Improving access to mental health services is key to reversing US life expectancy decline
“Although the world is full of suffering, it is also full of the overcoming of it.” – Helen Keller
This past month was Mental Health Awareness month, yet just having one month to address an issue that impacts us all is not sufficient while our country is suffering. We have a crisis on our hands, one which will require all levels of government to respond with the resources and evidence-based policies that can improve mental health and well-being for all.
U.S. life expectancy decreased for the third time in a row–something unprecedented just a decade ago. This disturbing trend, largely driven by the increase in drug, alcohol and suicide deaths remains a significant wake-up call that there is a serious crisis in this country; they are signals of grave underlying concerns facing too many Americans – about pain, despair, loneliness, isolation and lack of opportunity – and the urgent need to address them.
If trends continue, 1.6 million more people could die from the preventable causes of drugs, alcohol and suicide by 2025. No portion of society is untouched–every day, 20 U.S. veterans die from suicide. Drug deaths for those aged 55-69 have increased nearly nine-fold in the past decade. And, according to the U.S. Centers for Disease Control and Prevention, the overdose rate of black Americans more than doubled between 2011 and 2017.
People have been calling out for help for a long time now–yet treatment and mental health services have not met the demand and aren’t meeting people where they are. In reality, about one in 10 people with substance use disorders receive recommended treatment. And, according to the Kaiser Family Foundation, 39 percent of American adults have delayed accessing health care because of concerns about cost, and 4 in 10 adults with insurance say they have trouble affording their deductible.
Right now, all elected officials should be working to ensure every single person has access to quality mental health care regardless of their ability to afford that care.
To do this, the nation needs to expand and scale up evidence-based efforts integrating mental health across the health system and into the community, to deploy a full-scale strategy against loneliness, despair, drug and alcohol misuse, and rising suicide rates.
Politicians and policymakers must, finally, prioritize prevention, reduce risk factors and promote resilience in children, families, and communities–to prevent small problems from growing into bigger ones. This includes supporting programs like SBIRT, school counseling, CRAFFT, and others, that identify early warning signs and help connect people–especially the nation’s youngest– to the services they need.
Focusing on the youngest makes a tremendous investment in America’s future. Early childhood education programs have a $4-$12 return for every $1 invested. The Zero Suicide model program has shown an 80 percent reduction in suicides. Top school substance misuse prevention programs have a $3.80 to $34 return for every $1 invested.
As seen in the controversy surrounding CDC’s opioid prescribing guidelines, the nation can’t turn its back on those in real pain. We need to ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse, develop a dependency or overdose from these drugs.
Underlying all of these solutions is access–access to the health care system, to actual clinicians and programs, in the places people live, learn, work, pray and play. This crisis has grown for more than a decade–research has suggested many solutions to tackle this multifaceted problem. These solutions are within reach–it does not require scientific breakthroughs, it requires courage, will, and leadership.
Over the last 50 years, the nation has expanded coverage for seniors, kids, and people with low incomes; and added protections for people with pre-existing conditions– seamless and comprehensive access to mental health must be realized for everyone.
As Keller said, there is much overcoming of suffering in this world, policymakers need to do more, and do it now.
Andy Slavitt is former Acting Administrator of the Center for Medicare and Medicaid Services, Founder and Board Chair of United States of Care, and Dr. Benjamin Miller, PsyD, is chief strategy officer for Well Being Trust.