After a history of playing second fiddle to physical healthcare in terms of clinical resources and insurance coverage, behavioral healthcare is stepping from backstage into the national spotlight due to a variety of political and social forces.

A mélange of developments in January alone suggests that psychological assessments and treatments are finally getting the support that many professionals say is woefully overdue.

On January 18, the Centers for Medicare & Medicaid Services (CMS) announced development of the Innovation in Behavioral Health Model (IBH Model), designed to test new approaches to integrating behavioral and physical healthcare, as well as addressing health related social needs of Americans covered by Medicare and Medicaid.

The plan is to form community based, interprofessional care teams consisting of behavior and physical care providers in eight states. The teams will be charged with integrating services and bridging the gaps between physical and behavioral health.

In its announcement, the CMS reported that 25% of Medicare patients and 40% of Medicaid recipients experience mental illness or substance use disorder. The IBH Model officially launches this fall and is expected to operate for eight years.

Just four days after the IBH Model announcement came a notice from the Defense Department that armed forces members will gain greater access to mental healthcare in 2024 under the Brandon Act, signed into law by President Biden in December 2021 as part of the National Defense Authorization Act for Fiscal Year 2022.

Under Brandon, a service member can receive a mental health evaluation simply by making a request to a supervisor. Additionally, no explanation or further information is required.

The act is named after Petty Officer 3rd Class Brandon Caserta, a victim of suicide in 2018. Officials say his requests for help dealing with psychological issues went unheeded.

In a related development, a new report reveals that in the year and a half since the launch of 988 – the nation’s suicide and crisis hotline – more than 200 call centers have received about 8.1 million calls, texts, and chats.

While the volume shows encouraging signs of progress, the service is so popular that it’s experiencing staffing and training challenges like those in healthcare as a whole.

For example, some 988 counselors report management expectations that they end conversations with first-time callers and texters within 15 minutes if there were no indications of immediate plans of suicide. Officials say improvement efforts are underway.

Meanwhile, New Jersey is on track to become the third state to legalize use of psychedelic mushrooms for mental health therapy as well as recreational use.

State legislators have reintroduced a bill, the “Psilocybin Behavioral Health Access and Services Act,” to allow anyone aged 21 or older to “possess, store, use, ingest, inhale, process, [and] transport” 4 grams or less of the mushroom.

The bill was pulled back last year for revisions, and its reintroduction comes simultaneously with an announcement of a partnership between Hackensack Meridian Health, a New Jersey hospital network, and U.K. biotech company Compass Pathways to research synthetic psilocybin treatment.

Lastly, a research paper published in the latest edition of the Journal of the American Medical Association (JAMA) reports that states passing so-called trigger abortion bans in the aftermath of the overturning of Roe v. Wade experienced “a significantly greater worsening of anxiety and depression symptoms…” for women ages 18 to 45.

In an accompanying JAMA editorial, Julia Steinberg, PhD, of the University of Maryland, wrote that the findings contradict the argument that abortion may lead to mental health problems for women – a justification for the trigger laws.

“In fact those seeking abortions who are turned away experience mental health effects not observed in those who had received an abortion,” she wrote.

Editor’s Note: This article first appeared in the Healthcare Docket newsletter. Click here to subscribe and read the full newsletter. 

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