[NYAPRS Enews] Biden’s Plans to Address Our Mental Health and Substance Use Crises: Manderscheid

Harvey Rosenthal harveyr at nyaprs.org
Thu Feb 9 07:49:42 EST 2023 

NYAPRS Note: Ron Manderscheid has been a very respected national leader and change agent for many decades and a close friend of NYAPRS: here’s his summary of the plans and recommendations contained in President Biden’s State of the State vision. See factsheet at https://www.whitehouse.gov/briefing-room/statements-releases/2023/02/07/fact-sheet-in-state-of-the-union-president-biden-to-outline-vision-to-advance-progress-on-unity-agenda-in-year-ahead/.

President Biden’s Plans to Address Our Mental Health and Substance Use Crises
Ron Manderscheid, PhD Capstone Solutions Consulting Group  February 8, 2023

On February 7, President Biden delivered his third annual State of the Union Address to a joint session of the Congress. Just as he did last year, the President again gave major priority to mental health and substance use issues as part of his Unity Agenda. He identified key initiatives for these very pervasive and very disabling conditions.

Currently, the US is experiencing a major mental health crisis and a major opioid use disorder crisis. Present mental health care capacity is dramatically inadequate to address our current needs. Only one person in four with a mental health condition actually receives any care today. Overdoses due to opioid use disorder kill more than 100,000 persons each year, and 70,000 of these deaths involve the use of fentanyl. These are needless tragic outcomes.

We are delighted that President Biden understands these crises and that he has specific plans on how the Administration can address them. We look forward to working with the President on these essential initiatives.

Mental Health Initiatives
For mental health, Administration efforts will focus on extending the initiatives the President introduced last year to address our current mental health crisis. Specific activities are planned in the following areas:

Creating Healthy Environments—

  *   Protect Kids Online: Ban targeted online advertising for children and young people and enact strong protections for their privacy, health, and safety online.
  *   Strengthen Data Privacy and Platform Transparency for All: Impose stronger transparency requirements on Big Tech platforms, and impose strong limits on targeted advertising and the personal data that companies collect.
  *   Support the Mental Health of the Health Workforce: The Centers for Disease Control (CDC) will provide a hub of mental health and resiliency resources to health care organizations to support their workforces.
  *   Promote Youth Resilience:  Launch a new Children and Youth Resilience Prize Challenge at the US Department of Health and Human Services (HHS).

Connecting More Americans to Care—

  *   Improve School-Based Mental Health: Increase the number of mental health care professionals in high-need districts and strengthen the school-based mental health profession pipeline.
  *   Strengthen Parity: Propose new rules to ensure that insurance plans are not imposing inequitable barriers to behavioral health care and that mental health providers are being paid by health plans on a par with other health professionals.
  *   Enhance Crisis Services:  Improve the 988 Lifeline by investing in an expansion of the crisis care workforce; scaling mobile crisis intervention services; and developing additional guidance on best practices in crisis response.
  *   Expand Access to Telehealth: HHS will triple resources dedicated to promoting interstate license reciprocity for delivery of mental health services across state lines; the Department of Veteran Affairs (VA) will launch a new nationwide network of behavioral health clinicians to ensure timely access to virtual mental health services for veterans enrolled in VA health care; and the Department of Defense (DoD) will continue to expand the BRAVE Program, a virtual behavioral health center providing 24/7 services to military members and their families located on federal installations across the globe.
  *   Reduce Veteran Suicide: VA, HHS, and DoD will partner with the States and Territories through the Governor’s Challenge, to include a new grant program to develop and implement intervention proposals that are innovative. Other major steps will include efforts to increase lethal means safety through the KeepItSecure Program; expand outreach to justice-involved veterans by hiring more veteran justice outreach professionals for Veteran Treatment Courts; and expand access to legal support services through several VA programs for veterans, their family members, and veterans who are homeless or at risk of becoming homeless.

