Historic Gun Safety Law Shows AAFP’s Mental Health Advocacy

The Bipartisan Safer Communities Act (S. 2938), combining measures from several previous bills in the wake of recent mass shootings in Buffalo, N.Y., and Uvalde, Texas, places safety restrictions on access to firearms, a move in line with the AAFP’s work to treat gun violence as a public health epidemic. It also answers the Academy’s push to address a mental health emergency by providing considerable support for several programs that the AAFP has staunchly advocated for, benefitting primary care practices and patients.

Specifically, the law

• allocates $80 million to the Health Resources and Services Administration’s Pediatric Mental Health Care Access grant program, which the Academy this spring called on lawmakers to fund;
• devotes $60 million over five years to fund mental health training for primary care clinicians serving pediatric populations under the Health Resources and Services Administration’s Title VII Primary Care Training and Enhancement program; (the Academy has long pointed to such Title VII programs as crucial to addressing primary care’s workforce shortage and more recently pointed to them as a key tool for containing the mental health crisis);
• sends $250 million to states through the Community Mental Health Services Block Grant, funding for which the Academy recently advocated; 
• requires CMS to provide guidance to states on increasing access to behavioral health services through telehealth under Medicaid and CHIP and provide strategies for bridging the digital divide to expand equitable access to telehealth services (as the AAFP has urged); 
• requires CMS to review states’ implementation of Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment Services requirement to ensure appropriate coverage for behavioral health screenings and treatment, as the AAFP has called for; and 
• allots $500 million through the School-Based Mental Health Services demonstration grant program under Medicaid, meant to train and diversify behavioral health professionals in schools (a move the Academy supports as part of improving care coordination between school-based health care professionals and primary care physicians).

The Academy’s April letter to lawmakers (co-signed by numerous other health care organizations) urging “robust funding” for the Pediatric Mental Health Care Access Program — which increases children’s access to mental health services and enhances the capacity of pediatric primary care teams to deliver vital behavioral health treatment —cited a RAND Corp. study indicating that “12.3% of children in states with programs such as the ones funded under this HRSA program had received behavioral health services, while only 9.5% of children in states without such programs received these services.”

Some 139 million Americans live in mental health professional shortage areas, and one in five children and adolescents experiences a mental health condition each year. With these and other grim numbers in mind, the Academy last fall supported the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association in declaring children’s mental health a national emergency and this year has ramped up its advocacy for behavioral health integration in primary care practices and a number of the initiatives contained in S. 2938.

Last month, nearly 300 family physicians advocated for mental health legislation on Capitol Hill as part of the AAFP’s annual Family Medicine Advocacy Summit, supporting bills that reauthorized the Pediatric Mental Health Access Program, among other measures ultimately included in S. 2938.