APA Pleased Over Recent Legislative Wins but Must Keep Pushing

It has been a whirlwind first two months on the job as your president! I have been on the media and advocacy trail to promote awareness, educate the public, and support APA’s legislative agenda in Washington on major mental health initiatives. APA has had some key successes in Washington, yet there are also challenges ahead. In this month’s column, I first share with you some of the highlights of what APA is learning and doing to advance psychiatry, mental health, and the well-being of those we serve and then turn our focus to the ongoing work ahead as we push forward on the public- and policy-focused elements of my Roadmap for the Future.

Let’s start with the positives. With the increasingly widespread recognition of the mental health pandemic and public safety crises our country is facing as COVID-19 continues to simmer, in June Congress passed the Bipartisan Safer Communities Act with key provisions that align with APA policy on firearm safety and mental health resources (“Congress Passes First Significant Gun Safety Bill in Decades”). President Joe Biden signed the bill into law shortly after, and representatives of APA were at the White House last month to celebrate this historic legislation. (I even have a selfie taken by President Biden to prove it!) This is the first meaningful gun safety law passed in three decades and includes APA-supported measures to reduce firearm violence. Specifically, provisions include $750 million in grants for states to create, implement, and improve extreme risk protection orders (ERPOs), also known as red flag laws, to prevent possession of firearms by those at high risk for violence. The law also requires additional background checks for gun purchasers under 21, including access to juvenile records, and provides funding for violence-prevention programs in communities.

In addition, the bipartisan act includes funding for mental health initiatives to improve resources and promote access to care. The more than $9 billion in funding on these provisions includes $8 billion for Medicaid Certified Behavioral Health Clinics, $150 million to states for the rollout of the 988 National Suicide Prevention Lifeline, $500 million for school-based mental health services programs, $140 million for pediatric mental health care access and mental health training for primary care providers, and additional assistance to states to expand telehealth.

However, we cannot—and we will not—stop now. APA remains committed to additional measures to reduce gun violence and save lives, including restricting the sale and use of assault weapons and high-capacity magazines. In addition, while the provisions related to mental health are a welcome beginning in mental health investment, after years of inadequate flat funding of our nation’s mental health infrastructure, these resources are just the start of what’s needed to support Americans. In APA’s monthly public opinion survey in July, Americans expressed both anxiety and concern about mental health, with financial stress ranking first on the list. They are struggling to make ends meet to the point that the cost of treatment may lead them to forego care. We must work to prevent a downward spiral through future appropriations and parity enforcement. Some good news here is that the House of Representatives, through passage of the Restoring Hope for Mental Health and Well-Being Act (HR 7666) also in June, has supported investments in parity, collaborative care, crisis services, and workforce equity investments. I will continue to work tirelessly with the APA administration on these important initiatives to secure resources to advance psychiatric practice and reimbursement, reduce administrative burdens, and provide access to high-quality, evidence-based mental health care for every American.

On a final note, however, our path ahead will not be easy, especially in light of the recent Supreme Court Dobbs decision that not only overturned 50 years of federal protection for abortion as part of women’s reproductive health, but also sent a chilling signal regarding the Court’s potential to roll back or even eliminate other federal protections based on race, ethnicity, gender identity, and sexual orientation, to name a few. APA will continue the fight with our sister medical and mental health organizations to prevent government intrusion into the doctor-patient relationship in any domain of care and treatment and to preserve and promote the rights of every American to be free from discrimination in recognition of the damage to health—mental and physical—and human dignity itself that discrimination causes. We have our work cut out for us to create a mentally and physically healthy nation for all.

Please keep in touch! I learn so much from members who take the time to communicate their experiences and thoughtful views on what APA can do to secure a bright future for psychiatry and mental health. Join the conversation by following me on twitter @APA_Pres. And stay tuned for next month, when I will provide an overview of the innovative and timely in-person APA Mental Health Services Conference to be held in Washington, D.C., on October 13 and 14. ■