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Mental Health Policy in the Era of COVID-19

June 13, 2020

In Mental Health Policy in the Era of COVID-19, a new piece in Psychiatric Services, Dr. Marvin Swartz and colleagues – all members of the Psychiatric Services Policy Advisory Group – describe:

The response to the global COVID-19 pandemic has important ramifications for mental health systems and the patients they serve. This article describes significant changes in mental health policy prompted by the COVID-19 crisis across five major areas: legislation, regulation, financing, accountability, and workforce development. Special considerations for mental health policy are discussed, including social determinants of health, innovative technologies, and research and evaluation. These extraordinary advances provide an unprecedented opportunity to evaluate the effects of mental health policies that may be adopted in the post–COVID-19 era in the United States.

Regarding legislation: “The U.S. Congress has passed three major relief packages as of March 2020, with more on the horizon. The examples of legislation provided here include a range of measures relevant to mental health policy.”

And: “A wide range of regulations has been issued in response to the COVID-19 crisis, most of which aim to reduce requirements for face-to-face contact between patients and providers so as to minimize viral transmission.”

On financing: “Health care financing has shifted substantially in the context of COVID-19. As many people who are under- or uninsured seek care, rising unemployment precipitates losses in employer-based health insurance, with few alternatives for enrollment in public insurance exchanges, and health care systems face major reductions in revenue as they limit care to essential services. In addition to the appropriations described above, regulatory changes have been made to help mental health providers remain financially viable during the COVID-19 crisis.”

And: “The major areas of mental health policy described above—legislation, regulation, financing, accountability, and workforce development—encompass a large range of stakeholders, each of whom have unique perspectives and incentives. Engaging a diverse coalition of partners can help ensure the success of a policy, regardless of the lever involved. Some key domains of mental health policy that maintain broad support include social determinants of health, innovative technologies, and research and evaluation.”

Finally: ” Seldom in recent history have so many policies evolved so quickly as in this period of COVID-19 crisis response. These circumstances raise a critically important question: What evidence for new policies and approaches has been born from the COVID-19 crisis that should—or should not—be sustained in the future?”