This week, Hillary Clinton announced her comprehensive plan to support Americans living with mental health problems and illnesses. Recognizing that nearly a fifth of all adults in the United States — more than 40 million people — are coping with a mental health problem, Hillary’s plan will integrate the mental and physical health care systems. Her goal is that within her time in office, Americans will no longer separate mental health from physical health when it comes to access to care or quality of treatment. Hillary has been talking about mental health policy throughout her campaign, since hearing directly from American parents, students, veterans, nurses, and police officers about how these challenges keep them up at night.
According to a Fact Sheet provided by the Hillary for America campaign, Hillary will convene a White House Conference on Mental Health during her first year as President. In addition, her comprehensive agenda on mental health will:
- Integrate our nation’s mental and physical health care systems so that health care delivery focuses on the “whole person,” and significantly enhance community-based treatment opportunities. Hillary’s plan will foster integration between the medical and behavioral health care systems (including mental health and addiction services), so that high-quality treatment for behavioral health is widely available in general health care settings. Hillary will expand reimbursement structures in Medicare and Medicaid for collaborative care by tasking the Center for Medicare and Medicaid Innovation to create and implement new such payment models.
- Promote early diagnosis and intervention, including launching a national initiative for suicide prevention. The overall rate of suicide increased by 24 percent between 1999 and 2014, and is now at its highest level in 30 years. Hillary will direct all relevant federal agencies, including Health and Human Services, Veterans Affairs, and the Department of Education, to research and develop plans for suicide prevention in their respective settings, and create a cross-government initiative headed by the Surgeon General to coordinate these efforts. She also believes we must redouble our efforts around early screening and intervention – and that means training pediatricians, teachers, school counselors, and other service providers throughout the public health system, to identify mental health problems at an early age and recommend appropriate support.
- Enforce mental health parity to the full extent of the law. The Mental Health Parity and Addiction Equity Act of 2008, which Hillary co-sponsored, requires that mental health benefits under group health plans be equal to benefits for other medical conditions, and the Affordable Care Act requires insurance plans in the individual and small group markets to offer mental health coverage as an essential health benefit. But while the right laws are on the books, they are too often ignored or not enforced. As part of her commitment to fully enforcing the mental health parity law, Hillary will launch randomized audits to detect parity violations, and increase federal enforcement. She will also enforce disclosure requirements so that insurers cannot conceal their practices for denying mental health care and strengthen federal monitoring of health insurer compliance with network adequacy requirements.
- Improve criminal justice outcomes by training law enforcement officers in crisis intervention, and prioritizing treatment over jail for low-level offenders. As many as 1 in every 10 police encounters may be with individuals with some type of mental health problem, and our county jails today house more individuals with mental illness than our state and local psychiatric hospitals. She will dedicate new resources to help train law enforcement officers in responding to conflicts involving persons with mental illness, and increase grant funding to support law enforcement partnerships with mental health professionals. She will also increase investments in local programs such as specialized courts, drug courts, and veterans’ treatment courts, which send people to treatment and rehab instead of the criminal justice system, and direct the Attorney General to issue guidance to federal prosecutors, instructing them to prioritize treatment over incarceration for low-level, non-violent offenders. Finally, she will work to strengthen mental health services for incarcerated individuals and ensure continuity of care so that they get the treatment they need, which will improve outcomes for them after they reenter society and will reduce recidivism.
- Improve access to housing and job opportunities. As president, Hillary will expand community-based housing opportunities for individuals with mental illness and other disabilities. Hillary will launch a joint initiative between the Departments of Housing and Urban Development (HUD) and HHS to create supportive housing opportunities for thousands of people with mental illnesses and disabilities, who currently reside in or are at risk of entering institutional settings. The employment rate for people with serious mental illness is below 20 percent, even though many of these adults want to work and more than half could succeed with appropriate job supports. Hillary will work with private employers and state and local mental health authorities to share best practices around hiring and retaining individuals with mental health problems, and in adopting supported employment programs. She’ll also expand HHS’s “Transforming Lives Through Supported Employment” program, which already assists states and communities in providing supported jobs to people with mental illness.
- Invest in brain and behavioral research and developing safe and effective treatments. Hillary believes we need a pioneering, multi-sector effort to transform our knowledge of this field—from mapping the human brain to generating new insights into what drives our behavior to investing in clinical and services research to understand the interventions that work best and how to deliver them to patients. As president, Hillary will significantly increase research into brain and behavioral science research. She will provide new funding for the National Institutes of Health; build on cross-collaborative basic research efforts like the BRAIN initiative; scale up critical investments in clinical, behavioral, and services research; and integrate research portfolios with pioneering work on conditions like PTSD and traumatic brain injury already underway at DoD, the VA, and HHS. She will develop new links with the private and non-profit sectors to ensure that federal government efforts are aligned with those of other sectors to ensure that progress occurs as quickly as possible. She will also commit to brain and behavioral science research based on open data.
The full comprehensive proposal is available on HillaryClinton.com here.