The election fervor has reached its peak as the presidential campaign is coming to its end across the country. While trading political salvos, the Democratic presidential candidate Hillary Clinton has put forward her comprehensive mental health plan on Monday, 29th August.

Targeting over 40 million adults and 17 million children in the US, mental health problems are becoming increasingly prevalent in the country. As Ms Clinton’s recent address sheds light on the mental health issues, it seems that the state’s priorities are up for a change, and might go in the right direction, that is if Hillary becomes the next president. This future framework to improve healthcare system is equally appreciated by the American Psychiatry Association (APA).

APA President Maria A Oquendo, MD, said “The detailed mental health plan outlined by Hillary Clinton is sweeping in nature and, if enacted, would greatly improve the nation’s mental health care system.” She added that they welcome the attention mental health is getting from Clinton. Discussing mental health systems in election campaigns is a good starting point but unfortunately mental health needs often remain untreated.

Hillary Clinton’s Agenda For Mental Healthcare

Hillary is likely to work on the footsteps of Obama by aiming to integrate mental health with physical health and incorporate both as one entity under healthcare systems and laws. In her deliberations, she has attempted to address all the issues of mental health management in the country. She believes that promoting early diagnosis and interventions, including a national initiative for suicide prevention, are a need of the hour. Reflecting upon the failure of deliverance of healthcare facilities, she has said that community-based treatment will be provided while enforcing mental health parity across all states.

She identified the need to change imprisonment rules for minor offenses and suggested that mental health treatment should be preferred over jailing. Increasing recession is a major contributing factor for increasing unemployment and homelessness, which in turn affects a person’s mental health adversely. The presidential candidate hopes to find a permanent solution to the root cause. She is motivated enough to get rid of the stigma associated with seeking help for mental health.

While she showed commitment for extending research into brain and behavioral sciences, she also gives equal importance to increasing mental health awareness which includes maternal depression, infant mental health, trauma and stress in young children.

Most importantly, she also wants to expand the reimbursement systems for improving collaborative care models under Medicare and Medicaid schemes. This policy in particular will aim at treating patients through a team of healthcare professionals, including primary care doctor, a care manager and a behavioral health specialist. She also went on to pledge on hosting a White House conference on mental health to identify the progress, barriers and improvement for devising better mental health policies.

The Mental Health Crisis

One in five American adults is estimated to face a mental health problem at least once in their life, including struggling with anxiety or depression. Nearly one in five veterans who return from war is prone to giving in to post-traumatic stress disorder (PTSD) or depression. On the contrary, one in 25 Americans, that is about 10 million of the country’s population, fall prey to serious mental health illnesses such has schizophrenia or bipolar disorder.

A recent study published in the Journal of American Medical Association Internal Medicine has also reached an alarming finding which is in line with the mental health plan of the Democratic candidate. This study from experts from Columbia University found that less than a third of American adults who get diagnosed with depression, do not receive the required treatment. On the contrary, about two-thirds of the adults seek treatment for depression who are not even diagnosed for the condition.

The researchers said that emphasis is to be given to formulating treatment routes for depression to ensure that it is neither too intensive nor insufficient for each patient.

Mark Olfson, MD, MPH, professor of psychiatry at CUMC and study’s co-author, added, “Greater clinical focus is needed on depression severity to align depression care with each patient’s needs.”

The screening procedures and likelihood of getting treated for depression also showed a closely-knit connection with the social and financial status of the research participants. About 8.4% respondents were screened positive for depression and out of them 8% received the required treatment. These people were mostly white and college educated who held private healthcare insurance.

These staggering figures should be no less than an eye opener for the political leaders of the country as they evidently show disparity in the access of mental healthcare.

Mental Health Care Policies In The Past

Earlier, in President Obama’s tenure, the behavioral health coverage improved over the years. Before 2013 it only catered to the needs of 54% Americans for substance abuse treatment and about 61% for mental health treatment coverage. Surprisingly, in 2013, people with mental health problems like bipolar disorder, alcoholism, anorexia, schizophrenia and other mental or behavioral illnesses were not able to obtain private health insurances in many states. Those who were able to get themselves registered for insurance had to go through underwriting processes to prove their eligibility to hold an insurance which made the process inconvenient at many levels.

However, after President Obama introduced the Affordable Care Act (ACA), the act eliminated the underwriting in individual and small group markets from 2014 onwards. It also ensured that Mental Health Parity and Addiction Equity Act (MHPAEA) included individual, small group and Medicaid plans, and exclusively covered mental health and addiction treatments as essential health benefits without incurring an expense limit. Alongside, ACA made it mandatory for all coverage plans to cover the cost of mental health medications.

However, the implementation of the policies jotted down by ACA was not carried out smoothly in all states. With Hillary Clinton’s promising commitment to the cause, things are likely to continue in the right direction. It is hoped that if Hillary Clinton takes over the Oval Office, she will continue to work for the mental healthcare sector.