A Behavioral Health Crisis Should Lead to Regulatory Changes

Co-authored by Soteri Polydorou, medical director of addiction services at Northwell Health.

We all see the headlines: Suicide rates are rising, overdoses are up, and depression and anxiety cases are climbing.

It will be difficult to change the direction of these trends unless treatment becomes as freely available as the substances on our streets.

We learned lessons during the height of the COVID-19 pandemic. For example, when the government relaxed certain well-meaning regulations, it freed up the health care industry to deliver care more widely. This included the ability to increase remote services, which led to a large rise in telehealth visits.

Data from the Department of Health and Human Services showed that Medicare visits jumped to 52.7 million in 2020, compared to under 1 million before the pandemic. These visits were especially helpful in behavioral health. HHS reported that remote visits made up about one-third of behavioral health visits, compared to 8 percent of visits to primary care providers.

We also know that remote care helped. There was a fear that the lack of in-person contact from providers offering care for substance use disorders would lead to increased overdoses from people in treatment. That didn’t happen partly because behavioral health professionals would prescribe needed medications to patients remotely and offer telehealth services.

But we must do more, because too many people can’t access the care and treatment they need. The encouraging news is we can gain support from our broader health care system to help. Since, like the COVID-19 pandemic, the mental health access issue is a crisis, we must be allowed to be more flexible in how we deliver care.

One good example: For the better part of 20 years, physicians in offices have been allowed to prescribe or dispense buprenorphine, a medication that is effective in treating opioid use disorder, as part of a greater treatment plan.

This has helped patients access treatment without waiting for–or paying out of pocket for–behavioral health appointments. Since COVID-19, it’s also been permitted to be prescribed via telehealth, allowing more flexibility to engage those new to treatment. However, that could change if the relaxed but still temporary regulations aren’t permanently extended.

Also, it would be helpful if access to methadone is carefully loosened. Methadone treatment, for instance, can only be provided under certain licensed outpatient and detox rehab settings. Access is limited because of those restrictions, which create barriers. Methadone is a very effective treatment for opioid use disorder but requires monitoring and regular clinical assessments. Allowing more knowledgeable providers to prescribe methadone in medical settings will further destigmatize addictions and improve access to treatment.

The regulatory aspects of mental health care are but one part of making access easier for everyone. It is, however, one we can fix with relative ease if everyone pulls in the same direction. For the sake of everyone dealing with mental health issues, let’s make it happen.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 contact the National Suicide Prevention Lifeline, 1-800-273-TALK, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.