Geller Testifies on MH Needs During Pandemic and Beyond

During a virtual hearing of the U.S. House Committee on Energy and Commerce Subcommittee on Health on June 30, APA President Jeffrey Geller, M.D., M.P.H., urged Congress to take action to curb the mental health impact of the COVID-19 pandemic.

“We expect that, even after the infectious aspect of this pandemic is over, we’re going to have a mental health pandemic that could go on for quite some time,” Geller told the subcommittee.

The hearing, titled “High Anxiety and Stress: Legislation to Improve Mental Health During Crisis,” addressed 22 pieces of legislation related to mental health care pending before Congress. Geller expressed APA’s support for legislation that would achieve the following:

• Require the Department of Health and Human Services to collect, analyze, and make publicly available data on race and ethnicity related to COVID-19 testing, hospitalization, and mortality as well as the mental health effects of the pandemic.

• Enforce the parity law, which requires insurers to cover mental health at the same levels as other medical care.

• Continue expanded telehealth rules beyond the COVID-19 emergency.

• Strengthen congressional efforts to prevent suicide.

• Ensure that patients who present in the Emergency Department with suicidal ideation or who have attempted suicide are screened and referred to appropriate mental health treatment.

• Boost resources for call centers, 24/7 mobile crisis units, and crisis stabilization programs.

Geller especially expressed APA’s support for the Telemental Health Expansion Act of 2019 (HR 5201), introduced by Reps. Doris Matsui (D-Calif.) and Bill Johnson (R-Ohio). The legislation would permanently exempt tele-mental health services from Medicare’s geographic restrictions, such as requiring patients to travel to a qualifying “originating site” for appointments.

“About 65% [of psychiatrists] had not previously used telehealth, and now 85% are using telehealth for about three-quarters of their patients,” Geller told the committee. “The combination of allowing for visual as well as telephone-only services is very important as you have many patients who have no idea how to use any electronic equipment whatsoever.”

He also highlighted the Mental Health Parity Compliance Act (HR 3165), sponsored by Reps. Katie Porter (D-Calif.), Gus Bilirakis (R-Fla.), and Donald Norcross (D-N.J.). This legislation would ensure that health insurance plans comply with the Mental Health Parity and Addiction Treatment Act of 2008.

The COVID-19 crisis has unmasked clear racial disparities and inequities, Geller told the subcommittee. “We cannot begin to remedy systemic issues within health care access and delivery if we do not first have quantifiable data from which to inform our policy proposals,” he said in his written testimony.

During the question-and-answer portion of the hearing, Geller stressed that he believes a campaign is urgently needed to reduce prejudice and discrimination toward people with mental illness and called on Congress to help such an effort.

“We use the word ‘stigma,’ but I think it’s actually an unfortunate word,” he said. “It is prejudice and discrimination to think that if someone has a mental illness, they’re not capable of functioning.”

Geller also addressed the issue of domestic violence and sexual assault potentially increasing as people find themselves required to stay at home while living with a perpetrator of violence. “People are stuck at home together, they’re afraid to report, or they’re afraid to leave home to report,” Geller said. “We have to be cognizant of this phenomenon and specifically address it. It has not been talked about a great deal.”

The only bill addressed during the hearing that APA opposed was the Medicare Mental Health Access Act (HR 884), introduced by Rep. Judy Chu (D-Calif.), which would define psychologists as physicians under Medicare. In his written testimony, Geller noted that the bill “would further fragment care by creating unnecessary and dangerous silos between all health care providers who should be working collaboratively.” APA strongly encourages members to contact lawmakers to express their opposition to this legislation.

Geller testified along with former Rep. Patrick Kennedy, founder of the Kennedy Forum; Arthur C. Evans Jr., Ph.D., CEO of the American Psychological Association; and Arriana Gross, a member of the National Youth Advisory Board of the Sandy Hook Promise Students Against Violence Everywhere Promise Club. ■