Expressing the sense of the House of Representatives that in order to effectively address the high prevalence of those suffering from mental health conditions and substance use disorders, the United States needs to make historic financial investments into mental health and substance use disorder care and finally acknowledge such care as a priority in health care equal to physical health, and for other purposes.

IV 116TH CONGRESS 2D SESSION H. RES. 1057 Expressing the sense of the House of Representatives that in order to effec- tively address the high prevalence of those suffering from mental health conditions and substance use disorders, the United States needs to make historic financial investments into mental health and substance use dis- order care and finally acknowledge such care as a priority in health care equal to physical health, and for other purposes. IN THE HOUSE OF REPRESENTATIVES JULY 21, 2020 Mr. KENNEDY (for himself, Ms. MATSUI, Mr. TONKO, Mr. CA´RDENAS, and Mr. TRONE) submitted the following resolution; which was referred to the Committee on Energy and Commerce RESOLUTION Expressing the sense of the House of Representatives that in order to effectively address the high prevalence of those suffering from mental health conditions and sub- stance use disorders, the United States needs to make historic financial investments into mental health and sub- stance use disorder care and finally acknowledge such care as a priority in health care equal to physical health, and for other purposes. Whereas there is an urgent need to improve our health care system to better integrate mental health and substance use disorders so they are no longer seen separately; VerDate Sep 11 2014 01:52 Jul 22, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6300 E:\BILLS\HR1057.IH HR1057 SSpencer on DSK126QN23PROD with BILLS 2 •HRES 1057 IH Whereas according to the World Health Organization, mental illness is severely underdiagnosed, and less than half of those who meet diagnostic criteria are identified; Whereas there is a pressing need to provide a comprehensive solution to fix our health system that incorporates the needs and expertise of all its stakeholders, especially those who have expertise in mental health and substance use disorders; Whereas it is essential to remove the misguided association between mental illness and violence driven by fear and misunderstanding; Whereas mental illness and substance use disorders have been underresearched, undertreated, and overstigmatized; Whereas stigma, vilification, and dismissal of mental illness and substance use— (1) create a culture that— (A) discourages utilization of mental health and substance use disorder services; and (B) lacks acknowledgment that struggling with mental health conditions or substance use disorder is not something to be ashamed of; and (2) can vary in prominence in different cultures and communities, and are particularly high among commu- nities of color and minority communities; Whereas men in particular face cultural and societal barriers to seeking treatment for mental health concerns and sub- stance use disorders, which can contribute to concerning outcomes including suicide and aggressive behaviors; Whereas the bulk of our mental health and substance use dis- order services are reactive instead of proactive, treating patients when they are in crisis instead of incorporating VerDate Sep 11 2014 01:52 Jul 22, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6300 E:\BILLS\HR1057.IH HR1057 SSpencer on DSK126QN23PROD with BILLS 3 •HRES 1057 IH services and screenings earlier in an attempt to prevent such crisis from occurring; Whereas there is a need to increase access to treatment, serv- ices, and social supports for everyone to proactively ad- dress root causes of mental illness and substance use dis- orders; Whereas it is necessary to address the root causes of mental health concerns and substance use disorders; Whereas it is necessary to address suicide in a holistic man- ner and recognize and address suicide ideation and not just the action in isolation; Whereas there is a need to address social determinants of health, which are conditions that directly and indirectly affect the health, health care, and wellness of individuals and communities, in order to effectively provide care for all individuals living with mental illness and substance use disorders; Whereas mental health impacts physical health, and physical health impacts mental health; Whereas the current health care system does not adequately incorporate mental health and substance use disorders into the assessment or delivery of care, as evidenced by the fact that all vital signs are currently for physical health alone and do not touch on mental health or sub- stance use disorders; Whereas the lack of a united approach across the Federal Government to improve mental health and substance use disorders has left States and localities— (1) without adequate guidance or resources; VerDate Sep 11 2014 01:52 Jul 22, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6300 