Opinion: It’s Time to Act on Mental-health Access

By Sara Kendall, vice president of Clinical Operations at the Mental Health Assoc.

Safeguarding the mental health of all Baystate residents and ensuring their access to needed behavioral healthcare in a timely fashion is a key component of legislation currently before the Massachusetts Senate.

The Commonwealth generally rates well in national estimates comparing states on prevalence of mental illness and availability of care, but the coronavirus pandemic’s impact on this aspect of health has highlighted the need for more clinicians in the state to address it, more treatment beds outside of emergency rooms, and further measures that lock in fair and equal insurance payments to providers in this field.

Senate President Karen Spilka is a strong advocate of the bill, “An Act Addressing Barriers to Care for Mental Health.” It is sponsored by the Senate Committee on Ways and Means, whose members include Sen. Eric Lesser, who represents the First Hampden and Hampshire District, and the initiative would be funded in part with money from the federal American Rescue Plan Act.

One aspect of the bill that holds the potential for long-term progress in recognizing the equal importance of behavioral health and overall health and flagging any issues early is a provision that would provide coverage for an annual mental-health wellness examination.

The inclusion of such an exam for the general population, similar to a wellness check for physical symptoms, is a vote for prevention of chronic behavioral-health issues that can also lead to medical conditions when left untreated.

The foundation of an individual’s mental health begins early and is influenced in childhood by many factors, including relationships with family members and others, exposure to traumatic events, and genetic predispositions. It has been estimated that half of all mental-health conditions start by age 14, but that most go undiagnosed for at least a decade.

Similarly, studies over time have consistently shown mental-health disorders to be a top cause of disability. It is not uncommon for individuals to suffer more than one such disorder. For example, a substance-use disorder may exist with a diagnosis for depression or anxiety.

The language in Senate Bill 2572 defines a mental-health wellness exam as a “screening or assessment that seeks to identify any behavioral or mental-health needs and appropriate resources for treatment.”

This, it says, could include “observation, a behavioral-health screening, education and consultation on healthy lifestyle changes, referrals to ongoing treatment, mental-health services, and other necessary supports and discussion of potential options for medication.”

It also allows for “age-appropriate screenings or observations to understand a covered person’s mental-health history, personal history, and mental or cognitive state, and, when appropriate, relevant adult input through screenings, interviews, and questions.”

Spilka told reporters that legislators “really, really have a responsibility in this moment to ensure that every resident of the Commonwealth has equitable access to mental healthcare, no matter who they are, no matter where they live.”

This is, indeed, the moment to act in the best interest of everyone’s mental and physical health.