We Must Prepare for the Surge Behind the Curve

The COVID-19 pandemic has left the nation’s mental health and addiction treatment safety net at risk of total collapse. While Congress and the Trump administration have moved quickly to enact policies to ensure more people receive the health care they need during the crisis, the future is grim without immediate government action.

Nearly two-thirds (62.1 percent) of organizations providing mental health and addiction treatment services estimate they cannot survive more than three months under current conditions and nearly half (46.7 percent) have already cut staff positions, according to an online survey of 880 behavioral health organizations conducted in early April by ndp | analytics and the National Council for Behavioral Health.

Furthermore, most organizations (82.9 percent) report they lack sufficient personal protective equipment (PPE) to get through the next two months and nearly a third (31 percent) have canceled, rescheduled or turned away patients in the first month of the crisis.

Providers are overwhelmed by the financial shock created by a combination of lost revenue and increased costs from staff overtime, acquiring PPE and implementing telehealth where possible. Without immediate action to shore up the nation’s behavioral health system, we can expect millions of individuals with mental illness and addiction to arrive in overtaxed emergency departments across the nation.

We can avert this secondary crisis, but only if Congress acts quickly.

The National Council, along with more than 40 other national organizations addressing mental illness and addiction, has requested a $38.5 billion infusion of emergency funds for community behavioral health organizations (CBHOs) to avert a large-scale public health calamity, with a significant portion of these funds dedicated to CBHOs enrolled in Medicaid and serving some of the nation’s most vulnerable individuals.

This funding would immediately stabilize the system and ensure the continued availability of mental health and addiction treatment services to millions of individuals nationwide. But the value of such an investment goes far beyond the immediate need.

We are only two months into this pandemic and already more than 33 million Americans have filed for unemployment. According to new data from McKinsey, 74 percent of people who have either lost their jobs or had a reduction in hours report feeling anxious or depressed. If organizations are unable to handle demand from people who are struggling today, how can they possibly handle the crushing demand yet to come?

Today, our heroic frontline health care workers are running on adrenaline. When the crisis begins to recede, many will be living with the aftershocks, including trauma and PTSD.  Just when they need us most, I worry that behavioral health care providers may be struggling for survival themselves.

Policymakers must prepare now for the surge behind the curve.  

Right now, we have an historic opportunity to rethink our social contract. It begins with a recognition that, before the pandemic, the status quo was unacceptable. Too many people were unable to access mental health and addiction treatment services when and where they needed it.  

As a nation, we must embrace the essential truth: there is no health without mental health. Recovery must be the expectation, not the exception. 

So as policymakers consider emergency funding measures to prevent a total collapse of the behavioral health system, I would encourage them to lay the foundation now for a better future.  Let’s go beyond just avoiding the next catastrophe. Let’s begin to change the future, now.

Let’s be sure that organizations providing mental health and addiction treatment services have enough money to hire sufficient staff and, in turn, provide quality, evidence-based services to all the people that need care.  

That is a bold goal, and it is just the starting point. The ultimate goal is to make life better for the 1 in 5 Americans living with mental illness and substance use disorders. No one should be sidelined simply because they cannot receive the treatment they need. Instead, we need every player on the field. Only then will our nation reach its full potential. And only then will we be ready for the next crisis.

On behalf of the nation’s behavioral health care providers, I urge Congress to include $38.5 billion of emergency funds in the next stimulus. But I hope we can also think beyond the immediate crisis. I hope every American will commit to a new social contract, one that ensures no one is ever unable to receive the mental health and addiction treatment services they need to be healthy, thriving members of our society. The time has come — let’s change the future, today.

Chuck Ingoglia, MSW, is president and CEO of the National Council for Behavioral Health, which represents more than 3,000 organizations serving over 10 million individuals with mental illnesses and addictions.