WashU Expert: 21st Century Cures Act good start, should focus more on immediate needs

The newly passed 21st Century Cures Act ¬†awaiting President Obama’s signature will provide necessary funding to help those with mental illnesses, but a mental health expert at Washington University in St. Louis says it should focus more on mental health outcomes of those suffering right now.

“Over 40 million Americans suffer from a mental health condition at any given time,” said Ryan Lindsay, associate professor of practice and chair of the mental health concentration at the Brown School.

Ryan Lindsay

“The impact of untreated and unrecognized mental health conditions is staggering,” he continued. “More importantly,¬† less than half of people with a diagnosable mental health condition receive treatment. The consequence to this lack of treatment seeking and access leads to significant social and economic problems. So, in that regard, this bill is a huge step forward.”

The sweeping mental health legislation, passed this week by a bipartisan U.S. Senate and Congress, provides needed resources to various areas that are “all critically important to addressing the impact of severe mental illness,” Lindsay added. Those areas include: medical models of care; biomedical treatment developments; some of the most effective interventions, such as Assertive Community Treatment, for individuals with severe mental illness; and early intervention strategies to help lower the disease burden of illnesses such as schizophrenia.

“Unfortunately, the bill is mainly focused on building research avenues for biomedical interventions to better alleviate biological implications of brain diseases such as schizophrenia and neurological disorders,” he said. “The allocations to current treatments that are known to be the most impactful interventions are extremely small, therefore leaving an opportunity to enhance the mental health outcomes of those suffering, right now, largely out of the equation.”

As a social worker, Lindsay said he is acutely aware that the majority of mental health services in this country are provided by professional social workers.

“This bill allows for training, student loan repayment and professional development for psychiatrists and psychologists to support scientific training and research, however, leaves the largest workforce providing mental health services in this country to individuals with severe and persistent mental illness strapped with high student loan debt and low salaries,” he said.

Although Lindsay recognizes the critical role of developing biomedical interventions for brain disorders that cause some of the most significant impairments, “there is a larger population suffering from a wide range of mental health conditions who are suffering daily,” he said. “The bill takes needed steps for early intervention for serious mental illness, opiod and drug use and its impact, but leaves out needed step-down interventions, funding for development of programs that reduce unneeded and highly expensive hospitalizations, and leaves out helping to disseminate and enhance the workforce right now.”

While there is a lot of good in the bill, Lindsay considers it simply a start.

“It will help people with severe and persistent mental illness and the expanding impact of neurocognitive disorders in the future,” he said. “I would have liked to have seen more outpatient support, money for training and workforce development to include social workers, and money to expand and adapt programs like Assertive Community Treatment models to prevent highly restrictive and expensive hospitalizations.”

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