The year 2020 has put an exclamation point on the need for robust mental health care in the United States, first with the ongoing isolation posed by Covid-19 that is now magnified in the West by wildfires forcing everybody indoors.
Americans are being asked to take never-before-seen steps to keep themselves safe: staying at home, wearing face coverings in public, limiting social interactions and human contact, and more. These measures are necessary to slow the spread of Covid-19, but they are taking their toll on Americans’ minds.
In the West, millions of people are living in a surreal, smoke-tinged reality. Many can barely set foot in their backyards due to the poor air quality, while others have been forced to abandon their homes and flee the path of fires.
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A recent survey by the Kaiser Family Foundation showed that nearly half of Americans feel their mental health has deteriorated during the pandemic, and as many as one-fifth reported that the pandemic was having a “major impact” on it. Those numbers stand to become more pronounced as winter approaches, when cold weather reduces options for socially distanced outdoor activities. And it’s more clear than ever that the impact has disproportionately been felt by Black, Hispanic, and Native American communities across the country.
Contending with mental health challenges is nothing new in the Wyden family. My brother Jeff suffered from schizophrenia for years, eventually losing his battle with the illness nearly 20 years ago. Night after night, my family and I worried that Jeff would end up out on the streets and hurt himself or someone else. We kept our phones close at hand those nights, always hoping there wouldn’t be a call with bad news.
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My family is far from the only one that watched America’s health care system fall short for a loved one.
There is a practical solution: Empower mental health care providers to care for patients via telemedicine to help meet the staggering increase in demand for assistance. Telemedicine, by which doctors and other medical practitioners provide health services to patients via telephone or video call, has the potential to put mental health care within reach of millions who had trouble securing help even before the pandemic.
Under current law, telemedicine is mostly available only to Medicare beneficiaries living in rural areas and, in many cases, seniors must travel to an intermediate medical facility to dial in to another provider for telemedicine services.
Congress should make mental health care via telemedicine a right for all Americans. That starts with legislation I’ve offered to allow seniors with Medicare to receive mental health care from their homes via telemedicine. Expanding benefits in Medicare is often a springboard to getting those benefits covered by private insurance, which will help Americans below retirement age to see similar access to virtual mental health care.
Why now? Demand for mental health care services is as high as ever, if not higher. Many of the restrictions around telemedicine in Medicare have been temporarily lifted to aid the response to Covid-19, but the authority to waive these restrictions will go away when the Trump administration declares an end to the public health emergency. Continual access to health care services is critical at any time, but especially now when stress and anxiety are running high across the country. Health providers may also need the certainty of a permanent extension of these benefits to begin to adopt the technology in the first place.
A decade ago, Congress passed a law establishing mental health parity, stipulating that insurance companies must cover mental health services at levels similar to physical health services. In the Wyden household, the passage of this law was greeted with huge cheers. We hoped it would mark a new beginning for adequate mental health treatment in America. Too late for Jeff, but perhaps just in time for millions of other families.
Sadly, many reports suggest these requirements are being honored in name only. Researchers have a growing concern that insurance companies subcontract mental health services out to other providers who fail to honor the mandate and confuse patients, who are unaware of how to proceed. At my request, the GAO is investigating this matter now. Between a lack of data and the continued stigma surrounding mental health treatment, mental health parity is still an aspiration. Telemedicine will be an important tool to bridge the gap.
Fortunately, there is an opportunity to permanently address the mental health needs of our citizens. Congress is presently debating another relief package to respond to the economic and public health challenges caused by the Covid-19 pandemic, and lawmakers will be missing a key piece of the puzzle if policies that boost Americans’ mental health care are not included. Leaving people behind without accessible mental health services will have life-altering consequences for too many families.
Mental health care must be established as a right in America to help those struggling with their mental health, now and in the future.
Ron Wyden, a Democrat, is the senior United States Senator for Oregon and the ranking member of the Senate Committee on Finance.
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September 23, 2020 at 04:00PM
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Make mental health care via telehealth a right for all Americans - STAT - STAT
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