Bill Overview
Title: Undertaking Needed Investments in Therapy, Education, and De-Escalation Act of 2022
Description: This bill reauthorizes through FY2027 and establishes new mental and behavioral health programs. It also temporarily extends certain waivers related to the provision of telehealth services. The bill reauthorizes the Community Mental Health Services Block Grant program, which supports the provision of mental health services for adults with serious mental illnesses and children with serious emotional disturbances. Additionally, the bill reauthorizes grants for the Suicide Prevention Resource Center and other suicide prevention programs, including those in institutions of higher education, schools, juvenile justice systems, and other child- and youth-serving organizations; community crisis response systems; training teachers and other school personnel to recognize symptoms of childhood and adolescent mental health disorders; clinical education and training of students seeking to enter mental and behavioral health professions; and assertive community treatment (i.e., comprehensive services for individuals with severe functional impairments associated with serious mental illness). Further, the bill establishes (1) a national center to facilitate the exchange of knowledge and expertise related to behavioral health services for community recovery; and (2) grants for crisis call centers to hire and train staff, purchase or upgrade technology, and improve operations. With respect to telehealth services, the Department of Health and Human Services waived, using emergency authorities, certain requirements that applied to services furnished through telehealth during the COVID-19 emergency. The bill extends those waivers for two years following the end of the emergency.
Sponsors: Rep. Gonzales, Tony [R-TX-23]
Target Audience
Population: People who rely on mental and behavioral health services
Estimated Size: 66000000
- The bill aims to improve mental and behavioral health services in the U.S., impacting both individuals with current mental health issues and those at risk.
- It will support adults with serious mental illnesses and children with serious emotional disturbances through the reauthorization of the Community Mental Health Services Block Grant program.
- Suicide prevention initiatives will affect individuals in educational institutions, juvenile justice systems, and organizations serving youth.
- Teachers and school personnel trained under this bill will have a broader impact on their student communities by recognizing and addressing mental health disorders.
- Clinicians in training entering mental and behavioral health professions will be critical for expanding service capacity, affecting many future patients.
- Telehealth service expansions will make access to mental health services easier for various populations, particularly those in remote or underserved areas.
Reasoning
- Given the large target population of 66 million Americans for this mental health policy, it is essential to distribute the available funds efficiently. The policy is likely to have a widespread, though potentially varied, impact across different demographics and locations.
- The policy includes provisions for both immediate and long-term programs, suggesting that effects may be gradual in some areas due to the time required to train personnel and establish systems like crisis centers.
- The impact of telehealth services extension will likely be more immediate, providing access to mental health services for individuals in rural or underserved areas.
- The training of educators and clinical professionals in mental health is crucial, as it creates a ripple effect, allowing many individuals to benefit from better recognition and treatment of mental health issues.
- Budget limitations indicate that the most profound impacts will be felt by those in programs with the greatest immediate need, such as the Community Mental Health Services Block Grant or crisis response initiatives.
- As this policy extends over several years, initial impacts may be subtle, with more substantial improvements in wellbeing seen in later years as programs become fully operational and entrenched.
Simulated Interviews
High School Teacher (rural Wisconsin)
Age: 45 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- I think extending mental health training to teachers is overdue. We see kids struggling every day and often feel helpless.
- The policy offers hope that I can do more to help my students, especially with the new resources and training.
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 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 6 |
College Student (Los Angeles, CA)
Age: 22 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 18/20
Statement of Opinion:
- It's encouraging to see more funding going towards campus mental health resources. The stress here is intense.
- I hope they put more counselors on campus and make appointments easier to book.
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 | 7 | 6 |
| Year 20 | 7 | 6 |
Telehealth Therapist (Houston, TX)
Age: 35 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 7.0 years
Commonness: 10/20
Statement of Opinion:
- Telehealth waivers during COVID were a game changer. Extending them means I can continue reaching clients who otherwise wouldn't have access.
- This policy helps us bridge the gap in mental healthcare access.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 5 |
| Year 5 | 9 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 8 | 4 |
Call Center Operator (New York City, NY)
Age: 30 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- Investments in crisis centers will improve response times and reduce burnout for workers like me.
- It's reassuring to know we'll have better training and resources to handle the volume of calls effectively.
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 | 8 | 6 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Psychiatrist (Chicago, IL)
Age: 50 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 15.0 years
Commonness: 12/20
Statement of Opinion:
- More training for future clinicians is crucial, but it'll take time before we see the benefits in practice.
- I'm optimistic about the potential improvements in adolescent mental health services with this policy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 9 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 8 |
| Year 20 | 8 | 7 |
Retired (Phoenix, AZ)
Age: 60 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- Improved funding could mean better community services, but I've heard these promises before without much changing.
- Accessing mental health resources is crucial for me, and anything that solidifies this access is good news.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 5 |
High School Student (Detroit, MI)
Age: 19 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 13/20
Statement of Opinion:
- I hope this policy means more resources at school. We need more counselors and less stigma around seeking help.
- It'd be nice to have teachers who understand what we're going through.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 4 |
Software Engineer (San Francisco, CA)
Age: 27 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 17/20
Statement of Opinion:
- Telehealth services have been critical for me, especially when dealing with anxiety while working remotely.
- Supporting mental health through policy ensures ongoing access to these essential services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
Juvenile Justice Worker (Atlanta, GA)
Age: 33 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 9/20
Statement of Opinion:
- The funding for at-risk youth programs is directly needed in my work. Kids fall through the cracks when we can't address their mental health needs.
- I'm hopeful that this policy will give us more tools to change the trajectory for these kids.
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 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 5 |
Unemployed (Miami, FL)
Age: 41 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 8.0 years
Commonness: 14/20
Statement of Opinion:
- Reauthorization of mental health services is critical for people like me. We've been lacking consistent support for too long.
- I wish the policy could have a more immediate impact on wait times and counselor availability.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 3 |
Cost Estimates
Year 1: $500000000 (Low: $450000000, High: $600000000)
Year 2: $525000000 (Low: $475000000, High: $625000000)
Year 3: $550000000 (Low: $500000000, High: $650000000)
Year 5: $600000000 (Low: $550000000, High: $700000000)
Year 10: $750000000 (Low: $700000000, High: $850000000)
Year 100: $920000000 (Low: $870000000, High: $1020000000)
Key Considerations
- The sustainability of funding mechanisms post-FY2027 when current authorizations expire.
- Potential challenges in scaling up mental health workforce capabilities to meet increased service demand.
- Monitoring and evaluating the effectiveness of expanded services and supports.