APA Kicks Off New MH State Advocacy Forum

At the inaugural session of the new Legislative Representatives Forum, more than half of APA’s district branches (DBs) gathered virtually in June to share their experiences, tools, and tips for shaping mental health care legislation within their states.

The goal is to create a community of advocates. The forum came about because members noticed an uptick in legislation at the state level that impacted psychiatry, such as access to care measures, explained Debra Koss, M.D., a child and adolescent psychiatrist and clinical assistant professor of psychiatry at Rutgers Robert Wood Johnson Medical School.

“As legislators become more aware and interested in this work, it is critical that we as physicians are joining them at the table, lending our expertise and bringing the science to shape legislation. Without that expertise, the potential for unintended consequences with new legislation is high.”

For example, many state lawmakers expanded access to telehealth during the pandemic and are now seeking to rescind those regulations out of concern that wider access could potentially increase costs. “This would put an abrupt halt to treatment for many patients,” Koss said. Ultimately, physicians who are using telehealth to provide treatment are meeting the same standards of care and maintaining patients’ continuity of care, thereby lowering costs by reducing emergency room and hospital utilization. “Yet those are not messages that lawmakers will hear unless we get involved.”

The forum is intended for legislative representatives, DB presidents, and DB executive directors. “Certainly it’s very exciting to see the turnout we’ve had, and we hope that all DBs will join us. I really appreciate the diversity of voices that is available to us in the forum,” Koss said.

At that first meeting in June, participants found that although their local politics in each state differ, they share many of the same concerns. The most pressing issues among attendees were expanding access to telehealth and ensuring fair payment for it; increasing compliance with mental health parity; halting scope of practice expansion for nonpsychiatrists; and implementing 988, the three-digit hotline for suicide prevention and mental health crisis.

Katherine Kennedy, M.D., chair of APA’s Council on Advocacy and Government Relations, said the goal of the forum is for state DBs to collaborate, harness new approaches, and share the tools and resources created by APA staff in the Department of Government Relations, such as model legislation.

“Being in a forum with others facing similar challenges helps energize you. We tend to live in our silos, and sometimes we are reinventing the wheel. The forum allows members to share the setbacks they’ve encountered—as well as effective approaches and best practices—so states can help each other succeed.”

Kennedy said she sees legislative advocacy as a way to improve patient health outcomes at the population level and reduce the health disparities created by the social and structural determinants of health. For example, DBs that attend the forum might learn from other states how they are tackling opioid overdoses among people who have been recently released from incarceration. “You can save lives,” she said.

“Imagine what we could accomplish if we had the collective wisdom of all our legislative representatives and could share with one another the lessons learned within each of our own states. Ultimately, it’s a way to enhance our ability to be effective advocates for mental health care.” ■