The U.S. is facing an intensifying mental health and substance use crisis. Nearly one-third of adults now report symptoms of depression or anxiety — triple the rate from 2019 – and even more severe mental illnesses like bipolar disorder or schizophrenia now affect about one in 25 adults. At the same time, overdoses are officially over 110,000, not including the 350,000 who die from alcohol-related deaths.
Additionally, according to the American Foundation for Suicide Prevention, in 2022, over 49,000 Americans died by suicide, with an estimated 1.6 million suicide attempts.
These statistics and the heart-wrenching stories we hear and read about each day reflect a growing public health emergency that cuts across all demographics, affecting individuals and families regardless of income, age, gender, political affiliation, or zip code.
Having lived much of my life in the public eye, I’ve experienced firsthand the profound challenges of facing addiction in such a visible way. No where else in healthcare do you need to know someone in order to access care, including a Member of Congress (who was denied coverage for an inpatient detox), a news personality, or a partner at a global investment firm.
My own struggle was not just a personal reckoning — it became a public one. Since then, I’ve dedicated countless hours every week responding to urgent calls from friends, family, and even neighbors who are desperate to find a therapist or secure an inpatient treatment facility for themselves or a loved one.
It’s heartbreaking, but all too common, that in the field of mental health and addiction care, it often feels like you need to know someone on the inside just to access the help you so desperately need. Nowhere else in healthcare is this gap so evident — where navigating the system becomes a barrier to getting care. We need to change this. Everyone should have equal access to treatment, without the need for personal connections or insider knowledge.
Growing public awareness and research helps us better understand the broad scope of the challenge before us; what is clear to me is that we must build and strengthen a mental health system to meet our needs today and that can evolve to meet future pressures. Today, substantial barriers exist to ensuring people in need can access appropriate and necessary care. A fragmented care delivery system combined with insufficient insurance coverage and a lack of quality metrics make access to care challenging and worsen existing health disparities in low-income communities. Shortages in the clinical workforce and sites of care in community amplify access problems and patients and their families struggle to find services and make inroads in addressing their conditions.
Opportunities exist to build on and expand existing innovations in the private sector and government. Telehealth and digital health solutions have helped to expand access to mental health care and reduce barriers related to geography and availability, especially in underserved or rural areas. Health plans are working to integrate behavioral health with physical health, recognizing the interconnectedness of mental and physical well-being. Additionally, innovative reimbursement models and financing mechanisms, which encourage shared investments across healthcare, government, and business, can demonstrate how funding non-medical social services and prevention efforts can significantly reduce medical costs and improve societal outcomes in sectors like education, criminal justice, and national security. These types of innovations must be replicated and improved.
More broadly, addressing this crisis requires comprehensive policy action, informed by patients and families and advanced by policymakers who can remove barriers to building a more accessible mental and behavioral health system.
Many organizations have already developed actionable policy recommendations but now is the time to take action and implement change. Building out and strengthening the clinical workforce and broader use of social workers and other community-based models of care will take time and investment at the federal level. Attention to training and recruiting for underserved regions is particularly critical. Implementing a unified framework to assess the quality of behavioral health services is an important step toward consistent standards of care. Building a robust data infrastructure for this information could enable informed decision-making for both providers and patients and their family caregivers.
Such a system would drive value-based payment reforms, aligning incentives with the delivery of effective care, rather than the volume of services provided, and it would empower consumers to have greater self-determination and confidence in the care plan and services that they receive.
Our work on behalf of patients must also include improving the current regulatory environment which burdens providers and payers and falls short of the incentives and resources needed to address the crisis at hand. Aligning federal regulations and reducing unnecessary administrative obstacles would enable stakeholders to focus on delivering high-quality care. We have the tools, innovation, and policy ideas to make meaningful progress — what is needed now is the combined efforts of multiple parties and the will to implement these solutions.
The release of the Mental Health Parity and Addiction Equity Act Final Rule highlights the urgency for system-level reforms. Stakeholders will have varied reactions to this important step forward and we must take this opportunity to understand these perspectives and reach consensus on policy priorities and additional legislative and administrative actions that focus on those in need, while enabling the mental health care and addiction care systems to step up to address that need.
During this important election year, more voters are demanding real solutions to address the mental health and addiction crises. Americans are no longer willing to stand by while more lives are lost to untreated mental illness and substance use. Although these challenges are deep-rooted, solutions are within reach.
Collaboration is key. Solving this crisis requires all of us — policy leaders, health care providers, payers, community advocates, patients and their families — to work together in exploring new pathways in mental health and addiction care. By uniting around common goals and leveraging diverse perspectives, we can create sustainable solutions that make a real-world impact on individuals, families, and communities across the country. The time for action is now.
Lives depend on it.
Patrick J. Kennedy is a former Member of Congress from Rhode Island’s First Congressional District from 1995 to 2011, who co-authored the landmark Mental Health Parity and Addiction Equity Act (Federal Parity Law). He is now a partner at Healthsperien, LLC, leading its Mental Health and Addiction Practice.
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