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Federal Report Provides Roadmap to Help People with Serious Mental Illness and Emotional Disturbance

December 22, 2017

The Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) reports to Congress and federal agencies on issues related to serious mental illness (SMI) and serious emotional disturbance (SED). ISMICC released its first report entitled, “The Way Forward: Federal Action for a System That Works for All People Living with SMI and SED and Their Families and Caregivers.” The report sets the course for the ISMICC’s work plan for the years ahead.

ISMICC, authorized by the 21st Century Cures Act, is comprised of leadership from eight different federal agencies and private stakeholders including national experts on health care research, mental health providers, advocates, and people with mental health conditions and their families and caregivers.

During the next five years, ISMICC will work in collaboration with federal interdepartmental leadership to build a system that provides the full range of treatments and supports needed by individuals and families living with SMI and SED. In this initial report, committee members identified five areas of focus and numerous implementation recommendations to aid federal agencies in better aligning and coordinating their efforts to support people with SMI and SED.

Focus areas include:

  1. Strengthen federal coordination to improve care
  2. Improve access and engagement
  3. Treatment and Recovery: Close the gap between what works and what is offered
  4. Increase opportunities for diversion and improve care for those involved in the criminal and juvenile justice systems
  5. Develop finance strategies to increase availability and affordability of care

The committee’s initial report paints a grim picture of challenges faced by the roughly one in 25 adults that have SMI during a given year. While effective treatment models exist, they are not widely available. Relatively few adults with SMI receive evidence-based treatment. The percentage of the population that has access to effective treatment varies widely across states.

Most states report insufficient psychiatric and crisis response capacity including insufficient numbers of inpatient psychiatric hospital beds. The current capacity fails to meet individuals’ needs, resulting in worse outcomes for individuals with SMI. Those outcomes include greater criminal justice system involvement, and a higher risk of suicide, unemployment, homelessness and a life of poverty, than the general population.

The picture is no less inadequate for the roughly one in eight children and youth with SED. Most children and youth with SED do not receive treatment, putting them at risk for adverse outcomes.

While federal programs account for almost half of all spending on mental and substance use disorders, the federal support system is fragmented across 170 different federal programs, grants, and time-limited pilots administered by eight different federal departments. People with SMI and SED and their families must navigate complex logistical challenges to access and coordinate the care they need.

The committee’s final report to Congress, due in 2022, will include data on progress within the five areas of focus and additional recommendations to guide federal coordination during future years.

HAP welcomes the committee’s commitment to better align federal programs to meet the needs of individuals and families living with SMI and SED. The association is hopeful that coordinated federal efforts will enable the commonwealth and Pennsylvania providers to expand access to evidence-based mental health treatment and supports. HAP will continue to work with Pennsylvania stakeholders to secure the funding and regulatory reforms necessary to build strong community‐based care systems across Pennsylvania; provide individuals and their families with effective treatment options; and end harmful practices such as unnecessary incarceration and “boarding” of people with acute psychiatric conditions in inpatient units and hospital emergency departments.

For more information about HAP’s behavioral health advocacy agenda, contact HAP’s Jennifer Jordan, vice president, regulatory advocacy.

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