In a bold move to tackle the mental health crisis in the United States, Democratic presidential candidate Kamala Harris has unveiled a comprehensive plan aimed at reforming mental health treatment across the country. If passed, this plan could lead to new opportunities for behavioral health providers, increase reimbursement rates, and expand access to care for millions of Americans. The proposal includes a series of initiatives to address the nation’s growing mental health needs, ranging from increasing the number of mental health treatment beds to expanding telehealth services and removing the restrictive Institutions for Mental Diseases (IMD) exclusion. Harris’s plan also prioritizes efforts to address the behavioral health workforce shortage and the stigma that continues to surround mental illness.
The Plan’s Key Objectives
Harris introduced her plan Monday in South Carolina, which, along with Iowa, Nevada, and Michigan, will be a priority state under the proposal. At its core, the plan aims to overhaul how the United States addresses mental health care, moving it out of the shadows and creating a system that treats mental health with the same seriousness as physical health. As Harris noted during the announcement, “It is about time that we take this issue out of the shadows, that we stop stigmatizing this issue and that we give people the health care they need both from the neck down and from the neck up.”
While the specific cost of the plan was not detailed, Harris has made it clear that it will largely be funded by her previously released Medicare for All plan, which guarantees comprehensive coverage without deductibles or copays for those seeking treatment. Additionally, the proposal calls for a $100 million Tribal Emergency Fund, administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), to address behavioral health challenges in tribal communities.
Doubling the Number of Mental Health Treatment Beds
One of the most significant aspects of Harris’s plan is the proposal to double the number of mental health treatment beds nationwide. The shortage of treatment beds has long been a challenge for those seeking inpatient psychiatric care. Many individuals facing severe mental health issues, including those with substance use disorders, often struggle to find the care they need due to limited bed availability. By increasing the number of mental health treatment beds, Harris’s plan aims to reduce wait times, improve access to inpatient care, and ensure that those who need intensive treatment can receive it in a timely manner.
Removing the IMD Exclusion
Another major component of Harris’s plan is the removal of the IMD exclusion, which currently prohibits Medicaid from covering treatment for individuals in in-patient psychiatric facilities with more than 16 beds. This exclusion has been a longstanding barrier to accessing necessary care, especially for people with severe mental health or substance use issues. The exclusion has been criticized as outdated and counterproductive, particularly as the nation faces a growing behavioral health crisis.
In practice, the IMD exclusion limits Medicaid beneficiaries’ access to larger treatment centers, which often have the resources and specialized care necessary to treat individuals with complex mental health and addiction needs. By removing this restriction, Harris aims to expand access to critical care and ensure that people who require in-patient treatment can get the help they need, regardless of the size of the facility.
Expanding Telehealth Services
The importance of telehealth has never been more apparent, particularly in the wake of the COVID-19 pandemic. Harris’s plan proposes expanding access to telehealth services, making it easier for individuals to receive mental health care wherever they are. Telehealth services have proven to be an effective and flexible solution for people who face barriers to in-person care, including those living in rural or underserved areas, individuals with mobility challenges, and those who struggle to find available appointments with mental health professionals.
In particular, Harris’s plan seeks to invest in telemedicine to ensure that “all Americans can get mental health care whenever and wherever they need it.” This investment could lead to a significant reduction in the barriers to care, making it easier for patients to access therapy, counseling, and psychiatric services. Additionally, the increased use of telehealth would reduce wait times, allowing more people to receive timely mental health support.
Tackling the Behavioral Health Worker Shortage
A critical issue facing the behavioral health sector is the shortage of trained professionals. Mental health providers, including psychiatrists, therapists, and counselors, are in high demand, but the supply has not kept up with the increasing need for services. Harris’s plan addresses this challenge by proposing a student loan forgiveness program for mental health workers who choose to practice in areas experiencing the worst shortages. This initiative would incentivize mental health professionals to work in underserved communities, where they are most needed.
Additionally, the proposal calls for funding programs that would encourage nurse practitioners and physician assistants to specialize in psychiatry. This effort is aimed at expanding the workforce and ensuring that more individuals have access to mental health care, particularly in areas where behavioral health services are limited.
Closing the Reimbursement Gap
One of the most pressing concerns for behavioral health providers is the disparity in reimbursement rates between mental health and physical health services. As Harris pointed out in her announcement, addressing behavioral health issues often requires multiple visits over an extended period of time, but mental health providers are not compensated in a way that encourages them to dedicate the time necessary to fully address these issues. Harris’s proposal aims to close the gap in reimbursement rates between psychiatric providers and other medical professionals, ensuring that mental health care is appropriately funded.
A recent report from Milliman Inc., a Seattle-based actuarial and consulting firm, highlighted the stark difference in reimbursement rates for behavioral health services compared to physical health services. According to the report, U.S. employees are far more likely to receive lower reimbursement for mental health services and are also more likely to go out-of-network for behavioral health care. Harris’s proposal seeks to change that, which would benefit both patients and providers.
Expanding the Certified Community Behavioral Health Clinic (CCBHC) Program
The Certified Community Behavioral Health Clinic (CCBHC) program is another important aspect of Harris’s plan. This program, which currently operates in eight states, provides a higher-than-usual Medicaid reimbursement to behavioral health clinics that offer comprehensive mental health and substance use disorder services. The CCBHC model has been shown to improve access to services, reduce wait times, and offer coordinated care for individuals with complex behavioral health needs.
However, the CCBHC program is set to expire in December unless additional funding is allocated. Harris’s proposal includes expanding and continuing funding for the program, ensuring that CCBHCs can continue to operate and provide vital services. By expanding this program, Harris hopes to increase the availability of care and improve outcomes for individuals struggling with mental health and substance use disorders.
Supporting Vulnerable Populations
Harris’s plan also places a special focus on vulnerable populations, including veterans, minorities, and children who have been impacted by trauma. The proposal outlines several measures aimed at addressing the mental health needs of these groups, including improving access to culturally competent care and providing targeted support for those who have experienced trauma.
Another key aspect of the plan is its focus on ending the “mental illness to jail pipeline,” which disproportionately impacts individuals with mental health issues, particularly people of color. Harris’s plan seeks to ensure that individuals with mental health conditions are treated in the appropriate settings and not incarcerated due to a lack of access to proper care.
A Comprehensive Approach to Mental Health Reform
Kamala Harris’s mental health reform plan offers a comprehensive and bold approach to addressing the growing mental health crisis in the United States. By focusing on increasing access to care, addressing workforce shortages, expanding telehealth, and removing outdated regulations, Harris aims to create a mental health system that is more equitable, accessible, and effective for all Americans.
As Harris’s proposal makes clear, it is time to take mental health out of the shadows and treat it with the same urgency as physical health. If enacted, this plan could have a lasting impact on the behavioral health landscape, improving outcomes for millions of individuals and providing much-needed support for behavioral health providers across the country.
