Blunt urges nationwide expansion of successful excellence in mental health program

Missouri U.S. Senator Roy Blunt Michigan U.S. Senator Debbie Stabenow (Mich.) spoke on the Senate floor to urge support for their legislation to expand the Excellence in Mental Health Act. Read the full press release below:

Missouri and Michigan are both part of the Excellence pilot program, which created the nation’s first Certified Community Behavioral Health Clinics (CCBHCs). Blunt highlighted the success Missouri CCBHCs have had in improving access to care, reducing hospital and ER visits, and providing mental and behavioral health support to local law enforcement.

 Blunt, the top Republican on the Senate appropriations subcommittee that funds health programs, has also prioritized funding for CCBHCs in states that are not currently part of the Excellence program. With the addition of CCBHC grant funding, there are now clinics serving around 1.5 million people in more than 40 states.

Following Are Excerpts of Blunt’s Remarks:

“So glad to be here with you, Senator Stabenow. We’ve been friends a long time. We have worked together on a number of issues, both in the House, where we came in at the same time, and in the Senate, when I got to the Senate.

“But, clearly, this is one of the things that I think we both have a strong sense that we’ve really made a difference, not only how we look at mental health but also in the way we talk about mental health. You know, Senator Stabenow’s point of treating mental health like all other health and what happens when you do that. 

“We got an award last month when I was home and Senator Stabenow was virtually in Jefferson City, Missouri, for a few minutes from the Missouri Behavioral Health Council, the Excellence in Mental Health Award.

“Brent McGinty, the head of that council, talked about what they were doing and what they were seeing from what they were doing. Also, we talked about the partnership with community health centers, another thing we’ve worked together on. And Joe Pierle and Brent McGinty are actually both here today, coincidentally, when we’re talking about this issue so important to both of them.

[…]

“One of the things that we’ve looked at is, we’ve looked at the 41 states now that have some unit of Excellence in Mental Health, the Certified Community Behavioral Health Centers in their state. Maybe it’s a big county. Maybe it’s a city that was able to qualify with the 365 days a year, 24/7 standards with the kind of staff available that you have to meet that criteria first.

[…]

“NIH says about one in five adult Americans has a behavioral – diagnosable, and almost always treatable – behavioral health issue, and one in five adult Americans probably has other health issues as well. In fact, they obviously would have.

“And one of the things we’ve been trying to keep track of is: what happens in the real, confined health care world when you deal with people’s mental health problems like they were any other health problem. Do they start showing up at appointments more frequently? Do they take the medicine that they’re supposed to take for either behavioral health issues or other health issues? Eating better, sleeping better, feeling better about themselves? And I think it’s pretty clear and totally logical that that would be exactly what happens.

“You know, another thing we’ve seen, after that 50 years of whatever happened in mental health between October [1963] and the day we were on the floor in 2013, is in so many ways, the police department, law enforcement, and the emergency room became the de facto mental health system for the country.

“And we’ve seen, we’ve had people come and be part of press conferences with us, Senator Stabenow, and talking about fewer people being taken to the emergency room, the importance of having a contact that you can make, maybe a place that’s not only a place to spend a night but also a place to then, for you and your family, to know that you’re going to have an ongoing opportunity to have a relationship, to deal with your mental health problem just like you would if you had to be taken to the hospital to deal with other problems.

“And we’ve seen some things there, Senator Stabenow, you may want to talk about a little bit with everything from the iPad that people, that law enforcement officers in the crisis intervention team uses in Springfield, Missouri, and other places in our state, to where they can immediately link the person that they’re dealing with up on the screen of the iPad with the behavioral health counselor that’s there any time of the day, fully-manned, 24/7, and see what begins to happen when a professional is dealing with a person in crisis.

“And I’ve seen that happen, and I’m sure I was there with probably the best crisis intervention center that the police department had, person that they had. But you could tell a difference when they start looking at that screen and talking to somebody, not only as a behavioral health specialist but also who’s just a little bit removed but totally prepared to enter into that discussion. And we’ve had lots of people talk about the impact on departments, in emergency rooms, Senator Stabenow.

… 

“Where we are, you know, what you were talking about the, getting people into the health care system instead of the criminal justice system is obviously one of the goals we should have.

“Missouri got really, was started in January 2017, and in that first four years, they served more than, in these certified centers, they served more than 150,000 Missourians, more than 3,500 veterans. And that was a 41% increase over the four years of not being in the program, to being in the program.

“And, not only did you serve people, but because of the way this is set up, you’re able to serve people so much more quickly. You’re able to have the staff that you can have because you know you’ve got the funding you need to have the staff.

“Largely, this is an increase of the Medicaid coverage, but the other Medicaid costs go down more than the behavioral health costs add to the system. And we’ve always known that this was the right thing to do, right thing to do in the long run, right thing to do for police officers, right thing to do for the emergency room, right thing to do for the prison system, right thing to do for people being at work.

[…]

“And, you know, what we saw in the last two years with COVID was the real crisis that became part of that that health care crisis, the mental health crisis of isolation, of people who develop some kind of dependency.

“You know, if you don’t have a mental health problem before you become dependent on opioids or something else, you have one as soon as you become dependent on those problems. The suicide numbers went up, and having a structure in place, ready to reach out and man the suicide hotline to get people to where they need to get. 

“You know, there’s no, there’s no waiting list for somebody who’s thinking about doing harm to themselves or others. We need to have a society where we understand that’s an immediate problem. It has to be dealt with immediately. And it’s a societal, not only a societal goal, but actually it should be one of our primary responsibilities [in] society. And I think that’s what we’re seeing here over and over again, Senator Stabenow. 

… 

“But if you need to be at the front of the line, you get to go to the front of the line. If you need to be seen the first day, you get to be seen the first day. No more seven-day waiting period for a crisis moment. People still may have to occasionally wait and come back tomorrow or come back Wednesday or whatever the schedule might be. And I think that’s critically important.

“And then, now, Senator Stabenow, what you and I are trying to do is to further expand the opportunity. You know, the president said, in his State of the Union message, ‘let’s get all Americans the mental health services they need.’ That’s a quote, ‘let’s get all Americans the mental health services they need.’

“That was a goal in the president’s State of the Union message. It should be a significant goal for the country. And what we’d like to see happen in this Congress is the expansion of Excellence in Mental Health to every state that wants to do it.

“Initially, we had 24 states apply to be part of the eight pilot states. Nineteen of them went all the way through that entire process. And, you know, all 50 states may not apply, but we’d like to create an environment where all 50 states could apply.

“And, frankly, every time we get a score on this bill, the score is a little lower than it was before because I think the facts are beginning to persuade even the Congressional Budget Office that this makes economic sense to do. And there may be some startup costs, but the long-term costs may be actually long-term savings.

“If you can do the right thing and save money while you’re doing it, Mr. President, that’s a pretty good place to be in for a society or a government or a country. And that’s what we’re trying to get done, Senator Stabenow, in this Congress.

…

 “And you can have a community behavioral health center working with a primary care center. Or you could have an independent provider working with their other health care provider, or vice versa. It’s very interchangeable. The one criteria for the Certified Community Behavioral Health Centers is the level of staffing, 24/7, 365 days a year, always available to be that critically important partner that people with a mental health challenge need. And, frankly, their families and people who care about them need it as well. This is a big challenge for the individual that has a behavioral health problem, but it can be an equally big challenge for people who care about them.”