Legislation aims to expand access to mental-health treatment

Billings Gazette

by Cindy Uken

Low-income Americans would have access to expanded mental-health services under a bill being proposed by a bipartisan group of U.S. senators, including Jon Tester, D-Mont.

The bill would especially benefit veterans, who are seeking mental-health services in greater numbers.

Veterans and representatives from national organizations are supporting passage of the Excellence in Mental Health Act, which would improve the quality of care at community mental health centers. It would also put mental-health services on more equal footing with physical-health services.

Debate on the Senate bill is expected to begin Tuesday. A vote could come as soon as next week.

One in four veterans returning from Iraq and Afghanistan will need mental-health treatment of some kind, and Community Mental Health Centers nationally are expected to soon be serving more than 200,000 veterans. The centers complement services offered in Vet Centers.

“People deserve a choice,” said Jodi Daly, deputy director for the Western Montana Mental Health Center in Missoula. “This would enable veterans to get services in their community so they don’t have to travel to Vet Centers.”

With an average of 22 suicides per day, veterans kill themselves at a rate that is twice the national average. In fact, the annual military death toll from suicides has for several years exceeded the number killed on the battlefields of Iraq and Afghanistan.

For some returning vets, their injuries are obvious. Many others struggle with unseen wounds like post-traumatic stress disorder and traumatic injuries.

The Excellence in Mental Health Act would:

— Establish criteria for federally qualified community behavioral health centers to ensure the centers cover a broad range of outpatient and crisis services and better integrate physical- and mental-health care.

— Authorize prospective Medicaid payments to centers that meet the new standards, phasing the payments in over five years.

— And support the modernization and construction of behavioral health center facilities.

Services would be aimed at uninsured and low-income Americans with the most serious and persistent conditions.

The legislation would expand access to care for those who have no ability to pay, Daly said. “This should reduce ER care and jail admissions.”

Too often, those who need help have nowhere to turn, and that is especially true of veterans and those who live in the remote areas of Montana, Tester said.

“Community health centers are often the first place folks go for physical care, and this legislation would make affordable community-based facilities the first stop for mental health care treatment as well,” Tester said.

Community Mental Health Centers are the primary source of outpatient mental-health services in many communities, serving 8 million people in 48 states, according to the Substance Abuse and Mental Health Services Administration.

Patients with serious mental illnesses too often lack access to care and some experience difficulty in obtaining treatment, Tester said.

One-third of the 4.8 million people suffering from mood disorders do not receive treatment, according to a national survey by the Substance Abuses and Mental Health Services of America. The Excellent in Mental Health Act is designed to close the gap, Tester said.

There are four regional community mental health centers in Montana – in Billings, Miles City, Missoula and Great Falls – and 21 licensed community health centers throughout the state.

Montana has had one of the highest rates of suicide in the nation for more than 35 years, and mental-health resources are inadequate. More than 90 percent of those who commit suicide have a diagnosable psychiatric illness.

Matt Kuntz, executive director of the Montana Chapter of the National Alliance on Mental Illness, said the Excellence in Mental Health Act is not only a “good thing” for mental-health care in Montana but also “necessary.”