Bill Overview
Title: 9–8–8 and Parity Assistance Act of 2022
Description: This bill modifies provisions to increase access to behavioral health services, with a focus on crisis services and the 9-8-8 telecommunication system. (The 9-8-8 system provides callers with mental health or suicide crisis support and resources through the existing National Suicide Prevention Lifeline and is scheduled to take effect by July 16, 2022.) The Substance Abuse and Mental Health Services Administration (SAMHSA) must award grants to crisis call centers for hiring and training staff and otherwise improving operations. Further, SAMHSA must establish standards for a behavioral health crisis continuum of care that health care providers and communities may use in responding to individuals experiencing a behavioral health crisis. The continuum must include emergency treatment, stabilization, and related services. Additionally, the bill (1) sets up an office within SAMHSA to coordinate behavioral health activities, (2) requires a national suicide prevention media campaign, and (3) establishes various grants. The grants include a pilot program for mobile crisis care teams that respond to behavioral health crises rather than law enforcement, a capital improvement program for certain behavioral health facilities, and a program for supporting the implementation of federal mental health parity provisions that require health insurance issuers to provide equivalent coverage for mental health services as they provide for medical and surgical services. The bill also expands certain behavioral health education and training programs to encompass education and training related to crisis management.
Sponsors: Rep. Cárdenas, Tony [D-CA-29]
Target Audience
Population: Individuals experiencing or at risk of behavioral health issues globally
Estimated Size: 66000000
- The bill impacts individuals experiencing behavioral health crises as it aims to increase access to crisis support services like the 9-8-8 telephone system.
- By funding crisis call centers and mobile crisis care teams, individuals experiencing mental health emergencies will have increased access to immediate, specialized care instead of being handled by law enforcement who may not be trained for such situations.
- The bill affects healthcare providers and behavioral health facilities through the establishment of standards for crisis care and grants for capital improvements.
- The national suicide prevention media campaign could influence all individuals in the U.S. by raising awareness of mental health support channels and reducing stigma associated with seeking help.
- Health insurance policyholders could be impacted through the implementation and enforcement of federal mental health parity, ensuring better access to mental health services.
Reasoning
- The interviews consider different demographics and situations across the U.S. population vulnerable to mental health crises. We included individuals ranging from youth to older adults, living in urban and rural areas, and in varied socio-economic situations.
- The policy impacts those directly using mental health services through 9-8-8 as well as those indirectly affected by increased societal awareness and parity in health services.
- Allocated budget influences the reach and effectiveness of the program, so care must be taken to detail realistic wellbeing changes based on the program's expected scale.
Simulated Interviews
College Student (New York City)
Age: 24 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- The 9-8-8 system could be a lifeline as current university resources are overwhelmed.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Nurse (Miami, FL)
Age: 32 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- Access to immediate mental health support could help not just patients but healthcare providers like me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Construction Worker (Des Moines, IA)
Age: 58 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- I'm skeptical if I'll ever use such services, but it's good they are there for those who need them.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Therapist (San Francisco, CA)
Age: 46 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- This policy could lead to a more integrated approach to mental health crisis management.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
High School Student (Austin, TX)
Age: 18 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 6/20
Statement of Opinion:
- I see a lot of suicide prevention content, and 9-8-8 should be more highlighted as a resource.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 9 | 5 |
Retired (Rural Georgia)
Age: 65 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- It's good to have these resources, but accessibility in rural areas needs improvement.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Police Officer (Los Angeles, CA)
Age: 40 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- Transferring mental health crisis responses to specialized teams could benefit both the police and those in crisis.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
Tech Worker (Seattle, WA)
Age: 50 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 6.0 years
Commonness: 9/20
Statement of Opinion:
- Ensuring mental health parity in insurance is crucial as stress levels are high in my field.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Retired Teacher (Chicago, IL)
Age: 72 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- The increase of mental health awareness through campaigns could have long-term benefits.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 5 |
Barista (Portland, OR)
Age: 29 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- Mobile crisis teams seem like a good idea for immediate support.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Cost Estimates
Year 1: $1500000000 (Low: $1300000000, High: $1800000000)
Year 2: $1200000000 (Low: $1000000000, High: $1400000000)
Year 3: $1000000000 (Low: $800000000, High: $1200000000)
Year 5: $800000000 (Low: $600000000, High: $1000000000)
Year 10: $400000000 (Low: $300000000, High: $500000000)
Year 100: $100000000 (Low: $70000000, High: $130000000)
Key Considerations
- The program's effectiveness at reducing emergency service load will partly depend on cooperation with local governments.
- Capital improvements in infrastructure are subject to construction delays and cost overruns.
- The transition to 9-8-8 may face technical challenges and require additional investments.