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Ambassador Susan Rice, director of the U.S. Domestic Policy Council, laid out the Biden administration's plan to address the nation's burgeoning mental health crisis during an hosted by the USC-Brookings Schaeffer Initiative for Health Policy and the Commonwealth Fund on Wednesday afternoon.

Rice cited a that showed that one in three high school students said they felt persistent feelings of sadness or hopelessness in the prior year -- a 40% increase from a decade earlier. Additionally, teen suicide rates jumped by 57% from 2007 to 2018, with Black teens twice as likely to complete suicide versus white teens.

During the COVID-19 pandemic, more adults have reported depression and suicidal thoughts, and mental health problems among young people have continued to worsen, she said.

President Biden's American Rescue Plan invested $5.5 billion to expand substance use and mental health services and another $122 billion to help schools reopen safely and to address students' academic and emotional challenges.

"And thanks to many of these efforts, schools are hiring more counselors, nurses, and social workers. More rural and underserved young Americans have access to mental health providers. More dedicated staff are answering the phones at crisis call centers," Rice said, adding that mobile crisis response teams and community behavioral health clinics are also increasing in numbers, leading to more services being provided in the community rather than institutions.

"But this moment calls for more than incremental progress. It demands transformational change," she stressed.

Discussing the core elements of the administration's plan, Rice noted that "our strategy is built around three fundamental goals: First, building a system with enough capacity to treat everyone. Second, connecting people to the services they need by tackling high costs and other barriers. And third, supporting all Americans by creating environments that improve their health and well-being in the first place."

Goal #1

Rice pointed out that three in five counties in rural America lack a single psychiatrist and more than one in three Americans live in areas where there's a shortage of mental health professionals, especially those who have the language abilities and cultural competency to effectively care for patients.

To that end, the HHS FY 2023 budget request includes $700 million for scholarships, loan repayment assistance, and training to increase the number of providers in rural and underserved areas, including providers from diverse backgrounds.

The administration has also requested a "dramatic increase" in funding for community health workers, counselors, recovery coaches, and other mental health professionals, Rice said. Additionally, President Biden recently signed into law the Dr. Lorna Breen Health Care Provider Protection Act, which directs $135 million towards reducing healthcare worker burnout.

In July, the administration will launch the 988 crisis response line and will invest an additional $700 million to ensure that crisis centers are staffed appropriately, so that anyone who calls in gets an answer and has a place to go, she added.

Goal #2

Accessing healthcare should be "comfortable and convenient" for everyone, Rice said. To that end, the Biden administration is seeking to integrate mental health care into traditional and non-traditional sites of care, from primary care physicians' offices, to college campuses, libraries, and homeless shelters.

Increasing telehealth and virtual care are also clear priorities, she added. "We're going to work with Congress to make telehealth available across health plans and across state lines."

Rice also noted that too many insurers have ignored the provisions of the 2008 . In response, President Biden is proposing to mandate that all health plans "cover robust behavioral health services," and provide three behavioral health visits each year without any cost-sharing. Insurance companies will also be required to show there are enough in-network mental health providers to meet patients' needs.

The 2023 budget includes a request to help enforce these measures and others that would provide "vital protections" around mental health parity, she said.

Goal #3

As for promoting mental health and overall well-being, "we want to reduce the likelihood that someone develops serious mental health challenges in the first place, and help people stay healthy after treatment," Rice explained.

In that vein, the administration has requested more funding for treatment courts or "" which help steer people with substance use disorders towards services rather than jail time.

To help nurture the "youngest brains," President Biden's budget would increase funding for home visiting programs that teach parenting skills and help "build safe, healthy homes," Rice said. In addition, the administration has called for increased funding for "community schools," which offer counseling and other services to students and families, and streamline reimbursement for in-school mental health professionals through Medicaid.

The administration also plans to promote healthier online environments for young people by holding social media companies accountable for their product designs, including algorithms that return "hateful content" after a search for certain terms, and by investing in research to examine the impact of social media on mental health and how to correct these issues, Rice noted.

"By acknowledging our vulnerabilities, and identifying our shortcomings, we can grow stronger and healthier. That's what this is about. That's what's at stake," she said.

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