Dr. Anthony Tersigni: Mental and behavioral health crisis deserves our national attention

Behavioral disorders and mental illness are nearly ubiquitous in our society. The Surgeon General reports that mental illness is so common that only a few U.S. families are untouched by them. According to the National Alliance on Mental Illness, more than 43 million adults experience mental illness each year. To put it bluntly, the United States is struggling with a mental and behavioral health crisis and it demands a national discussion that is transparent and honest. 

At Ascension, improving the health of our communities is central to our mission of providing compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. Individuals with serious mental illness and addiction are among our most vulnerable citizens. They often face an increased risk of chronic medical conditions, adding to the already rising costs of our healthcare system. Sadly, according to the Substance Abuse and Mental Health Services Administration, nearly 60 percent of adults with a mental illness didn't receive mental health services in the previous year. Failure to help these individuals as early as possible results in far more pain for them and much higher costs for society.

Professionals with Ascension's Behavioral and Mental Health Service Line work to expand and improve our services and ensure we are caring for each individual physically, emotionally and spiritually to foster better health outcomes. Across our 2,500 sites of care, we are sharing best practices and learning from one another to better integrate behavioral health expertise into more primary care settings. In seeking to offer comprehensive treatment programs, we are focusing on expanding our telehealth services to serve more individuals where they are. We are also addressing the social determinants of health to understand conditions that have given rise to the increase of mental and behavioral health disorders, and ensuring that behavioral healthcare is integrated with our population health management work. Many of our physicians have started to add social workers and health psychologists who focus on patients' mental health needs to their practices.

As Congress continues the healthcare reform debate in the coming weeks, any legislation the Senate considers should aim to improve the mental health system. The legislation should preserve mental and behavioral health as a covered benefit and not permit states to opt out of this crucial coverage. Because of its expense, states and some insurers may object to including it in any package of mandated benefits. But odds are high that any of our families may have to endure the pain and cost of treating a family member for mental illness or addiction. In both the short and long term, our society is better off when those costs are covered immediately through affordable insurance.

Any legislation also should increase funding for addiction programs and avoid other provisions that would ultimately put individuals with mental illness and their families at risk.

These diseases are often progressive: delaying treatment only makes matters worse for the individual, his or her family, and the rest of society. The costs of poor or delayed mental and behavioral healthcare have impacts far beyond the health system, affecting the areas of criminal justice and social services. And these costs often are incurred without addressing or treating the underlying causes. For that reason, Ascension is working to remove barriers to the integration of federal and state programs that address issues of access to care.

Last fall, we were pleased to see Congress overwhelmingly pass the sweeping 21st Century Cures Act, the most significant reform to the mental health and substance abuse system in a decade. The legislation included major provisions aimed at improving mental healthcare for millions of Americans, and took positive steps to address the opioid epidemic our country faces. While the legislation authorized increased federal coordination of mental health resources, integrated service delivery and access to specialized services, it still needs to be funded. While we applaud the current administration for not cutting funds to address the opioid epidemic and for requesting that the appropriation of some of the funds authorized in the Cures Act go towards improving access to treatment, the roughly $400 million in recommended cuts to mental and behavioral health agencies and their treatment programs would hinder our ability to care for this vulnerable population.

Ascension's support for 100 percent access and 100 percent coverage emphasizes our national health ministry's push for mental and behavioral health reform. We call on Congress to work with the administration on this bipartisan and paramount issue. We owe it to the millions of Americans who experience mental illnesses and substance use disorders, and their families, to provide affordable healthcare access and coverage.

Anthony R. Tersigni, EdD, FACHE, is president and CEO of St. Louis-based Ascension, the nation's largest non-profit health system.

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