Now is not the time for silence | The Kennedy Forum

Now is not the time for silence
September 14, 2020

By Patrick J. Kennedy

Each year, mental health advocates mark September as a national month of recognition for suicide prevention and addiction recovery. This year, some people may feel they lack the drive to focus on these special observances after months of navigating a global pandemic, being bombarded with bad news, and confronting our nation’s social conscience in profound ways. It is, however, for exactly these reasons that I urge you to do the opposite: embrace the occasions with more focus and fervor than ever before.

We have now seen what happens when a public health emergency catches our country off guard and underprepared. Consider that this is exactly how we have handled the suicide and overdose crises for years. If you are frustrated with our country’s response to COVID-19, be frustrated, too, for the hundreds of thousands of individuals who continue to suffer from mental health and substance use disorders in silence—or the countless families out there grieving a loved one whose life could have been saved if our health care system embraced the concept of preventative, integrated care.

The COVID-19 pandemic stands to make an already bad situation worse, as Americans grapple with isolation, unemployment, grief, anxiety, and financial strain. We’ve already seen calls to mental health crisis lines increase by nearly 900%, screening rates for depression and anxiety reach all-time highs, and national overdose deaths increase by almost 15%. Mental health and addiction are not an afterthought of the COVID-19 pandemic, they are very much a part of it.

Like most health statistics, the true toll of suicides and overdoses is unknown until federal data can be collected, analyzed, and published—meaning we typically find out just how bad things are in hindsight. But we do have important indicators and information that alert us when we are headed down a dangerous path. Now, more than ever, we must rely on these early insights to spring into action and try to right the ship. For example, the CDC recently released preliminary data showing overdose deaths rose to a record high in 2019, and projections for 2020 show rates are likely to increase even more. This is a major red flag that deserves immediate attention from our government officials, insurers, and health care leaders.

In addition to heeding the warnings of preliminary data, we also have a responsibility to peel back the layers behind such alarming numbers. This means recognizing the gross inequities that plague our country and understanding how a broken mental health care system serves to further oppress and marginalize Black, Indigenous and People of Color (BIPOC) communities. For example, we know that less Black youth receive treatment for major depression than their white counterparts, and simultaneously have the fastest growing suicide rates of any racial or ethnic group. As we continue to have the hard but incredibly important conversation about racial injustice in the U.S., let’s bolster systems of care for mental health and addiction in BIPOC communities through increased funding for certified community behavioral health centers (CCBHCs), culturally diverse provider networks, and more.

These annual observations of suicide prevention and addiction recovery also offer an opportunity to reflect on what progress has been made and what is working. It’s critical to champion best practices and promising innovations so that more people can benefit from them.

As our health care system has struggled to adapt to the many challenges of a COVID-19 world, we have seen unprecedented policy changes that expanded access to telehealth treatment for mental health and substance use disorders. Telehealth is helping to mitigate access barriers that far precede the current pandemic, including red tape for prescribing medication-assisted treatment (MAT) and restrictions on audio-only therapy. The value of these adaptations cannot be understated. And they can’t be treated as temporary exceptions for unusual times. We must fight for them to be enacted long-term to address historic rates of overdose death and suicide in this country.

Another timely lesson we’ve learned is the importance of a clear, coordinated response that unites entities instead of dividing them. We are always at our best when we work together. That’s why I am proud to be involved with two important initiatives that coalesce a host of experts in forging new paths in suicide prevention and addiction recovery.

The Mental Health & Suicide Prevention National Response to COVID-19 (National Response), for which I have the honor of serving as co-chair, engages public and private sectors to define and lead a coordinated mental health and suicide prevention response. The Recovery Access Coalition (RAC) aims to eliminate access barriers to digital therapies for those with substance use disorders. Specifically, the Coalition is seeking policy changes in Medicare, Medicaid, and the commercial insurance market to authorize coverage for digital therapies, including prescription digital therapeutics (PDTs).

This month, please join me in shining a spotlight on suicide prevention and addiction recovery. Here are some simple steps you can take:

For far too long, our health care system has put mental health and addiction on the back burner, only addressing them when people are in crisis. This antiquated, backwards approach contributes to the loss of over 100,000 American lives from suicides and overdoses each year. We can only work toward real solutions if we confront problems head on. It’s time to change the narrative and demand action from our government, our insurers, and our health care systems. Your voice can make a difference.