The Parity Act holds tremendous promise to ensure that insurance companies and the federal government, when it acts as an insurer, treats brain diseases like any other illness in the body. We must make sure that everyone gets the care they need by fully enforcing the federal Parity Law and state parity laws. The federal government and state regulators should conduct random audits of insurers to ensure compliance and absolutely must conduct audits of companies who are the subject of repeated parity violations. The Kennedy Forum and the Scattergood Foundation created ParityTrack.org to help consumers understand and enforce their rights to insurance coverage for behavioral health that is equal to their coverage for other medical care.
Workplace Mental Health
Taking a proactive approach to employee mental health and well-being is critical, especially amid historic rates of overdoses and suicides. Stress, burnout, addiction, and depression ultimately cost employers billions in productivity and health care related expenses. It’s time for business leaders to redefine workplace culture and showcase tangible solutions for addressing mental health onsite and off. Additionally, given their collective purchasing power with health plans, business leaders are in a unique position to drive systemic change and advance parity in insurance coverage. Gone are the days of standard-issue benefits as the be-all and end-all. Mental health and addiction treatment must be part of the package.
It is essential that we learn to manage stress and other emotions early in life. This type of education must be incorporated into our school curriculum—at all stages—in the form of Social and Emotional Learning (SEL). Additionally, those children and adolescents who show signs of mental health conditions should be diagnosed and treated before the conditions progress. School systems are ideal locations for this. By building partnerships between community mental health professionals, researchers, and educators, we can advance prevention and intervention programs that will put our youth on track to become high-functioning adults.
Every medical exam should include a brain health evaluation, including a depression screening. At every age, patients should get a simple “check up from the neck up” (a phrase coined by the Mood Disorders Association of Ontario) every time they see a health care provider. This is especially true for people who have a history of mental illness or addiction. These screenings must be tied to an aggressive plan of early diagnosis and treatment. Mental illnesses and addictions are progressive, but the majority of conditions can be managed, treated or cured with early intervention.
Brain Fitness and Technology
Almost half of American children have experienced serious trauma, damaging their ability to learn, and leading to symptoms of mental illness as they age. Poor academic performance in the U.S., compared to other countries, is largely due to the lack of early and effective interventions for students in need. The research shows that brain fitness programs in America’s schools would help all children become more focused and resilient. These brain-building interventions would center on executive function training; social and emotional learning activities; mindfulness training; brain literacy (learning how the brain works); and neurofeedback. As a nation, we must embrace brain fitness training at every stage of life, as well as new technologies like the expanded use of MRIs, smart phone applications, and electronic medical records that have the capacity to improve the diagnosis and treatment of brain diseases.
Advocacy and Policy
An estimated 22.5 million Americans identify themselves as needing treatment for alcohol or substance use disorders. Nearly 12 million Americans self-report needing mental health treatment or counseling in the past year. As the walls of stigma and shame begin to come down, people experiencing behavioral health conditions and their families are finding each other and organizing themselves. These families represent a powerful political movement that is holding candidates and policymakers accountable for bringing America’s mental health system into the 21st century. As a former Congressman and member of one of the nation’s best-known political families, Patrick is the leading voice for this growing movement for transformative change.
Quality and Outcomes
To improve quality and achieve better outcomes for patients, our behavioral health system must move toward a greater adoption of evidence-based and measurement-based care. For example, only about 18 percent of psychiatrists and 11 percent of psychologists in the U.S. routinely administer symptom rating scales (also known as patient-reported outcome measures) to monitor the improvement of people in their care. Symptom rating scales for depression, anxiety, bipolar disorder, post-traumatic stress, and other conditions are easy to administer and help practitioners determine whether a treatment is working. This is one among many relatively straightforward improvements that our behavioral health care system could adopt quickly.
We have an unprecedented opportunity to uncover the secrets of the human brain and revolutionize our understanding of new ways to treat, prevent and cure brain diseases such as Alzheimer’s, schizophrenia, autism, epilepsy, and traumatic brain injury. This research will require a greater and sustained public and private investment. All brain research should be conducted according to One Mind open science principles, which allow results to be shared around the world to accelerate cures and treatments.
The fastest way to increase the chances of reaching the 26 million Americans who need, but don’t receive behavioral health care each year is to integrate behavioral care into the primary care system. Under the collaborative care model, people can get treatment for conditions like depression and anxiety from their primary care provider, with support and recommendations from a mental health specialist by video or phone. A growing body of research shows that collaborative care is effective in improving patient outcomes and lowering costs. We need to stop talking about collaborative care and start actually providing it.