A Mental Health Crisis in the US- What’s going to happen?

The healthcare system is failing those with mental illness all across our country for a multitude of reasons, but at the top of that list, is a lack of mental health services. Sounds pretty straightforward? But it’s not.  

According to a recent study published in Psychiatric Services, hospital emergency departments are considered the frontline services when triaging a mental health crisis. Emergency rooms are not set up to be any sort of a frontline responder to people experiencing significant and debilitating symptoms stemming from mental illness. And yet it has been widely reported that emergency room visits by people seeking psychiatric assistance have been steadily increasing throughout the pandemic.  

It’s become apparent as a result of the pandemic, the emergency management system has been stretched beyond capacity. A complete and significant capacity expansion of community mental health centers, Certified Community Behavioral Health Clinics ( CCBHCS), and mobile crisis teams among other services need an immediate infusion of dollars at the Federal, State, and local levels. A significant infusion of dollars that is supported by a new policy that is set with an eye on a totally revamped system of care rooted in accessibility, affordability, and one that is results-based with clear systems of measurements put in place. 

When taking into account, individuals with severe mental illness who are not lucky enough to be connected to evidence-based care, these individuals get caught up in a life of frequent emergency room visits and subsequent hospitalizations, and/or involvement with the criminal justice system that all too often leads to incarceration. You can include homelessness in this life of suffering! And the suffering shouldn’t be blamed on the person suffering. It’s really not their doing.  

I could never adequately address this topic without underscoring the devastation that our youth have faced throughout the pandemic. Disruptions in everyday life for kids have led to the crisis. The pandemic has caused far too much social isolation and lost learning. Isolation, falling behind in studies, and seeing so much sickness and death over the last two years have been the perfect storm for depression, anxiety, eating disorders, suicide attempts, and addiction issues.  

NJ.com recently ran a story titled Saving Charlie which poignantly depicts a teen suicide crisis through the experiences of the family of a teen and a broken system ill-equipped to “save” Charlie. It should be noted that this story takes place in New Jersey, whereas a long-time treatment provider, I can attest to the fact that New Jersey has in place a robust system of mental health care for youth. The bottom line is we need to do more! 

https://linkprotect.cudasvc.com/url?a=https%3a%2f%2fwww.dropbox.com%2fs%2fe910qpmglpnnj5e%2fSaving%20Charlie%20-%20nj.comsavin&c=E,1,G-zEBZGMBz3qPDgrbSxwfCMZKyqbKPlZAEyaTnuMAkr0wQ5Jg1dQA7aJed_oH1HPJzAmc1kwONSG0vfu0skHkV5407eKLV5XPV656r9I&typo=1 

When you factor in the increasing drug and alcohol use over the pandemic, the situation in our country is even direr.   

The latest data from the U.S. Centers for Disease Control and Prevention (CDC) shows that drug overdose deaths have reached another record high. There is no doubt that addiction is deeply embedded with mental illness in a majority of those negatively affected by the pandemic. Our country had been struggling with an opioid epidemic long before the onset of the pandemic. The problem as judged by loss of life is mounting each and every day.  

Within this ongoing crisis, we need to not only be cognizant of physical and mental health care to be delivered in an equitable manner, but in addition, we need to diligently tackle this problem that has existed long before the pandemic and has only become more of a problem over the course of the pandemic.  

Nearly half of all Black, Hispanic, Asian, Native American, and LGBTQ+ individuals say they have personally experienced increased mental health challenges over the past 12 months, but few received treatment, according to a new poll by the National Council. “The COVID-pandemic has spared no one, and now we’re facing a second public health crisis – a mental health and substance use crisis – and the impact on Black, Hispanic, Asian, Native American and LGBTQ+ individuals represents an immediate concern,” said National Council President and CEO Chuck Ingoglia. 

This blog is not meant to be an exhaustive list of growing concerns related to mental health in the U.S. because the list is just too long. However, equally important as the other identified concerns in this blog is the current workforce shortage. I know people love to throw around the word “crisis” seemingly now more than ever but shortages around the country in the behavioral health treatment system are truly a crisis! The behavioral health workforce has historically been underpaid due to it being the nonprofit community that has served patients needing life-saving services and nonprofits are mainly funded by state departments without rate adjustments for many years. Market forces are driving the need to increase pay for workers who struggle themselves as they attempt to provide for their own families amidst their own safety concerns. Many have left the workforce entirely and some have decided to work remotely is all they wish to do at least in the immediate future as we all try to define what our new normal is.  

There are solutions and thankfully some of them are in the process of being implemented. Effective solutions have to be supported by the top, and yes, be embraced by the bottom and from side to side. And in our case, the top means the Office of the President.  

President Biden has laid out a vision to transform how mental health is understood, perceived, accessed, treated, and integrated in and out of health care settings.  

It’s great to see the recently unveiled Federal budget has:  

  • Increased SAMHSA’s funding to $10.13 Billion, a 35% increase from FY2022 
  • Allowed all states and territories to participate in the existing Certified Community Behavioral Health Clinics (CCBHCs) demonstration program 
  • Invested in the behavioral health workforce and delivery, allocating $750 million 
  • Increased the number of mental health providers serving Medicaid beneficiaries
  • Invested in youth mental health and suicide prevention programs and in training, educational loan repayment, and scholarships that help address the shortage of mental health and substance use providers
  • Furthered investments in access to crisis services through 988 and the National Suicide Prevention Lifeline
And there’s more the behavioral health prevention treatment and recovery communities will embrace.  

However, if we’re ever going to get ahead of this mental health, substance use, workforce, youth, equitable care crisis’, this must be a coordinated effort from the top right down to local leaders in true partnerships all coming together to literally save lives. There aren’t many who dispute this to be a top American priority! 

Read more population health articles on the AIHI Blog