Everyone has a story. A family member who can’t get an appointment with a therapist for months. A child suffering an acute episode languishing in the emergency room, waiting for a treatment bed to open up. A friend who is considering a career change due to historic levels of burnout.
We are in a mental health crisis in Massachusetts. There is an extreme shortage of treatment options, fueled in large part by a dearth of mental health professionals and experienced support staff. Across all ages, races, genders and socioeconomic groups, mental health issues like depression, anxiety, addiction and suicidality are steadily rising — and we, quite simply, do not currently have the capacity in the commonwealth to treat them. The COVID-19 pandemic has exacerbated an already dire situation.
This crisis is particularly acute for our young people. At the end of March, 247 children were waiting in emergency departments for treatment in Massachusetts. More often than not, these are windowless rooms meant to serve as a short stay for patients with extreme physical health problems — not long-term places for healing and respite. In fact, children may receive little to no psychiatric care while waiting for a more appropriate setting for treatment. Social media, isolation and political vitriol are magnifying the already difficult experience of growing up. Our kids are not okay.
We have seen this crisis firsthand, both in our roles in government and in our private lives. Like everyone in our state, we know too many people struggling with mental health needs who are unable to get the support they need and deserve.
It’s not all bad news. If the pandemic has a rare silver lining, it’s that more people are coming forward with their desperate need for quality mental health care, and so the longstanding stigma surrounding mental health is finally coming apart. People don’t want to struggle in silence anymore.
This increased demand for services is straining our health care system, which is ill-equipped to meet it. Longtime neglect of mental health services has left our health care institutions and providers unable to increase capacity to address mental health needs. Our residents and providers are reaching out for help and, as policymakers, we are obligated to answer their call.
We are starting to make progress. We are optimistic the Legislature will pass meaningful mental health reform before the end of this year’s legislative session. The Legislature also ensured that $400 million of our American Rescue Plan Act funds were dedicated to mental and behavioral health, including for the recruitment and retention of the behavioral health workforce. But we must continue to ramp up investments in this area, including building a sustainable pipeline and creating lasting incentives to go into the field, particularly for people of color. Too many providers still don’t take insurance, blocking patients who cannot afford to pay out of pocket from accessing care. It also reinforces a double standard that we desperately need to erase.
We must update and reform our behavioral health parity laws to ensure that they clearly address practices that create barriers to access, and then we must aggressively enforce them. Mental health parity as a concept is simple: Insurance coverage for mental health care should be equal to coverage for any other medical condition. This concept has been codified in federal and state law for decades, but interpretations of the laws have differed and enforcement has been challenging.
As a result, inequities persist, and patients often are unable to use their coverage to access treatment that is every bit as critical to managing their health as treatment for diabetes or heart disease. We also need to prioritize our health care dollars to pay for what patients need: expanded access to high quality services and investments in the professionals who provide them. We need to encourage our health care institutions to invest in these services, too.
The challenges we face in a post-pandemic world are only going to get more complex, not less. And the very human need for connection and wholeness is never going to go away. That’s why it’s time to finally treat mental health care as health care. Massachusetts is home to groundbreaking advancements in medicine and world-class care. We can, and should, once again lead the nation in mental health care, so no one struggles alone.
Maura Healey has served as Massachusetts attorney general since 2015 and is a Democratic candidate for governor. Senate President Karen Spilka has represented the 2nd Middlesex & Norfolk Senate district since 2005 and has served as president of the Massachusetts Senate since 2018.