E:\BILLS\HR1057.IH HR1057 SSpencer on DSK126QN23PROD with BILLS 4 •HRES 1057 IH (2) without resources unable to provide the mental health and substance use disorder services needed to ade- quately meet the needs of their populations; and (3) with resources unable to effectively distribute services to adequately meet the needs of their popu- lations; Whereas there is a need for greater collaboration across all Federal departments that touches various aspects of the health care system in order to fully incorporate the needs and concerns of everyone involved in the mental health and substance use disorder system; Whereas there is a need for greater collaboration between Federal, State, and local departments that touches on various aspects of the health care system; Whereas there is a need for one centralized location within the Federal Government for good, reliable information on mental health and substance use disorders for providers, patients, and caregivers; Whereas there is a need for standardized definitions, stand- ards of care, and metrics for mental health and substance use disorders across disciplines; Whereas there is a need to change incentives for providers to better ensure everyone with mental health and substance use disorders needs gets access to the necessary care and treatment; Whereas the Mental Health Parity and Addiction Equality Act has been in effect since 2008, and 12 years later there is still a lack of compliance among insurers not adequately covering mental health and substance use dis- order services; VerDate Sep 11 2014 01:52 Jul 22, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6300 E:\BILLS\HR1057.IH HR1057 SSpencer on DSK126QN23PROD with BILLS 5 •HRES 1057 IH Whereas Medicaid is the single largest payer of mental health and substance use disorder services, and reimbursement is far from adequate; Whereas there is a need to incentivize payers to adequately cover mental health and substance use disorder services in the same manner that all specialty services are cov- ered; Whereas there is a need to increase the number of mental health and substance use disorder providers; Whereas 55 percent of counties in the United States do not have a single psychiatrist, psychologist, or social worker; Whereas only 10 percent of people suffering from a substance use disorder receive specialty treatment; Whereas there is a need to increase access and utilization to telemedicine for mental health and substance use disorder services both within States and across State lines; Whereas patient privacy needs to be protected, but there needs to be a better way to share information among pro- viders to better serve the patient’s needs; Whereas safe housing needs to be recognized as a basic re- quirement for treatment to be successful and needs to be better addressed as people transition care; Whereas there is a need to improve social determinants of health, such as increased access to stable housing and jobs, for those suffering from mental illness and sub- stance use disorders to have a sustained recovery; Whereas there is a need to provide care in more appropriate and integrated settings for all patients, such as treating geriatric patients in their homes as opposed to nursing homes, when appropriate and in compliance with the VerDate Sep 11 2014 01:52 Jul 22, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6300 E:\BILLS\HR1057.IH HR1057 SSpencer on DSK126QN23PROD with BILLS 6 •HRES 1057 IH Americans with Disabilities Act of 1990 (Public Law 101–336) and the Supreme Court’s Olmstead v. L.C. de- cision; Whereas there is a need for greater focus on intensive out- patient, partial hospitalizations, residential programs, day programs, supported housing, assertive community treat- ment, mobile crisis services, peer support services, sup- ported employment, and community-based services for adults with mental illness and substance use disorders; Whereas there is a need to ensure that services support indi- viduals with mental health conditions and substance use disorders to participate fully in their communities and live and thrive independently Whereas there needs to be consistent care coordination and more effective transition services for those moving be- tween hospitals and the community; Whereas there is a need to address isolation issues geriatric patients face which can negatively impact their mental health; Whereas depression, anxiety, post-traumatic stress, and psy- chosis are some of the most common conditions women experience pre- and postpartum; Whereas unmet parental mental health and substance use disorder treatment and service needs contribute to in- creased involvement with the child welfare system, which leads to preventable foster care placements, given that— (1) in 2018, 262,956 children entered foster care, with the leading reasons related to mental health and substance use disorder needs of the parents, with— (A) 36 percent of children entering care as a result of parental drug abuse; VerDate Sep 11 2014 01:52 Jul 22, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6300 