It was scheduled for 2 p.m. I had no idea that such things were scheduled.
For 2 p.m.
OK, I am on it.
I dutifully called into the conference line, dialed in my PIN, and entered into a cavernous silence. We—and I had no idea who “we” consisted of—were to be briefed on Secretary Clinton’s mental health care reform platform. Within minutes, Mrs. Clinton and her staff were on the phone.
What she had to say was amazing. No, stupefying. The Democratic platform for mental health reform went so far beyond what had ever been done before that it was difficult not to be speechless. Not that I could have “unmuted” myself, since naturally, one had to be “recognized” to speak.
The platform has multiple aspects. For example, it proposes to focus on early intervention. It especially attends to the threat of maternal mental illness, including depression, which affects not only the mother, but her children. This agenda clearly recognizes that treating maternal depression is more than a two-fer. Yes, it relieves the mother’s suffering. Yes, it improves behavioral problems in her children. But as well, it likely means better lifelong mental health for those kids. That is a big deal. Moreover, Clinton proposes to double set aside funding for early intervention initiatives, such as the APA Foundation’s Typical or Troubled? program that specifically benefits children and young adults.
Another focus is on availing clinicians and the public with the best information on treatments for mental illness through databases such as the National Institute of Mental Health’s Early Psychosis Intervention Network (EPINET), which provides one-stop shopping for best practices to treat psychosis. Ensuring that high-quality clinical guidelines are available to providers can translate into better, evidence-based care.
The platform also puts a strong emphasis on suicide prevention and proposes a national initiative to be headed by the Surgeon General to pursue the Zero Suicide goal promoted by the Department of Health and Human Services. Importantly, the focus will be across the lifespan including for high schoolers and college students, among whom suicide is a top cause of death.
While the Mental Health Parity and Addiction Equity Act was passed in 2008, we know that it has not been implemented to meet the full intent of the law. The platform proposes to make sure that the law is followed to the letter, to permit our citizens unfettered access to mental health care.
As well, the plan is to increase integration of medical and behavioral health care systems and to expand community-based treatment, which includes development of reimbursement codes for collaborative care models and a nationwide strategy to address the shortage of mental health providers.
Finally, and very close to my heart, is a major push to increase federal and other funding for brain research. We know so much more than we ever have about the pathophysiology of the illnesses that we treat with both pharmacological and behavioral interventions. But there is so much more to learn. The more we know about the brain and the neurobiological underpinnings of psychiatric conditions, the more likely we are to find novel ways of relieving human suffering. And that is what gives me hope every day. ■
