overlooked the needs of the estimated 53 million people in our nation who struggle with mental illness or substance use disorders and the community behavioral health organizations appealing for assistance so they can continue providing treatment and services.

Lawmakers were correct to focus on the urgent needs of health care institutions when the pandemic began to spread violently across our nation. COVID-19 represents one of the single greatest threats to the physical health of our nation and the world, and it made sense to focus on the needs of emergency rooms and the physicians and nurses putting their lives on the line every day.

In March, Congress appropriated $100 billion in direct aid through the CARES Act to health care institutions on the front lines of the crisis. A second bill in April provided $75 billion for reimbursement to hospitals and health care providers. It seemed like a perfect solution for all segments throughout the health care continuum. But very little of that funding has made its way to community behavioral health organizations, even though the pandemic also threatens our nation’s mental health. That’s because the medical, social and economic impact of mental illness and substance use disorders remain grossly misunderstood throughout the federal government.

Many people already diagnosed with mental illness and substance use disorders are struggling due to isolation and physical distancing. The coronavirus may lead to an uptick of 75,000 “deaths of despair,” according to a report released last month by Well Being Trust, a national foundation focused on mental wellness. Deaths of despair include suicides and deaths related to substance use, including overdoses.

The safety net is being shredded, too. Nearly one-third of our members have not received CARES Act funding at all, according to the results of our latest member survey. Among those who did receive funding, 39% received less than $50,000. That won’t pay the bills, and the outlook for our members is as bleak as ever, with 44% of members responding that they only have enough funding to remain open for up to six months.

Many won’t make it that long.

Community behavioral health organizations are struggling to keep their doors open and maintain treatment and services, with 71% having canceled or rescheduled appointments or turned away patients over the past three months, according to the member survey.

The World Health Organization already has warned of a global mental health crisis as a result of the COVID-19 pandemic. A financial crisis among providers will accelerate that crisis.

We’ve mapped out a solution, and we are working with the Department of Health and Human Services (HHS) to simplify and speed up distribution of provider relief funds. Ideally, Congress will appropriate $38.5 billion to community behavioral health organizations that we requested in April. We’ve also shined a light on the plight of our members by generating nationwide media coverage in The Washington Post, USA Today, NPR and Politico. Here’s the bottom line: if we can’t obtain dedicated funding, we must help HHS unlock money from the CARES Act for our members by making it easier to apply for and receive this elusive federal assistance.

We must no longer allow the federal government to overlook those diagnosed with a substance use or mental disorder.

We must no longer allow lawmakers to ignore the organizations that treat those with mental illness or substance use disorders.

What does it say about our country if we fail to offer assistance to community behavioral health organizations, despite the overwhelming need? What does it say about our country if we ignore the needs of people coping with mental illness or substance use disorders by allowing the clinics that provide treatment and services to close, increasing barriers to access?

Lawmakers understood the value of providing resources to hospitals and other health care institutions quickly when the pandemic began, but they have failed to grasp the value of quickly extending that same assistance to behavioral health clinics. We can already quantify the impact of this failure: a spike in suicide rates, increase in drug and alcohol use, relapses due to isolation, a rise in depression, anxiety, post-traumatic stress disorder and more all brought on by the COVID-19 pandemic. Hospital systems will see their emergency rooms overrun with behavioral health care patients. But those with mental illness and substance use disorders don’t belong in emergency rooms.

We don’t lack resources. Our nation spends more on health care than any other country.

We only lack vision.

Fortunately, the solution is as obvious as the consequence of inaction.

Providing community behavioral health organizations with access to federal resources now will send the strongest signal possible that our federal government understands the risk of mental illness and substance use disorders to Americans who struggle with these unseen illnesses and to a nation threatened by a looming behavioral health pandemic. And in the post COVID-19 era, let’s leverage this extremely difficult experience to finally achieve full parity with the rest of health care.