In a presidential campaign that has already deemed to be historical, Hillary Clinton’s recent release of a national mental health agenda appears to be another historical landmark, viewed by some as the most comprehensive plan to be released by a presidential candidate to date.
“The Clinton campaign released the most comprehensive plan ever–by an actual candidate who could be president–to reform mental health addiction care top to bottom,” reflected former congressman Patrick Kennedy, a key figure in the passing of the 1996 Mental Health Parity and Addiction Equity Act. “The plan embraces the smartest and most evidence-based approaches to enforcement of the parity laws, open science, early intervention tied to appropriate medical treatment, behavioral therapy and peer support.”
While it is not unusual for presidential platforms to fall apart after election day, Clinton’s mental health agenda has been presented as a long-term policy solution. Promising an increase in spending and resources, Clinton also pledged to convene a White House Conference on Mental Health during her first in office, using the meeting as a way to highlight success interventions and discuss continued barriers that need to be further addressed.
In the body of her mental health agenda, Clinton focuses on the following key policy areas: early diagnosis and intervention, the decriminalization of mental health, and healthcare integration and parity.
Early Diagnosis and Intervention
As Clinton cites in her mental health briefing, two-thirds of children living with mental health needs go untreated, leading to consequences further down the road. In fact, these adolescents may be three times more likely to drop out of school and twice as likely to face premature death. By increasing both public awareness and access to standard mental health screenings, through services like Medicaid, Clinton’s focus on intervention on early diagnosis and intervention ensures children receive the treatment they need to succeed and grow.
Furthermore, as a means of intervention, Clinton pledged to improve federal support for suicide intervention. Aiming to achieve the Department of Health and Human Services’ goal of “Zero Suicide,” Clinton’s proposes a cross-government initiative, led by the Surgeon General, that would research and develop suicide prevention plans for respective federal agency settings. Similarly, evidence-based suicide prevention measures would be implemented in school systems, colleges, and universities- emphasizing mental health literacy, training, and counseling. As a whole, Clinton pledges to invest up to $50 million per year in the country’s education system- implementing these prevention and intervention frameworks on behalf of all students.
Decriminalization of Mental Health
Today, our nation’s penitentiary system houses more individuals with mental illness than our state and local psychiatric hospitals. Clinton’s plan aims to address this issue from two different approaches: first, by preventing encounters with the criminal justice system through intervention and community- based treatment, and second, by prioritizing treatment over punishment while individuals are in correctional facilities.
Healthcare Integration and Parity
Clinton’s bold inclusion of healthcare integration and telehealth in her national agenda coincides with recent findings that integrating mental and physical health services leads to better patient outcomes and lower costs. Acknowledging that the demand for mental health services far outweighs the supply, the briefing also proposes integrating physical and behavioral healthcare- a holistic approach that, according to Clinton, could “yield $26-$48 billion in savings annually.”
In an effort to increase access to behavioral healthcare, Clinton promotes the use of health information technology and tools, specifically telepsychiatry, so that patients are able to receive the quality care they deserve with ease and affordability. Pledging to adjust payment systems in Medicare, Medicaid, and under the Public Health Service Act, the agenda proposes a more progressive and widely-accepted reimbursement of telehealth services for consumers. Furthermore, Clinton pledges to fully enforce the Mental Health Parity and Addiction Equity Act, which she co-sponsored, to require that mental health benefits be equal to all other medical condition benefits offered under group health plans.
By setting up more widely accepted payment systems and the increased federal monitoring of parity laws, the benefits of telepsychiatry may be more attainable to mental health consumers, whether accessing the services from home, hospitals, or behavioral health outpatient clinics. This policy, along with the many others presented in Clinton’s comprehensive agenda, may have the potential to finally equate the treatment of mental health to that of physical health.
As her campaign concluded in the announcement of the agenda: “The next generation must grow up knowing that mental health is a key component of overall health and there is no shame, stigma or barriers to seeking out care.”