President Obama’s Plan in Response to Sandy Hook

I really don’t want to flood people’s inboxes with information, but after reading Now Is the Time–the President’s Plan to Protect Our Children and Our Communities by Reducing Gun Violence, I just HAD to share it and make a couple comments.

First, I appreciate the President including mental health in his plan, but also presenting it in a non-stigmatizing way.  Unfortunately, a lot of the coverage of the Sandy Hook tragedy negatively portrayed people with mental illness, and when that happens, people are less willing to seek help.  I think the messaging for the mental health component of this report is right on target.

Second, I think the mental health recommendations themselves are excellent.  They are practical and address many of the issues for which we have been advocating–training teachers in recognizing the signs of mental illness, promoting early identification and referral to treatment, increasing the mental health workforce, and finalizing the Mental Health and Addiction Equity Rules.

Of course, whether Congress actually approves the funding tied to these proposals is still up in the air, but I think this is a great first step and one that all behavioral health advocates should support.

For ease of view, I have pasted the mental health recommendations below.

MAKE SURE STUDENTS AND YOUNG ADULTS GET TREATMENT FOR MENTAL HEALTH ISSUES

Three-quarters of mental illnesses appear by the age of 24, yet less than half of children with diagnosable mental health problems receive treatment. And several recent mass shootings, including those at Newtown, Tucson, Aurora, and Virginia Tech, were perpetrated by students or other young people.

• Reach 750,000 young people through programs to identify mental illness early and refer them to treatment: We need to train teachers and other adults who regularly interact with students to recognize young people who need help and ensure they are referred to mental health services. The Administration is calling for a new initiative, Project AWARE (Advancing Wellness and Resilience in Education), to provide this training and set up systems to provide these referrals. This initiative, which would reach 750,000 young people, has two parts:

Provide “Mental Health First Aid” training for teachers: Project AWARE includes $15 million for training for teachers and other adults who interact with youth to detect and respond to mental illness in children and young adults, including how to encourage adolescents and families experiencing these problems to seek treatment.

Make sure students with signs of mental illness get referred to treatment: Project AWARE also includes $40 million to help school districts work with law enforcement, mental health agencies, and other local organizations to assure students with mental health issues or other behavioral issues are referred to the services they need. This initiative builds on strategies that, for over a decade, have proven to decrease violence in schools and increase the number of students receiving mental health services.

 • Support individuals ages 16 to 25 at high risk for mental illness: Efforts to prevent school shootings and other gun violence can’t end when a student leaves high school. Individuals ages 16 to 25 are at high risk for mental illness, substance abuse, and suicide, but they are among the least likely to seek help. Even those who received services as a child may fall through the cracks when they turn 18. The Administration is proposing $25 million for innovative state-based strategies supporting young people ages 16 to 25 with mental health or substance abuse issues.

• Help schools address pervasive violence: Twenty-two percent of 14 to 17 year olds have witnessed a shooting in their lifetime. Research shows that exposure to community violence can impact children’s mental health and development and can substantially increase the likelihood that these children will later commit violent acts themselves. To help schools break the cycle of violence, Congress should provide $25 million to offer students mental health services for trauma or anxiety, conflict resolution programs, and other school-based violence prevention strategies.

• Train more than 5,000 additional mental health professionals to serve students and young adults: Experts often cite the shortage of mental health service providers as one reason it can be hard to access treatment. To help fill this gap, the Administration is proposing $50 million to train social workers, counselors, psychologists, and other mental health professionals.  This would provide stipends and tuition reimbursement to train more than 5,000 mental health professionals serving young people in our schools and communities.

 • Launch a national conversation to increase understanding about mental health: The sense of shame and secrecy associated with mental illness prevents too many people from seeking help. The President is directing Secretaries Sebelius and Duncan to launch a national dialogue about mental illness with young people who have experienced mental illness, members of the faith community, foundations, and school and business leaders.

ENSURE COVERAGE OF MENTAL HEALTH TREATMENT

While most mental illnesses are treatable, those with mental illness often can’t get needed treatment if they don’t have health insurance that covers mental health services. The Affordable Care Act will provide one of the largest expansions of mental health coverage in a generation by extending health coverage to 30 million Americans, including an estimated 6 to 10 million people with mental illness. The Affordable Care Act will also make sure that Americans can get the mental health treatment they need by ensuring that insurance plans cover mental health benefits at parity with other benefits.

• Finalize requirements for private health insurance plans to cover mental health services: The Administration will issue final regulations governing how existing group health plans that offer mental health services must cover them at parity under the Mental Health Parity and Addiction Equity Act of 2008. In addition, the Affordable Care Act requires all new small group and individual plans to cover ten essential health benefit categories, including mental health and substance abuse services. The Administration intends to issue next month the final rule defining these essential health benefits and implementing requirements for these plans to cover mental health benefits at parity with medical and surgical benefits.

• Make sure millions of Americans covered by Medicaid get quality mental health coverage: Medicaid is already the biggest funder of mental health services, and the Affordable Care Act will extend Medicaid coverage to as many as 17 million hardworking Americans.There is some evidence that Medicaid plans are not always meeting mental health parity requirements today, an issue that will only become more important as Medicaid is expanded. The Administration is issuing a letter to state health officials making clear that these plans must comply with mental health parity requirements.

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