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21st Century Cures Act Report Recommends Changes to Mental Health Care Infrastructure

The federal Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) released its first report to Congress detailing major barriers to treatment for individuals with serious mental illness (SMI). The ISMICC, created by the 21st Century Cures Act, recommended ways to improve government-wide coordination to address unmet needs of people with serious mental illness. Their recommendations highlighted expanding the Certified Community Behavioral Health Clinic (CCBHC) program, improved payment rates for psychiatry, and more criminal justice system diversion and early identification and intervention services for children and young adults.

A summary of the report’s major recommendations follows. The full report can be found here.

  • Adding Treatment Capacity by Expanding Certified Community Behavioral Health Clinics. The report notes that more than one-third of people with serious mental illness received no treatment in the past year, and that a major driver of this unmet need is lack of treatment capacity nationwide. The committee recommended expanding the current eight-state, two-year Certified Community Behavioral Health Clinics program, which increased access to services at participating clinics by 25 percent in its first six months. Authorized by the Excellence in Mental Health Act, CCBHCs must meet rigorous requirements to provide comprehensive, science-based, high-quality care for treatment of serious mental illness and addiction. Moreover, by receiving a reimbursement rate based on the actual costs of providing these services, CCBHCs can recruit and retain psychiatrists and other professionals to treat people with multiple and complex needs.
  • Addressing the Shortage of Psychiatrists. According to the report, 96 percent of the counties in the nation are experiencing a shortage of psychiatrists who prescribe medications for people with SMI. This shortage is one of the major barriers people with serious mental illness experience when trying to access effective evidence-based treatments. The ISMICC recommends increasing the number of practicing psychiatrists creating psychiatric payment rates that cover the actual cost of care and are at parity with the rates received by other physicians.
  • Increased Criminal Justice Diversion and Early Intervention. The report also details the need for more criminal diversion programs, which direct individuals with SMI away from incarceration and towards treatment programs. The report explains that about 2 million people with serious conditions are jailed every year. The ISMICC also recommends prioritizing early intervention and treatment for children and young adults showing symptoms of serious mental illness for the first time. The NIMH National Comorbidity Survey Replication found that while 80 percent of people with a serious psychiatric condition eventually seek treatment, the average delay between onset of symptoms and receipt of treatment is 10 years. One program that would help family members, friends, or coworkers identify the early signs of mental illness and get their loved to treatment sooner is Mental Health First Aid. Mental Health First Aid, a national, evidence-based program that has trained more than 1 million Americans to identify someone who is experiencing a mental health or substance use problem and assist them in seeking help.

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