By Shalini Wickramatilake, MHS

Over the past two months, several U.S. Senate offices have released requests for information (RFIs), seeking input from stakeholder groups about how to address mental health and addiction issues in the U.S. Specifically, the following Senators requested comments from stakeholders:

Senators Wyden (D-OR; Chair of Senate Finance Committee) and Crapo (R-ID; Ranking Member of Finance Committee) solicited policy proposals to address unmet mental health needs in America.
Senators Bennet (D-CO; member of Finance Committee) and Cornyn (R-TX; member of Finance Committee) released a white paper titled, “A Bold Vision for America’s Mental Well-being,” and sought input from experts, community leaders, and constituents on policies to help achieve intended outcomes laid out in the paper, with an ultimate goal of helping to inform a legislative package to address mental health and substance use disorders.
Senators Murphy (D-CT; member of Health Education, Labor, and Pensions [HELP] Committee) and Cassidy (R-LA; member of HELP Committee) sought input on federal mental health and substance use programs, with a particular interest in programs that were last authorized in the 21st Century Cures Act of 2016.

2020 Mom responded to all three of these RFIs. The responses to Senators Wyden & Crapo and Bennet & Cornyn were similar, as our recommendations in both letters were focused on areas where the Senate Finance Committee has jurisdiction (i.e., Medicaid). For the Finance Committee, we offered the following ideas on how to overcome certain barriers to mental health care:

Providers lack guidelines, referral pathways, capacity, and support to screen and treat.
- We recommend:
  - Screening incentives for providers;
  - Treatment expansion, including through bolstering peer support services for mental health;
  - Expanding the use of virtual PCP-to-Psychiatric Consult services; and
  - Having health insurers develop mental health and maternal mental health case management programs to oversee timely treatment access, in coordination with PCPs and obstetricians post-screening and initial treatment plan development.
Medical and mental health insurance and health delivery systems/providers are not integrated.
- We recommend that medical insurers:
  - Bring mental health in-house;
  - Include mental health benefits in all medical care benefit contracts; and
  - Expand medical provider contracts to reimburse for MMH services.
Screening rates are not consistently measured and reported.
- We recommend that the federal government consider the role that the Centers for Medicare and Medicaid Services, the Department of Labor (DOL), and the Agency for Healthcare Research and Quality (AHRQ) should play in ensuring quality measures are developed and reported on, with a particular focus on mental health and maternal mental health.
The federal government is not coordinated in its efforts to support moms with mental health disorders.
- We recommend that Congress prioritize advancing the bipartisan Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act (H.R. 4217/S. 2779).
Moms of color face increased rates of maternal mental health disorders and lower rates of access to care.
- We recommend that Congress swiftly pass the bipartisan Moms Matter Act (H.R. 909/S.484).

For Senators Murphy and Cassidy, who serve on the HELP Committee, which has jurisdiction over most federal health programs, we focused on programs within the Substance Abuse and Mental Health Services Administration (SAMHSA). Some of our recommendations included:

Creating a Center of Excellence for Maternal Mental Health to offer training and technical assistance to providers, helping them better understand how to serve those with maternal mental health disorders.
Authorize a family-centered residential services grant program for those with maternal mental health disorders. The U.S. does not currently have a residential mental health service delivery system for mothers, and 2020 Mom supports the creation of a grant program to offer this level of care to this priority population.
Establish a Pregnant & Postpartum set-aside in Community Mental Health Services (CMHS) Block Grant: The CMHS Block Grant, administered by SAMHSA is a formula grant distributed to all States/territories, ensuring that those with mental health disorders receive the care that they need. We recommend creating a set-aside in the CMHS Block Grant so that pregnant/postpartum moms get priority treatment admissions.
Create a program within SAMHSA to develop the next generation of maternal mental health leaders. This program would aim to strengthen the leadership skills of participants; bolster the capacity of providers and policymakers to address maternal mental health disorders; and create a network of maternal mental health leaders.

If you would like to read the full letters that 2020 Mom submitted, they can be accessed here:

For more information about 2020 Mom’s federal policy platform please feel free to contact our Public Policy Director, Shalini Wickramatilake, at Shalini@2020mom.org