Presidential interviewers should ask about mental health policy

As a mother of three teenagers, I worry about their economic future – their ability to find jobs and afford housing.

But I am equally concerned about their mental health and well-being. A 2022 national survey found that nearly half of 18-25 year olds have a mental illness, a substance use disorder, or both. Suicide and overdose rates remain at an all-time high: As Nicholas Kristof wrote, “every three or four days we lose as many Americans to drugs, alcohol and suicide as dead the Sept. 11 attack,” affects almost every American family. However, other than addressing the supply of fentanyl, no presidential candidate has brought up this country’s mental health crisis in their speeches, nor have they asked questions. they asked about this.

The upcoming presidential debate is the perfect opportunity for both candidates to let voters know how they will address the most pressing public health issue of our time.

There is no denying that we are in a mental health crisis. The Centers for Disease Control and Prevention recently released data showing that 53% of high school girls report feeling sad or hopeless. It’s no wonder that parents of children under 18 now place mental health as their number one concern.

Although the problem of mental health in young people is still there, adults are also affected. Researchers have found that nearly one in four maternal deaths are caused by suicide and drug overdose, making mental health the leading cause of maternal death. Men are also affected by these conditions. They are four times more likely to die by suicide and are more likely to use lethal means, such as firearms. As in other areas of health care, there are significant disparities based on race, ethnicity, gender identity, sexual orientation, disability, and income.

I’m not ignorant – I know that health policy is no more trivial than other issues and the media may not get the most memorable information from these questions. But considering the huge impact on our future prosperity and the loss of hundreds of thousands of lives every year, voters should have an opportunity to evaluate the quality and thoroughness of their response.

Here are three areas that managers David Muir and Linsey Davis need to make sure they address.

1) Can you improve access to mental health and addiction services?

It is very difficult to find a mental health care provider that will take your insurance. A recent study found that “in the largest US cities, only 17.8% of nurses listed as in-network for Medicaid were available, accepted Medicaid, and could provide new patients.” In 2023, Senate Finance Committee staff conducted a confidential consumer survey of Medicare Advantage (MA) plan provider directories, which yielded similar results. In the MA program, insurance plans can receive additional value payments, but the size and accuracy of the network are not included in the $13 billion bonus program. How will candidates coordinate recommendations to ensure better access to providers in the Medicaid and Medicare programs?

Private plans are no better. In the summer of 2023, the Biden administration proposed stronger equity laws to hold health insurance plans more accountable for access to care. Do candidates support strong gender equality laws and commit to implementing them?

Provider fees continue to be inadequate. For example, Medicaid rates for peer support professionals, who help engage and support people with mental health and substance use conditions, vary widely and widely. inexplicable – from $5.98 per 15 minutes in South Carolina to $26.23 in Missouri, two states with comparable costs of living. . How will candidates address the labor shortage and the causes of the shortage, including below-market wages?

Telehealth has been a bright spot in this bleak environment, but progress is not guaranteed. State licensing regulations and individual requirements threaten progress. There is a current battle between the health care industry and drug enforcement agencies over the delivery of addiction and mental health medications via telehealth. Who will you put in charge, and what will you do to expand the reach of the telephone?

Schools and medical facilities are important opportunities to serve people in local communities and reduce inequality. Providing mental health care in schools has been shown to reduce absenteeism. Considering that one in eight children in America is served by community health centers, investing in early childhood programs and integrated health care in these centers will have an impact. Research shows that most people who die by suicide have received health services in the past year, giving the opportunity for better outcomes. How will candidates integrate health care into schools and primary care to reach people where they are?

2) How will you express yourself in these matters?

We will never have enough resources to treat our way out of this problem, so we need a prevention strategy that addresses our mental health problems. For example, reducing adverse childhood conditions, providing housing, and increasing economic stability through tax credits or grants have been shown to reduce risk and improve mental health outcomes. What ideas do the candidates have for improving and preventing mental health and substance abuse?

No prevention strategy would be complete without a focus on social media. Recent research shows that young people spend about five hours a day on public streets. Yet no federal agency is charged with keeping users safe.

When you go to the grocery store, you can look at the box and find information in the same way. It should be the same with social media and knowing where to go to manage our feed and improve our privacy.

And we need to invest in research so that social media can be more effective in promoting well-being, rather than harming it. So, to the candidates: Do you believe that we need to better regulate social media companies and understand the advantages and disadvantages of this platform? Which organization will you put in charge, and what do you want them to do?

Finally, I hope managers will ask the most important questions:

3) Are voters aware of the scale and danger of the mental health crisis?

If so, how will they mobilize a national response equal to the challenges we face led by people who have experienced these issues?

Voters deserve to know the answers to these questions, and managers should ask.

Mary Giliberti is the executive director of public policy at Mental Health America, a national advocacy organization with 143 local and state members. He is the author of the book It is designed to fail blog series and numerous articles on mental health advocacy.

If you or someone you know is thinking about suicide, contact the 988 Suicide & Crisis Lifeline: call or text 988 or chat 988lifeline.org. For TTY users: Use your preferred relay service or call 711 then 988.