My Three-Part Call-to-Action: How We Can Fix Our Mental Healthcare System

Allen Doederlein
President, Depression and Bipolar Support Alliance (DBSA)

thehill
Photo Credit: The Hill

Last Thursday, February 26, I represented those with lived experiences at The Hill’s mental health briefing Fixing America’s Mental Healthcare System to an audience of nearly 100 leaders and activists in Washington, DC. The discussion focused on the current state of the mental health care system in America and outlined key next steps that Congress and government agencies should consider to solve the inefficiencies and fill the treatment and service gaps experienced by millions of Americans living with a mental health condition. Watch the event’s archived video.

Why the Lived Experience Voice Shouldn’t, and Can’t, Be Overlooked
I’ve often found that the “voice of the lived experience” is missing from the discussion around mental health care policy reform. I find this both unfortunate and ironic, given that these conversations seek to improve the system but don’t consult those who actually need and use it. That’s why I was so pleased to represent the perspective of the individual with the lived experience at this important forum.

At the briefing, Senator Chris Murphy (D-CT) and Congressman Tim Murphy (R-PA) spoke about introducing bills in the Senate and House targeting necessary measures to equalize the mental health care landscape, as well as the need for cross-collaboration across parties. It is essential that these pieces of legislation support a much-needed shift in the dialogue between providers embracing only the medical model and those with lived experiences.

How We Are Being Failed by Current Mental Healthcare Policies
While designed with well-meaning intentions, much of the current legislation and policies fail to properly support the individual. During his remarks, Dr. Seth Seabury from USC Schaeffer Center for Health Policy & Economics shared research outcomes that reveal how Medicaid formulary restrictions designed to curb spending actually have the opposite effect. Dr. Seabury’s research found that by restricting access to antidepressants, the probability of hospitalization increased by 16.6 percent for those with major depressive disorder (MDD). Further, these restrictions had no numerical evidence of net savings for Medicaid. These prescribing limitations truly hinder the recovery process of those who need these medications.

Finding Solutions
During the panel discussion in which I participated, I shared that a peer specialist stands for mental health alongside the individual living with the condition by offering support. One of the most helpful things one person can say to, or hear from, another is “I’ve been there.” This evidence-based practice, when incorporated into the delivery of mental health services, results in an increase in positive outcomes.

My Call to Action
Based on the discussion last Thursday, I see a three-part call to action:

  1. Encourage greater and more open communication between providers and those with lived experiences: Current and future health care professionals entering the medical and mental health fields must be encouraged to have increased, candid conversations across the lived experiences-professional divide. Those with lived experiences must insist that their providers shift their thinking to recognize the importance of a holistic, patient-centered, and integrated approach to mental healthcare, and reimbursement must follow suit. Those with lived experiences are the “captains” of their recovery and providers must take on a stronger role as their “navigators.” Without embracing this dynamic, the mental health care system will continue to fail the millions of Americans with lived experiences.
  2. Reform the current Medicaid prescribing limitations: In their current state, formulary restrictions on antidepressant therapy in state Medicaid programs are associated with worse outcomes for those with MDD. These formulary restrictions must be changed: individuals with lived experiences respond differently to different medication treatments, and policies must reflect this.
  3. Advocate for legislation that recognizes the importance of peer support: Individuals with lived experiences respond more positively to those who have gone through similar, relatable experiences compared to those who have not. Peer support, an evidence-based practice, plays a significant role in helping individuals regain their voices and lives in the greater American community, and should be embraced as a component of mental health care.

Join us to ensure that those with lived experiences remain the driving force for change in mental health policies by commenting below on how you will work to help fix our mental healthcare system.

Questions

  • How has engaging with the peer community assisted you on your path to wellness?
  • How can we encourage better communication between mental health care providers and people addressing mental health concerns?

Allen Doederlein is President of the Depression and Bipolar Support Alliance (DBSA), the nation’s premier peer-led mental health organization focusing on mood disorders. DBSA reaches 2,000,000 people each year with current, readily understandable information about depression and bipolar disorder and empowering tools focused on an integrated approach to wellness.

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2 comments
LaurenJones2
LaurenJones2

I agree we need a change. There are all types of mental disorders that need other meds or combination of meds. We have to try several before u find one that works. Were basically test dummies but we have to in order to find a fit. People look at people w disorders and just think ur crazy or all in ur head. I have several disorders but I'm not crazy so don't judge. People grow out of meds n can become immune to some. My kids meds change w age.. Therapy groups should hire people who have been there n struggle. They can connect better than just someone who's never been there but just went to school. Same for AA n NA. If u haven't been there it'd harder for u to relate compared to someone already been thru the struggle