E:\BILLS\HR1057.IH HR1057 SSpencer on DSK126QN23PROD with BILLS 7 •HRES 1057 IH (B) 14 percent of children entering care as a result of the caretaker’s inability to cope; and (C) 5 percent of children entering care as a re- sult of parental alcohol abuse; (2) even when necessary to ensure a child’s safety, foster care itself creates additional trauma for both the child and family; and (3) longstanding racial inequities in child welfare services create disproportionate child welfare involvement for Black, Native, and Latinx children and families, which exacerbates those families’ experiences of trauma and contribute to health disparities while not resulting in needed access to quality mental health and substance use disorder services; Whereas children and adolescents have unique needs when it comes to mental health and substance use disorders and the services provided, given that— (1) 45 percent of children have experienced adverse childhood experiences which have the potential to signifi- cantly impact the mental health of children; (2) in the last 12 months, 49.4 percent of children who needed mental health services did not receive the necessary services, and there needs to be improved access to more appropriate treatment services, which must focus on community-based supports and services available near their home, in order to effectively prevent children from experiencing a mental health crisis; (3) many children suffering and struggling go undiagnosed and are not adequately supported, and there is a need to improve training and understanding of men- tal health and substance use disorder concerns for edu- cators since often there are barriers to mental health and substance use disorder treatment in a school setting; VerDate Sep 11 2014 01:52 Jul 22, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6300 E:\BILLS\HR1057.IH HR1057 SSpencer on DSK126QN23PROD with BILLS 8 •HRES 1057 IH (4) 42 percent of school districts have reported using threat assessment and risk assessment teams, an ap- proach created by the United States Secret Service that involves identifying, evaluating, and taking action on cur- rent or potential threats which— (A) can cause significant harm to the mental health and emotional well-being of children; (B) has compounded already existent stigma for groups of students; (C) has had a disproportionate impact on stu- dents of color by initiating justice involvement in lieu of more appropriate services; and (D) has had a disproportionate impact on stu- dents with disabilities; (5) families and caregivers need to be included when treating children suffering from mental illness and sub- stance use disorders; and (6) when children turn 18 they are cut off from mental health and substance use disorder services which impacts continuity of care; Whereas there is a growing need for mental health and sub- stance use disorder services amongst young adults and college-aged adults, and between 2007 and 2017, for those aged 18–34 there was a— (1) 108-percent increase in drug-related deaths; (2) 69-percent increase in alcohol-induced deaths; and (3) 35-percent increase in suicide deaths; Whereas despite the rising need for mental health and sub- stance use disorder treatment by young adults, there con- tinues to be disparities in accessing care experienced by young adults of color; VerDate Sep 11 2014 01:52 Jul 22, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6300 E:\BILLS\HR1057.IH HR1057 SSpencer on DSK126QN23PROD with BILLS 9 •HRES 1057 IH Whereas 5.5 million veterans and servicemembers rely on the Department of Veterans Affairs for health services, and 1.5 million veterans have received a mental health diag- nosis, and— (1) 1 in 4 active duty members shows signs of men- tal health conditions; (2) the rate of post-traumatic stress disorder (PTSD) is 15 times higher in servicemembers than com- pared to civilians due to military combat and military sexual assault and trauma; (3) the rate of depression is 5 times higher in servicemembers than compared to civilians; (4) every day, 22 veterans die by suicide; (5) there is a fear of disclosing mental health condi- tions and substance use disorders and seeking treatment due to negative career implications; and (6) less than 50 percent of veterans receive the men- tal health treatment and services they need; Whereas 11 percent of those entering the Veterans Affairs health system meet the criteria for a substance use dis- order; Whereas veterans are more likely to have an alcohol use dis- order than civilians; Whereas 2 in 10 veterans with PTSD have a comorbid sub- stance use disorder, and 1 in 3 veterans seeking services for a substance use disorder also have PTSD, showing the interconnectedness between these conditions; Whereas there is a need to better educate all those in the criminal justice system on the impact and needs of those with mental health conditions and substance use dis- orders; VerDate Sep 11 2014 01:52 Jul 22, 2020 Jkt 099200 PO 0000 [Text truncated for display. Full text available on Congress.gov.]