What Does 2014 Have in Store for Mental Health Funding and Access?

ChuckIngogliaCharles Ingoglia
Senior Vice President, Public Policy, National Council for Behavioral Health

Now that we’re a couple of weeks into January, 2014 is shaping up to be another important year for mental health policy. In today’s CFYM post, Charles Ingoglia, MSW, Senior Vice President, Public Policy, National Council for Behavioral Healthcare shares why he is optimistic about advancement of mental health policy issues in 2014.

Last week, we asked for your input about the most pressing mental health issues for the year ahead. So, there’s certainly plenty to talk about. Share your thoughts on whether or not you are optimistic about mental health advancements or if you think there is still much work to be done by commenting in today’s post.

Like you, I have read many a column at the beginning of the new year filled with predictions about the year ahead in all kinds of human endeavors, from guessing the results of local elections, to the possibilities of local building projects, to the chances of certain celebrities getting married or having children. I am always struck by the authors who begin with the warning that their crystal ball is fuzzy and they are equally as likely to be wrong as to be correct.

It is therefore with a bit of trepidation that I share my musings on what the year ahead may mean in terms of mental health funding and access. And I must confess, at this moment I am feeling confident that for many individuals, families and communities, the chances of accessing mental health services seem brighter.

To what do I owe this optimism? Let’s start with something almost remarkable… state revenue collections are looking brighter, meaning that there is more money available at the state-level to invest in things like mental health treatment and social services. It is true that any new investment will not make up completely for what was lost during the recession, but I will take some investment over cuts any day of the week. As state legislative sessions begin, I have hope that state-level appropriations for mental health services may get a boost.

Secondly, we ended 2014 with several significant movements at the federal level related to mental health services and capacity. The federal government (finally) released final regulations implementing the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA), which establishes standards within private health insurance guaranteeing that mental health and substance use treatment and payment must be comparable to treatment available for any other illness. The final regulations, while very technical in the details, establish a firm foundation of protection for thousands of individuals and families in need of care.

The Affordable Care Act builds on this foundation by extending coverage for mental health and substance use services to all insurance products available through the newly established Marketplaces and applies the MHPAEA standards to these plans as well. The combination of these coverage expansions with parity should guarantee access to needed services for thousands of individuals and families.

As 2013 came to a close, Congress was actively debating Medicare physician payment policy when Senators Debbie Stabenow (D-MI) and Charles Grassley (R-IA) offered an amendment based on the Excellence in Mental Health Act (S. 264) to the Senate Finance Committee version of the Medicare bill that was passed on voice vote. The Excellence in Mental Health Act would establish new standards and enhanced payment for community-based mental health services within Medicaid, support an increased array of services, and increase capacity for the many people who desperately need it. Some have called this the most important public-sector mental health bill since the passage of the Community Mental Health Center Construction Act in 1963, which gave birth to the community mental health movement. We are hopeful that the bill will find final passage in the Senate swiftly in the New Year as well as surviving the final stages of the legislative process to become law.

I look forward to seeing how this all plays out during the coming months and to offering you all year-end reflections to see which of these predictions stand the test of time.

Your Turn

  • What are the most pressing mental health issues for 2014?
  • Are you optimistic that significant policy advancements will be forthcoming this year?