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State of the Union: Biden Outlines Administration’s Next Steps to Address Mental Health, Substance Use
A year after unveiling a 4-part “Unity Agenda” in which addressing the nation’s addiction and mental health crisis were key tenets, President Joe Biden reaffirmed his administration’s commitment to those goals and outlined a series of initiatives to improve access to evidence-based care as well as disrupt the flow of illicit substances in the US.
“When I came to office, most everyone assumed bipartisanship was impossible. But I never believed it,” Biden said in his State of the Union address on Tuesday night. “That’s why a year ago, I offered a Unity Agenda to the nation as I stood here. We’ve made real progress together.”
Biden touted federal efforts to ease requirements for prescribing medications to treat opioid addiction among examples of the administration’s efforts to implement the Unity Agenda over the past year.
The president noted the role illicit fentanyl currently plays in the nation’s overdose crisis, with 70,000 of the 107,000 reported overdose deaths during the 12 months ending in August 2022 involving the synthetic opioid, according to data from the Centers for Disease Control and Prevention (CDC). Biden advocated for the launch of “a major surge to stop fentanyl production, sale, and trafficking” that includes collaboration with courier services and tighter border security.
Biden also pushed for more action on addressing the nation’s mental health crisis, specifically for children and veterans during his address.
In conjunction with Biden’s State of the Union delivered on Tuesday night, the White House released a fact sheet detailing the president’s vision to advance progress on his Unity Agenda.
>> READ the White House fact sheet on President Joe Biden’s Unity Agenda
Several goals related to mental health and addiction were presented, including the following:
Creating health environments. With research showing the long-term benefits of coordinating prevention and recovery support across settings, Biden pushed for improved regulation of social media platforms to protect children’s mental health online, increased mental health support for healthcare workers who are at risk of burnout, anxiety, and depression, and initiatives to increase youth resilience.
Improving access to care. The Biden administration will aim to boost school-based mental health services by allocating $280 million in grants to increase the number of mental healthcare professionals in high-need districts. The administration is also proposing new parity rules to ensure that insurance plans are not imposing inequitable barriers to care and that payments to mental healthcare providers are in line with other health services. The White House said it will look to invest in expanding the capacity of the 988 crisis line, scale mobile crisis intervention services, develop additional guidance on best practices in crisis response, and triple resources dedicated to promoting interstate license reciprocity for the delivery of mental health services across state lines—a key step for expanding access to telehealth.
Expanding access to prevention, harm reduction, treatment, and recovery services. In its fact sheet, the White House touted steps taken over the past year to expand access to naloxone, such as permitting the use of $50 million for local public health departments to purchase the opioid overdose reversal medication. Looking ahead, the Biden administration said it aims to build on that progress with the Substance Abuse and Mental Health Services Administration (SAMHSA) providing enhanced technical assistance to states with existing State Opioid Response funds alongside hosting peer learning forums, national policy academies, and convenings with organizations distributing naloxone.
To improve substance use disorder (SUD) treatment in correctional facilities, the Federal Bureau of Prisons will ensure that each of its 122 facilities are equipped and trained to provide in-house medication-assisted treatment by Summer 2023. The Centers for Medicare and Medicaid Services (CMS) will also provide guidance allowing states to use Medicaid funds to provide health services (including SUD treatment) for individuals in state and local jails and prisons.
Industry Leaders React
Chuck Ingoglia, president and CEO of the National Council for Mental Wellbeing, lauded the administration’s progress made over the past year to address the nation’s mental health and substance use crisis, but cautioned that several hurdles remain.
“Despite the investments Congress made in 2022, there is a lot of work to be done to resolve the workforce shortage, expand access to critical services in Medicare and Medicaid, expand telehealth provisions, fund Certified Community Behavioral Health Clinics (CCBHCs), ensure parity enforcement, and remove barriers to care for those with a substance use challenge,” Ingoglia said in a statement. “All those issues must be addressed to improve mental health and substance use treatment.
“Mental health and substance use treatment programs suffered years of starvation, and we need to rebuild our nation’s capacity to help those in need of care, especially our youth as they face a future with higher rates of anxiety, depression, substance use, and suicide.”
Meanwhile, the Drug Policy Alliance (DPA), a New York-based not-for-profit organization that seeks to advance policies that reduce the harms of drug use and drug prohibition, expressed skepticism regarding the Biden administration’s planned approach to tackling illicit fentanyl.
“We are glad to see President Biden continue to call for increased access to evidence-based treatment, harm reduction, and recovery services. But his support for harsher penalties for fentanyl-related substances—which will result in broader application of mandatory minimum sentencing and disproportionately harm Black, Latinx and Indigenous communities—in the same breath is incredibly counterproductive and fails to recognize how we got to this place to begin with,” Maritza Perez Medina, director of DPA’s Office of Federal Affairs, said in a statement.
“The reason fentanyl-related substances have overtaken our drug supply at this point is because of the drug trade responding to harsh crack downs and increased seizures of heroin and prescription opioids. And now that we are seeing harsher policies towards fentanyl, there are new and even more potent drugs, such as Xylazine and nitazenes popping up and beginning to overtake some markets. Make no mistake, this pattern will continue and sadly, more lives will be lost as long as we continue down this path.”
References
Biden J. State of the Union Address. February 7, 2023. Accessed February 8, 2023.
