April 14, 2022, 12:24 p.m.— It is objectively true that diagnosing and treating the behavioral health needs of the majority of Americans is among the areas in which primary care physicians have for too long been obliged to do more with less. How much more care you’ve delivered than in the past, with how much less support — and how best to adjust policy while improving patients’ mental health — are relatively subjective matters, but legislation that would move us in the right direction already exists. And last week, with the Academy’s guidance and enthusiastic support, lawmakers turned their attention to some of these bills.
We provided detailed testimony to the House Committee on Energy and Commerce’s Subcommittee on Health for an April 5 hearing titled “Communities in Need: Legislation to Support Mental Health and Well-Being.” Nineteen bills related to that broad topic were on the agenda that day, signaling that lawmakers could begin the markup process ahead of passing much-needed legislation — including some for which the AAFP has steadily lobbied.
The hearing itself was a strong signal that our recent push to center primary care in behavioral health policy is gaining ground. And other testimony supported our position: Carole Johnson, the recently confirmed administrator of the Health Resources and Services Administration, used her part of the five-hour hearing to tout HRSA programs we support, echoing advocacy we shared with her in a recent letter outlining AAFP priorities and requesting a meeting.
All of this could hardly be more important. As I told you this past winter, one analysis of 2016 to 2018 Medical Expenditure Panel Survey data showed that nearly 40% of all visits for depression, anxiety or cases defined as “any mental illness” were with primary care physicians, and these physicians were more likely to be the source of physical and mental health care for patients with lower socioeconomic status and those with co-morbidities. Meanwhile, the unmet behavioral health needs of children and adolescents last fall led the AAFP to join 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.
Specifically, our latest testimony endorsed
The Academy also expressed qualified support for other legislation under the subcommittee’s consideration while urging lawmakers to include primary care physicians in their comprehensive agenda. These bills include
Existing programs to improve resources for family physicians and better integrate behavioral health into the primary care setting need reauthorization. That’s why the Academy is firmly behind the Supporting Children’s Mental Health Care Access Act, which would renew funding for the HRSA’s Pediatric Mental Health Care Access Program and expand it to all states. That would preserve and expand the ability for primary care clinicians to consult with child mental health teams via telehealth. Please use our Speak Out tool to ask your elected officials to support this important legislation.
I’m also asking you to join our Speak Out campaign to encourage your members of Congress to support the Collaborate in an Orderly and Cohesive Manner Act (H.R. 5218). The legislation would provide grants to primary care practices to implement the Collaborative Care Model, create technical assistance centers for primary care practices and fund studies on additional integration models. Expanding the use of this evidence-based model will help address workforce shortages, increase access to mental health and substance use disorder treatment, improve outcomes and health equity, and reduce health care costs.
Our behavioral health advocacy complements National Minority Health Month, which raises awareness about health disparities affecting racial and ethnic minority populations and encourages action through health education, early detection and control of disease complications. The AAFP observes NMHM while reflecting on how we can contribute to addressing racism and inequalities in patient care and elevating Academy member voices. We’ve worked with the Office of Minority Health for more than 15 years on clinical recommendations and practice ideas that can help family physicians improve care for minority patients and underserved communities. This month we’re supporting Public Health Week (April 4-11), Black Maternal Health Week (April 11-17), National Infant Immunization Weeek (April 24-30) and World Immunization Week (April 24-30). And we continue to lobby lawmakers and regulators to improve health equity for all Americans by strengthening primary care. Black Maternal Health Week, for example, is a good moment to reiterate the Academy’s staunch support for the Black Maternal Health Momnibus package.
Stephanie Quinn, AAFP senior vice president of advocacy, practice advancement and policy. Read author bio »