Priorities

The Parity Act holds tremendous promise to ensure that insurance companies and the federal government, when it acts as an insurer, treats brain diseases like any other illness in the body. We must make sure that everyone gets the care they need by fully enforcing the federal Parity Law and state parity laws. The federal government and state regulators should conduct random audits of insurers to ensure compliance and absolutely must conduct audits of companies who are the subject of repeated parity violations. The Kennedy Forum and the Scattergood Foundation created ParityTrack.org to help consumers understand and enforce their rights to insurance coverage for behavioral health that is equal to their coverage for other medical care.

It is essential that we learn to manage stress and other emotions early in life. This type of education must be incorporated into our school curriculum—at all stages—in the form of Social and Emotional Learning (SEL). Additionally, those children and adolescents who show signs of mental health conditions should be diagnosed and treated before the conditions progress. School systems are ideal locations for this. By building partnerships between community mental health professionals, researchers, and educators, we can advance prevention and intervention programs that will put our youth on track to become high-functioning adults.

Almost half of American children have experienced serious trauma, damaging their ability to learn, and leading to symptoms of mental illness as they age. Poor academic performance in the U.S., compared to other countries, is largely due to the lack of early and effective interventions for students in need. The research shows that brain fitness programs in America’s schools would help all children become more focused and resilient. These brain-building interventions would center on executive function training; social and emotional learning activities; mindfulness training; brain literacy (learning how the brain works); and neurofeedback. As a nation, we must embrace brain fitness training at every stage of life, as well as new technologies like the expanded use of MRIs, smart phone applications, and electronic medical records that have the capacity to improve the diagnosis and treatment of brain diseases.

To improve quality and achieve better outcomes for patients, our behavioral health system must move toward a greater adoption of evidence-based and measurement-based care. For example, only about 18 percent of psychiatrists and 11 percent of psychologists in the U.S. routinely administer symptom rating scales (also known as patient-reported outcome measures) to monitor the improvement of people in their care. Symptom rating scales for depression, anxiety, bipolar disorder, post-traumatic stress, and other conditions are easy to administer and help practitioners determine whether a treatment is working. This is one among many relatively straightforward improvements that our behavioral health care system could adopt quickly.

The fastest way to increase the chances of reaching the 26 million Americans who need, but don’t receive behavioral health care each year is to integrate behavioral care into the primary care system. Under the collaborative care model, people can get treatment for conditions like depression and anxiety from their primary care provider, with support and recommendations from a mental health specialist by video or phone. A growing body of research shows that collaborative care is effective in improving patient outcomes and lowering costs. We need to stop talking about collaborative care and start actually providing it.