Mental Health Care in the United States

The Case for Federal Action

By: United States Senate Committee on Finance

Narrated by: Tom Brooks

Letter from Chairman Ron Wyden:

The United States is experiencing a profound crisis when it comes to mental health care. In a recent Senate Committee on Finance hearing on youth mental health, US Surgeon General Dr. Vivek Murthy shared that Americans wait 11 years, on average, between onset of mental health symptoms and first receiving treatment. This gap is staggering. The consequences are plain to see: higher suicide and drug overdose rates, more Americans without a safe place to sleep at night, more children experiencing depression and anxiety that will compound as they grow into adulthood. The house is on fire, and the nation is short on firefighters equipped to put out the blaze. This crisis has been made even worse by the disruption, isolation, and loss experienced in the COVID-19 pandemic.

This issue is deeply personal for me. For years, my brother struggled to access the mental health care he needed, and our family struggled against the painful stigma that has surrounded mental illness for as long as I can remember. It is a tragedy that helping a loved one get care is still a challenge for millions of other families around the country.

I hear about the challenges of getting mental health care every time I visit communities in my home state of Oregon. Mental health is the premier concern for families across my state because their loved ones need help and too often are unable to find it. More people are in crisis, and there are fewer people to take care of them. Oregon's rate of unmet need for mental health treatment is one of the highest in the nation, ranking behind just three other states. One in five youth had a major depressive episode last year, and less than half received care. Among adults, 43 percent of adults in Oregon who reported any mental illness received treatment. People are calling for help. Youthline, a peer-to-peer crisis line, has seen a 15 percent increase in calls.

As chairman of the Senate Finance Committee, I am partnering with ranking member Mike Crapo on a major bipartisan effort to bring behavioral health care to the forefront of the US health system by leveraging the programs under this committee’s jurisdiction, including Medicare, Medicaid, and the Children’s Health Insurance Program. Ten members of the committee—five Democrats and five Republicans—have stepped forward to lead on policy areas that will be vital for a path forward, including Senators Debbie Stabenow and Steve Daines on the behavioral health workforce; Senators Catherine Cortez Masto and John Cornyn on care integration, coordination, and access; Senators Michael Bennet and Richard Burr on mental health parity; Senators Ben Cardin and John Thune on telehealth; and Senators Tom Carper and Bill Cassidy on improving care for children and young people.

The committee’s work has begun. In the fall of 2021, the committee issued a public request for information that received 300 submissions from experts and advocates around the country. The committee has held hearings bringing together leaders, providers, and patients who shared their stories and offered solutions.

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©2022 Tom Brooks (P)2022 Tom Brooks