May 2, 2022

How to transform mental health care: Follow the research

We applaud President Biden and Congress as they begin to set policies that focus on evidence-based approaches to meeting Americans’ mental health needs.

Contributed by Anthony A. Barrueta, Senior Vice President, Government Relations

In his 2022 State of the Union address on March 1, President Joe Biden called on Congress and the country to unite behind his agenda to improve the mental health and wellness of all Americans. Congress is also holding extensive hearings on mental health legislation introduced by both Republican and Democratic parties. It’s one bright area of bipartisan cooperation in a persistently polarized environment. Kaiser Permanente’s mental health and wellness guiding principles align with many of the administration’s priorities and some of the proposals before Congress.

This is important. Among the most encouraging details of the president’s plan is recognition that public policy must emphasize broader use of evidence-based models for treating mental health conditions — treatment modalities that are based on scientific research and are consistently shown to improve patient outcomes.

As described, the president’s plan is “laying out a vision to transform how mental health is understood, perceived, accessed, treated, and integrated — in and out of health care settings.” The White House plan also focuses on:

  • Increasing and diversifying the mental health workforce
  • Supporting collaborative care and other evidence-based models of treatment
  • Expanding access to video and virtual mental health care options
  • Investing in support for children and youth at their schools and universities
  • Expanding and strengthening mental health parity

By establishing and advocating for mental health public policy principles based on our own research and clinical expertise, our aim at Kaiser Permanente is to help policymakers focus on the fundamental objective of evidence-based care: improving patient outcomes.

From parity to new treatment models

The federal Mental Health Parity Act has been the law of the land for more than 25 years. It requires most health plans to provide equal coverage for physical health as they do for mental health and substance use disorders. Kaiser Permanente and other health care organizations support efforts to improve access to mental health and substance use disorder benefits through the vehicle of parity.

Nearly 1 in 5

Adults in the U.S. live with a mental illness

Still, during this Mental Health Awareness Month, we will miss the opportunity to drive needed change if we keep telling ourselves the primary problem is inadequate insurance coverage. America’s system of mental health care simply has not advanced much further beyond the decades-old, one-size-fits-all model of medication and regular psychotherapy. There is a place for this treatment model for many people, however, there is evidence to support other approaches to treatment.

We support new efforts from the president and Congress to encourage collaborative care and other evidence-based models of treatment. These efforts are exciting and could jump-start a remodel of our mental health care system for the benefit of the 53 million Americans living with a mental illness, especially those in underserved communities, in crisis, and who are experiencing homelessness.

Expanded workforce essential

At Kaiser Permanente, we believe the mind can’t be treated separately from the body. That belief guides our mental health research and our adoption of different treatment models for mental health care.

Our focus on collaborative care, for example, connects a patient’s primary care team with mental health and addiction specialists. We also use a feedback-informed care model, which continually gathers patient feedback to track progress and determine when to provide other evidence-based treatments. And we’ve seen positive outcomes from the use of telehealth, group therapy, digital self-care tools, and other ongoing support that helps patients receive care and maintain their mental well-being.

Of course, how rapidly we can realize the full potential of this array of evidence-based treatment models depends on how quickly we can significantly expand our mental health workforce to meet current and future needs. We are actively working to increase the number of diverse, full-time mental health clinicians trained to work within these models across Kaiser Permanente.

The real parity we seek

The new White House plan has the potential to significantly boost access to care. It supports research to validate treatments that can be tailored to individual patient needs. It also ensures those treatments can be used equitably in our communities with the help of a transformed workforce.

This can bring us closer to the real parity we seek — a mental health care system that is as effective as our medical care system — because it will help build out the capabilities and capacities of effective and lasting treatments for mental health conditions and substance use disorders.

None of us should be happy with the progress made to date in meeting the enormous unmet need in our society for mental health services. But with the right policy focus, we could find ourselves in an exciting and more hopeful period of transformation, one that ensures effective evidence-based mental health and addiction care are readily available for those who desperately need it.