President Biden’s proposed 2023 budget signifies a step forward in addressing today’s mental health crisis. It provides $697 million to expand crisis-care services for those at risk of suicide or who are experiencing a behavioral health crisis. It further includes $7.5 billion for mental health workforce development and service expansion; gives $35.4 billion to improve mental health access in Medicaid; and includes $4.1 billion to permanently extend funding for Community Mental Health Centers.
Yet such funding raises as many new questions as it answers. Which organizations or centers receive funding and how much? How much money will be slated for developing more child psychiatrists versus social workers? Will those in underserved areas be prioritized? And who will decide if the work is having a sufficient impact?
It’s time to formalize oversight of such funding and programs to ensure they’re serving to benefit the growing number of Americans affected by mental illness. To that end, President Biden should appoint a Mental Health Czar to best lead and direct such efforts.
A growing body of data has shown how the pandemic and pandemic-related policy has exacerbated the mental health crisis plaguing this country. Late last year, a coalition of the nation’s leading experts in pediatric health came together to declare mental health among children to be a national emergency, pointing to an acceleration of trends observed prior to 2020. And in late March 2022, the CDC released survey findings showing that more than a third of high school students experienced feelings of sadness and hopelessness since the onset of COVID. Approximately one in five of surveyed students seriously considered suicide and about one in 10 students attempted to end their lives.
The issue is not limited to children and adolescents. A Kaiser Family Foundation analysis of US Census Bureau data showed that between 2019 and early 2021, the number of adults reporting symptoms of anxiety or depression jumped from 1 in 10 to 4 in 10. In addition, there’s been extensive reporting of the pandemic’s impact on hospital workers and others on health care’s front lines.
Addressing such issues requires leadership, which is not possible without a designated and qualified person in charge. What’s more, such a leader could help push for continued improvements with key insight from mental health professionals who are in the trenches, helping individuals with mental health needs and their families every day.
For example, an empowered and informed Mental Health Czar might take issue with Biden’s budget allotment of $1.2 billion and $3.5 billion to improve access to behavioral health services in the private insurance market and Medicare, respectively — proposals that only cover three behavioral health visits per year . It doesn’t take extraordinary expertise to understand that three visits per year provides almost no help to those with mental health challenges, to say nothing of the 10 million individuals in the US who have been diagnosed with a serious mental illness requiring lifelong treatment and support .
A Mental Health Czar could also help keep abreast of shifting trends in the mental health landscape. For example, there was a time when middle aged white men were at the highest risk of suicide, yet rates of suicide for those in middle age ticked down during the pandemic while rates of suicide among young adults increased.
It is likely that this country’s mental health needs will continue to change as the US shifts its response to the pandemic. Ensuring those who are suffering receive sufficient and meaningful help can be best accomplished by empowering someone to lead and direct efforts at the federal level.
Carolyn Reinach Wolf is a mental health attorney who specializes in guiding families through the complex landscape of legal issues that affect those with serious mental illness. She is an Executive Partner in the law firm of Abrams Fensterman and Director of the firm’s Mental Health Law practice.