An Open Letter to New Mental Health Caucus Leader on Top Policy Priorities
By The 2020 Mom Policy Team
Rep. Stewart shared, "I couldn't be prouder to co-chair this bipartisan caucus and elevate the conversation around mental health…suicide is a top ten cause of death nationwide, as well as in my home state. We are wholeheartedly committed to finding real-world, bipartisan solutions to help all Americans struggling with mental health challenges, and we will work tirelessly to uphold that commitment."
2020 Mom submitted the following letter to Rep. Stewart’s office congratulating him and outlining three policy priorities we believe he and the caucus should be focusing on to address the U.S. Mental Health crisis.
February 22nd, 2023
The Honorable Rep. Chris Stewart
Co-Chair of the Congressional Mental Health Caucus
1610 Longworth House Office Building
Washington, DC 20515
Dear Representative Stewart,
We are writing to congratulate you on your recent appointment to serve as the Co-Chair of the Congressional Mental Health Caucus and to share two opportunities for improving the diagnosis and treatment of mental health disorders in America.
2020 Mom (soon to be the Policy Center for Maternal Mental Health) is a national non-profit think tank that aims to eliminate maternal mental health care gaps.
As you well know, our nation is grappling with a mental health crisis, unprecedented overdose rates, racial inequities in healthcare, and healthcare workforce shortages--all of which have been exacerbated by the COVID-19 pandemic.
Mothers, the backbone of families and the economy, certainly have not been immune. In September 2022, the CDC released updated maternal mortality data and found maternal mental health disorders and substance use are the leading cause of pregnancy-related death.
Your previous work authoring the National Suicide Hotline Designation Act and leading to the creation of the 9-8-8 National Suicide Prevention and Crisis Services Lifeline was monumental in the maternal mental health field. We applaud your work as the Co-chair of the 988 & Crisis Services Task Force. You are certainly well-poised to continue elevating mental health as a national bi-partisan priority to improve behavioral health care delivery.
Three immediate opportunities, which are not specific to maternal mental health, include:
Expanding primary care provider capacity by creating a “988 for Providers'' More specifically, creating a national consultation line for primary care providers to obtain real-time support from a psychiatrist to discuss a patient’s mental health with behavioral health professionals, including psychiatrists. Research shows PCPs are de facto mental health care providers and are treating depression but are not treating depression according to clinical guidelines, resulting in inefficient and often ineffective mental health treatment. A consultation program could address this. Such a service exists in many states for pediatricians. Still, it is a fundamental gap for PCPs who are being called on to provide mental health screening, preliminary diagnosis, and treatment plan development for depression and anxiety. This service could be modeled after the Health Resource and Services Administration (HRSA) - AIDs, National Clinical Consultation Center: https://www.hrsa.gov/grants/find-funding/HRSA-20-072
Addressing the Bifurcation of Mental Health from Medical Contracts, which is a foundational barrier to behavioral health integration in medical settings. Private Insurers, starting with the Big-5, could be encouraged to sign a pledge to “kill the carveout” of mental health benefits from patient benefit contracts and provider contracts.
Growing the mental health workforce by providing Technical Assistance to potential employers of lay mental health professionals such as Community Health Workers (CHWs) and Certified Peer Support Specialists (CPSSs). These professionals are well-established and recognized by the Centers for Medicaid and Medicare Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA). State-sanctioned training and certification exist in all 50 states for CPSSs and are growing for CHWs, including Texas and California. However, a substantive and foundational barrier exists: potential employers like health systems and behavioral health clinics are unsure where to find these trained professionals and are unfamiliar with supervisory requirements and billing protocol. A National Technical Assistance Center for the Employment of Lay Professional Workforce, and grants to state public health departments to raise awareness of such a center, could change the trajectory and support the implementation of lay professions into the U.S. health system. Such a program could be housed under HRSA or SAMHSA, though it's important to note CHWs may provide a range of health care service support, not exclusively mental health services.
We look forward to serving as a resource and collaborating with you and the Congressional Mental Health Caucus to tackle these issues and ensure that all mothers and families receive the support they need to lead healthy lives.
Please do not hesitate to contact me to discuss these solutions further.
Sincerely,
Joy Burkhard, MBA
Executive Director
2020 Mom
Joy.Burkhard@2020Mom.org