Workplace wellness was boosted when President Biden recently mandated insurance companies to increase coverage of mental health support services, including
The White House's
In 1996, Congress passed the Mental Health Parity Act (MHPA) to prohibit group health insurance plans from establishing disparate dollar limits for mental health vs. medical benefits. This law was focused on mental health conditions and did not address SUD, which has exploded because of the pandemic.
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In 2008, MHPA was expanded to the Mental Health Parity and Addiction Equity Act (MHPAEA) to ensure patients seeking treatment for mental health and SUD receive the same benefits afforded individuals receiving healthcare for physical conditions. The passage of the MHPAEA strengthened the parity between mental health and medical treatments while incorporating additional provisions requiring insurance plans to demonstrate compliance.
Fast forward to 2023. Although MHPAEA has been in effect since 2006, its effectiveness is still being questioned. Many believe the MHPAEA has improved insurance coverage and access to mental health and
In addition to eliminating disparities between insurance coverage for mental health and SUD, the law includes enforcement provisions. The U.S. Department of Labor, Health and Human Services, and state insurance regulators are allowed to conduct audits and provide oversight to ensure compliance.
Despite the existence of these legal requirements, certain insurers still engage in practices violating the parity law, leading to inadequate coverage for mental health and SUD treatments. This is why ongoing efforts are needed to ensure proper compliance and enforcement.
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According to this new executive ruling, health plans must evaluate outcomes of their coverage rules to ensure employees equal access between mental health and medical benefits. This evaluation will reveal gaps in legal compliance requirements and a lack of access to mental health care due to a scarcity of in-network mental health professionals and administrative red tape.
This is where the problem begins. It is notable and noble to believe a promising new mandate will increase the utilization of mental health and SUD services, ensure comparable payment for mental healthcare professionals and incent more people to join the mental health workforce. But in reality, this rule is certain to add additional stress to already distressed insurance and behavioral healthcare systems as noted in the December 2022
The AHA notes that the stresses of COVID-19 have exacerbated the existing mental health crisis. America is ill-prepared to respond to these needs due to severe shortages in the behavioral health workforce, as more than 100 million Americans live in areas lacking enough psychiatrists. The impact on hospitals and health systems has forced hospitals to decrease their workforce and often close their doors.
Further, the American Psychological Association
Just when behavioral healthcare givers are desperately needed, service providers are themselves desperately in need of care. These highly qualified professionals are reportedly leaving the field in droves, and some of those who remain are taking their lives more than any other profession. A Washington University study found nearly one doctor commits suicide every day. These statistics are alarming and foreshadow a behavioral healthcare system on the brink of collapse.
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The process to meet the current demand presents many barriers. Clinical psychologists must have a masters or doctoral degree. Furthermore, many states require aspiring clinical psychologists to participate in a postdoctoral psychology fellowship program to obtain 'supervised clinical hours' to qualify for licensure. Fellowships can add an additional two years to the educational journey. It can take students as long as 10 years of undergraduate and graduate study before they are eligible for licensure. This investment of time and money makes this career choice unobtainable for many.
What solutions currently exist to meet this critical need and relieve the stress on the overburdened system? As an HR professional who trains and certifies professional recovery coaches, addiction awareness facilitators, peer recovery support practitioners and others in the behavioral health workforce, I am a fierce advocate for expanding non-clinical behavioral health practitioners to supplement the continuum of care.
Many coaches, facilitators and peers have what is referred to as "lived experience" qualifying them to help struggling individuals connect with resources and navigate complex, expensive systems of care. Today's overextended behavioral healthcare system needs to expand adult prevention programs and develop a qualified non-clinical workforce to complement clinical practitioners. Such programs already exist and are committed to developing this workforce in less time and at a lower cost than through traditional clinical education pathways.
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In addition to having lived experience with mental and behavioral health issues, participants in these programs come from all backgrounds. Many are in recovery from SUD, while others work as addiction counselors and therapists, health and wellness coaches, HR professionals, nurses, airline pilots, musicians, attorneys and more.
These individuals are ideally suited to help develop and sustain the
The ICARE and IAPRC awareness, prevention and recovery support programs have been recognized by organizations such as
It is my hope that policymakers, insurance providers and others in the behavioral healthcare system will acknowledge the value of these non-clinical behavioral health professionals and work to cooperatively and expeditiously remove regulatory and financial barriers that impede the growth of today's desperately challenged workforce.
