Five Question Friday with The National Council for Behavioral Health

We recently sat down with The National Council for Behavioral Health to talk about mental health, advocacy, and public policy amidst COVID-19. As an organization that works to support behavioral health organizations and promotes mental health care for all individuals, The National Council is able to provide important insight into the current state of behavioral health and what the future holds for the organizations on a mission to support the individuals within our communities.

In this Five Question Friday session, we explore advocacy and awareness of mental health care during a pandemic, support and resources for behavioral health organizations, and the future of behavioral health for organizations and individuals in 2021 and beyond.

1.The National Council advocates for policies to improve care and access to treatments for mental health and substance use disorders. How have you seen the pandemic change views toward mental health?

There is considerable evidence that COVID-19 is already exacerbating the nation’s mental health and addiction crises. Data from the Centers for Disease Control and Prevention (CDC) in August showed that 40% of Americans are now struggling with mental health or substance use and that anxiety and depression, suicidal thoughts, and stress are all elevated nationwide.

It is important to note the pandemic is taking a disproportionate toll on minority, low-income, and vulnerable populations. The influx of COVID-associated behavioral health concerns, combined with increased risk for contracting and transmitting COVID-19 among patients with underlying behavioral health conditions, are putting tremendous stress on our nation’s behavioral health infrastructure.

We have surveyed our members throughout the COVID-19 pandemic and the data is clear – behavioral health organizations are struggling financially. They have been forced to reduce capacity, close programs, and turn away patients. However, because of the disproportionate impact of the pandemic on mental health, we are seeing increased interest in addressing this growing crisis on the federal and state levels. One example is the recent Department of Health and Human Services Provider Relief Funds – in announcing the third phase of funding, HHS Secretary Alex Azar emphasized how behavioral health providers have shouldered the burden of responding and confronting expanded challenges triggered by COVID-19.

It is clear that Americans recognize the need to address mental health care in this country. We recently partnered with Morning Consult to gauge American voters’ attitudes around COVID-19’s impact on mental health and substance use and found that an overwhelming majority (80% of Republicans and 91% of Democrats) now support increased funding for mental health and addiction recovery treatment.

2.How has the National Council been supporting behavioral health providers throughout COVID-19?

We have taken a multi-faceted approach to supporting behavioral health providers as they weather this pandemic. One key element has been our advocacy at the federal and state levels. Since the start of this pandemic, we have advocated for behavioral health in various COVID relief packages, as well as for an emergency appropriation of $38.5 billion for behavioral health providers to address their growing financial needs. We have also worked to secure additional funds for the Substance Abuse and Mental Health Services Administration (SAMHSA), successfully resulting in increased mental health and substance use block grant funding, as well as an increase in the Medicaid Federal Medical Assistance Percentage (FMAP) in COVID-19 relief packages.

We have served as a resource to behavioral health providers as they navigate funding related to the pandemic, as well as providing technical assistance for any financial or clinical concerns that have arisen. We also created materials to assist our members’ Get out the Vote initiatives, to help encourage civic engagement and its role in recovery. In March, we established the National Council COVID-19 Relief Fund, which allowed us to facilitate donations to providers, and between April and June we coordinated the distribution of 2.3 million masks to behavioral health organizations. The National Council established a COVID-19 Resource page for providers to access training, webinars, information on best practices and recent legislative and regulatory changes.

3.How do you see your advocacy efforts changing in 2021 and beyond amidst a changing behavioral health landscape?

As we continue to face the impact of the pandemic, we will continue to advocate for many of the same efforts in 2021 – expanding access to high-quality behavioral health care, extending and expanding the Certified Community Behavioral Health Clinic (CCBHC) demonstration, upholding behavioral health parity and increasing access to telehealth and opioid use disorder medication. As addiction treatment need rises, we will not be able to meet it with the current restrictions on mediation-assisted treatment (MAT) and existing telehealth restrictions.

Another effort we look forward to being involved with in the coming year is the implementation of 9-8-8, which was signed into law in October. While having a three-digit number available for those experiencing a mental health crisis is critically needed, the focus now turns to leading the charge on planning how to best position the behavioral health system to meet that need by 2022.

4.The National Council is also the organization behind Mental Health First Aid USA, which trains individuals on how to identify and respond to signs of mental health challenges. Can you speak to MHFA’s impact during the pandemic?

As soon as it became clear that in-person training would be unable to proceed, the National Council team quickly began creating a virtual delivery option for both instructor trainings and Mental Health First Aid courses. Since launching our virtual training in the spring, over 2,000 new instructors have been trained, more than 8,000 instructors have registered to be trained to teach virtually, and almost 5,000 virtually-certified instructors have trained more than 37,000 first aiders. Additionally, the MHFA team has published many resources providing information on how to help oneself and their loved ones take care of their mental health during COVID-19 and how MHFA can be a valuable tool to support this. These resources have included blog posts, social media posts, infographics, and toolkits sharing tips and resources from the MHFA curriculum to support different audiences during COVID-19. Audiences include adults, parents, teen, youth, employers, essential workers, public safety, health care workers, and caregivers.

The National Council continues to hear from our instructors, members, and the First Aider community on how essential this training is at this time. As one of our instructors wrote in a recent blog post, “It’s important that as First Aiders we normalize conversations about mental health and share available resources in our communities.” In this unprecedented time, continuing to train individuals to better support themselves and their communities remains essential and our central mission.

5.What impact, if any, do you expect that the recent election will have on behavioral health policy and funding in 2021 and beyond?

While we’re still waiting on the outcome of the two Georgia Senate races to determine control of the Senate, we expect that President-elect Biden’s administration will bring about many legislative and regulatory changes for behavioral health. President-elect Biden has demonstrated throughout the election that a major policy priority for his administration will be health care. Throughout the Biden campaign, President-elect Biden has expressed a commitment to behavioral health in a number of ways, including addressing the opioid crisis, working to enforce parity laws, supporting the expansion of CCBHCs, supporting the mental health workforce, and facilitating access to mental health care for veterans and the LGBTQ+ population. One thing this election highlighted to us is that mental health and addiction remain bipartisan issues. That is, access to high-quality behavioral health care is important to all Americans – no matter their political beliefs.