6 Real Policy Solutions to the U.S. Mental Health Crisis
Tags: Public Health, Mental Health, Healthcare, Effective, Covid 19 Crisis

6 Real Policy Solutions to the U.S. Mental Health Crisis

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The United States’ mental health crisis is the murmur turned cry within the wake of the Covid-19 pandemic. The CDC reports that depressive disorders quadrupled between June 2020 and the prior year. Mental health conditions, substance use, and suicidal ideation are also on the rise. These trends, while multiplied by Covid-19, have been mounting for decades. One in five U.S. citizens lives with a mental illness; and over the past 20 years, suicide rates have increased by 33%.

Now is the time to begin thinking about the long-term game of mental health in the United States — the approaches to build up the nation’s well-being in the coming months and years.

To be clear, I am not a mental health professional. I am a daughter of a parent lost to suicide. I am a witness to the shadows of mental health stigma; the stresses of the 2008 recession; and the hurdles to accessible and transparent mental health care. In the day-to-day, I am an analyst at the intersection of data-driven research and policy.

Here, I lay out six mental health policy recommendations for the United States during Covid-19 and beyond.

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1. Destigmatize mental health

Nearly one third of U.S. citizens worry about others judging them for seeking out mental health resources. In the face of stigma, even the most sophisticated mental health systems will have limited reach.

A publicly funded, multimedia public awareness campaign on mental health could have wide-reaching effects on stigma. Similar campaigns have been shown to shift perspectives, norms, and behavior in a range of contexts, including mental health in New Zealand and Australia. The corporate world, in parallel, plays no small role in influencing norms through advertising. Mental health destigmatization should become a strategic element of corporate social responsibility agendas in the coming years.

At the same time, state and federal policies should focus on bolstering mental health education programs in schools and workplaces across the country.

If the United States is to advance in its mental health, the veil of stigma must fall.

2. Widen accessibility of mental health care

Cost and insurance coverage was identified by 42% of U.S. citizens as the top barriers to mental health care.

Mental health care accessibility must be broadened now within the structure of the current health care system. This means strengthening enforcement of parity regulations between physical and mental health care; requiring insurers to publish clear information on coverage and approval criteria; and bringing together policymakers to decrease out-of-pocket costs.

In the long run, many argue that the path to equitable mental health care lies within universal health coverage. The United States, after all, remains the only industrialized nation in the world without it.

Mental health destigmatization should become a strategic element of corporate social responsibility agendas in the coming years.

3. Break down barriers to telehealth care

Statistics show that 55% of U.S. counties have no practicing psychiatrists, psychologists, or social workers. These shortages disproportionately impact rural counties, which report higher suicide and depression rates than their urban equivalents.

Telehealth can broaden the reach of mental health care to remote populations. While federal and state governments loosened telehealth restrictions as a response to Covid-19, many of these measures will expire upon the end of the current emergency phase. If so, obstacles to tele-provider licensing and credentialing, along with limited insurer coverage and reimbursement, will impede access to telemedicine in the post-pandemic period.

In the medium- to long-term, policymakers must continue to break down regulatory barriers to telehealth. This means facilitating interstate provider licensure, enabling prescriptions via telehealth, ensuring insurer coverage parity between tele- and in-person- treatment, and establishing reimbursement rules that incentivize both tele- and in-person- care. States like Minnesota lead the way in progressive telehealth policy and provide an example to follow.

4. Strengthen labor policies for low-skilled workers

The link between employment and mental health is well-documented, if not for economic reasons then for the sense of purpose, pride, and dignity that a workplace provides. In the face of unemployment, mental health falters. Between 2008 and 2010, every rise of 1% in unemployment was accompanied by a suicide rate increase of roughly 1%.

As automation becomes increasingly prevalent, Covid-19 is projected to accelerate demand cuts in low-skilled labor. Some 57 million U.S. jobs are vulnerable, largely in retail trade, manufacturing, nonessential health care, and professional services.

The United States needs to protect and empower its low-skilled workers. More and better-funded workforce development programs can transition individuals toward new jobs, economic empowerment, and better mental well-being amidst a changing labor market. Other policies like elevated minimum wages and more earned income tax credit have also been shown to benefit mental health outcomes.

5. Build a body of rigorous data and research

Across the world, mental health data is murky. In the United States, data on mental health is marked by poorly defined quality measures, limited descriptions of services, and a lack of integration between electronic health information systems. If not for polls, which are subject to bias, the data largely represents those who have sought some form of treatment or whose lives have been lost to mental illness.

This is insufficient.

Clearly defined indicators and carefully integrated data systems will make way for a clearer snapshot of mental health in the United States — and give policymakers the tools to act accordingly. With greater availability of representative data comes the opportunity to rigorously evaluate program initiatives. Evidence can guide clinical approaches, steer policymaking, and optimize mental health services.

6. Harness artificial intelligence and predictive analytics

Innovations in artificial intelligence (A.I.) can support mental health prognosis, diagnosis, and treatment. The Department of Veterans Affairs, for example, uses A.I. to identify veterans at risk for suicide, flagging and reaching out accordingly to 31,000 individuals and counting. Research shows that data as quotidian as social media posts can predict depression diagnoses; and facial expression, enunciation, and tone can predict suicide risk.

Prior to the Covid-19 pandemic, the U.S. Department of Health and Human Services forecasted shortages in behavioral health practitioners by 2025. As demand for mental health services balloons, A.I. can help to not only identify at-risk individuals, but also to assist practitioners in providing quality care. A.I. use doesn’t come without concerns of biased algorithms, privacy, or data security, all of which should be part of the conversation on future directions of A.I. for mental health.

Covid-19 can be the catalyst that pushes the U.S. mental health crisis from stigmatized darkness into the spotlight — and that mobilizes communities and policymakers into action. Now is the time to shed stigma; to expand mental health care access; to build up workforce development programs; and to harness better data, research, and analytics.

To thrive, the United States needs a better mental health environment. Tens of millions of individuals — and their children, parents, brothers, and sisters — rely on it.