There’s been an important and encouraging new development on the mental health front in New York State.
A new law holds forth the promise that significantly greater numbers of New Yorkers will be seeking out the care they need – and getting this care – in the years to come.
Effective July 1, an amendment to the State’s education law requires that mental health education must be provided in classrooms statewide. All elementary, middle, and high schools in New York State must modify their curriculum to include mental health as part of existing physical health instruction.
The welcome change is largely the outcome of five years of advocacy led by the Mental Health Association of New York State (MHANYS). New York State should be proud to now stand as a national leader in this vanguard modernization of our health education requirements. Virginia is the only other state with a similar law, and, coincidentally, its law went into effect on the exact same day.
However, this attention to actually getting people into care would be insufficient were it not for legislation passed by both houses – and awaiting the Governor’s signature – to strengthen the State’s Mental Health Parity laws. The “Mental Health and Substance Use Disorder Parity Report Act” went beyond the previous law which solely required plans to respond to consumer complaints. The new law requires plans to submit data on key parity measures – such as network adequacy and claims performance – to ensure that people are getting care when they seek it.
Mental heath providers have been painfully aware of the numerous obstacles to care – and we expect these reforms to help overcome some of them. The National Institute of Mental Health says that about 44.7 million Americans aged 18 or older had some form of mental illness in 2016. This represents nearly a fifth of all U.S. adults. Young adults aged 18-25 years had the highest prevalence of mental illness (22 percent) compared to adults aged 26-49 years (21 percent) and aged 50 and older (15 percent). About half of all chronic mental health conditions begin by age 14. About 22 percent of youth aged 13-18 experience serious mental disorders in a given year.
Yet only 43 percent of these adults received mental health treatment that year, with far more women (49 percent) than men (34 percent) getting help. And the percentage of young adults aged 18-25 years with who received treatment (35 percent) was lower than the proportion of adults with mental illness aged 26-49 years (43 percent) and aged 50 and older (47 percent) who got assistance.
Stigma and misinformation about mental illnesses are the most prevalent barriers to people obtaining care but the parity discrepancies have also contributed. To better understand this troublesome gap, Project Access – a study group convened by Roslyn Heights-based North Shore Child and Family Guidance – asked people who had successfully entered mental health care about their experience of obtaining that care. Fifty percent found it significantly more challenging than seeking physical health care. Three out of five said it took between two and 16 contacts to make a connection for mental health care.
Almost 24 percent couldn’t find providers that accepted their insurance. Nearly 39 percent had problems with affordability, 21 percent cited personal indecision as a factor, and 24 percent said their attempts at accessing help were futile. Regrettably, these obstacles contribute to increasing rates of suicide, substance abuse, addiction morbidities, legal problems, social isolation, and other social and economic struggles.
These new laws represent a good start to helping address many of these barriers.
To help with implementation of the education law, MHANYS will soon launch an online School Mental Health Resource and Training Center that will be available to public and private schools statewide. The Center, supported with funding from the New York State Legislature and Governor Andrew M. Cuomo, will provide assistance and guidance, a hotline for school districts, and a team of experts in education and mental health.
We agree with the Commissioner of the New York State Office of Mental Health, Dr. Ann Sullivan, who said that “by introducing mental health education at age-appropriate levels from elementary through high school, mental health will be normalized just as physical health is, stigma will be reduced, and children and parents will learn about prevention, and when and how they should ask for help.”
Coupled with insurance parity strengthening, this visionary law will encourage early intervention for mental health conditions – breaking from a pattern where too many commence their care after a hospital or ER visit. It can also serve as a catapult to efforts to ensure the repair of access issues. Let’s encourage and support our school districts to all do what they can to make the law a success.