Strengthening System Capacity—

  *   Enhance the Workforce: Implement legislation that already has created 350 new slots to help train the next generation of mental health professionals.
  *   Recruit Diverse Candidates to the Mental Health Profession: HHS will increase funding to recruit future mental health professionals from Historically Black Colleges and Universities (HBCUs) and expand the Minority Fellowship Program.
  *   Prioritize Research:  Promote research in key areas identified in the White House Report on Mental Health Research Priorities to address our national mental health crisis.
  *   Expand Access to Veteran Peer Support Specialists: VA will increase the number of peer specialists working at VA Medical Centers by 350 over the next seven years.
  *   Ensure Access to Affordable, Stable Housing for Low-Income Veterans: The Administration’s upcoming FY24 budget will triple the number of extremely low-income veterans who can access needed rent assistance.
  *   Deliver High-Quality Job Training for Veterans and Their Spouses: The Department of Labor (DoL) will expand its Veteran Employment and Training Service by implementing its Employment Navigator Partnership Pilot, and DoD will use the Military Spouse Career Accelerator Pilot Program to expand employment opportunities for eligible military spouses.

Substance Use Initiatives
For substance use, Administration efforts will continue to focus on reducing the opioid epidemic and related overdose deaths. Special initiatives are planned in the following areas:

Disrupt the Trafficking, Distribution, and Sale of Fentanyl—

  *   Stop Fentanyl at the Southwest Border Ports of Entry: Provide 123 new large-scale scanners at Land Points of Entry along the Border.
  *   Stop More Packages with Fentanyl from Being Shipped Into the US: Work with delivery companies to encourage them voluntarily to provide data that help law enforcement identify, inspect, and intercept suspicious packages and to expand these voluntary data sharing partnerships.
  *   Lead a Sustained Diplomatic Push that will Address Fentanyl and Its Supply Chain Abroad: Work with international partners to disrupt global fentanyl production and its supply chain and invite other countries to join this effort.
  *   Work with Congress to Make Permanent Tough Penalties on Suppliers of Fentanyl:  Make permanent the closing of a loophole that allows traffickers to create “fentanyl related substances” that currently evade regulation and enhance the drug’s impact because they are not defined as Schedule I drugs.

Improve Public Health Efforts to Save Lives—

  *   Deliver More Life-Saving Naloxone to Communities Hit Hard by Fentanyl: HHS will encourage and aide states to use existing funding to purchase and distribute naloxone, and the Substance Abuse and Mental Health Services Administration (SAMHSA) will work with states to provide technical assistance, learning forums, policy academies, and convenings on appropriate use of naloxone.
  *   Ensure that Every Jail and Prison can Provide Treatment for Substance Use Disorder: The Federal Bureau of Prisons will ensure that each of its 122 facilities is equipped and trained to provide medication-assisted treatment, and the Centers for Medicare and Medicaid Services (CMS) will provide guidance that will allow states to use Medicaid funds to provide health care services, including substance use treatment, prior to release from state, county, and city jails.
  *   Drastically Expand Access to Medications for Opioid Use Disorder: Work with medical professionals to ensure that proven medications for opioid use disorder are prescribed as part of routine health-care delivery and ensure that these medications are available to everyone with a prescription.
  *   Launch a National Campaign to Educate Young People on the Dangers of Fentanyl and How Naloxone Saves Lives: Continue the Ad Council’s Real Deal on Fentanyl Campaign, and launch a naloxone component of the campaign; develop media to be shared on college campuses and in public places warning of the dangers of fentanyl and highlighting naloxone resources.

Next Steps
We need to organize now to support President Biden’s efforts to address our current and continuing mental health and substance use crises. With the installation of the new 118th Congress, these efforts will be more difficult than they were last year. Our support should include clear advocacy about our current mental health and substance use crisis, as well as support for the President’s FY24 budget initiative once the Administration Budget is released about a month from now.

Ron Manderscheid, PhD (he/him/his)
Principal
Manderscheid Associates
rwmanderscheid at gmail.com<mailto:rwmanderscheid at gmail.com>
202-553-1827

Adjunct Professor
Bloomberg School of Public Health
Johns Hopkins University
Adjunct Professor
Suzanne Dworak Peck School of Social Work
University of Southern California


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