President Obama signed the 21st Century Cures Act on December 13th after overwhelming bipartisan support from the Senate and House of Representatives. While the act addresses health issues from the “Cancer Moonshot” to speeding new medications to market, some of its most significant impacts may prove to be in the field of psychiatry. The bill encourages funding for addiction and psychosis treatments, evidence-based psychiatric research, and programs to increase the number of psychologists and psychiatrists throughout the country. Although the authorization of grants does not necessarily guarantee funding in the future, many mental health advocates see this as one of the most significant steps forward in the treatment of mental illness in recent years.
One of the bill’s major areas of focus is America’s current opioid epidemic. The house approved $1 billion in state grants to fund addiction prevention and treatment in the hope that Americans in low-income and rural areas will gain access to effective programs. The act also makes substance abuse a top priority with new bureaucratic departments, including a Mental Health and Substance Abuse Policy Laboratory and a new Secretary for Mental Health and Substance Use position. The policy laboratory will prioritize evidence-based, rather than peer-reviewed, research to create better treatment plans for addiction and mental illness.
Proponents of the 21st Century Cures Act hope that it will also encourage early treatment of psychotic disorders and other serious mental illnesses. The bill requires states to use at least 10% of their mental health grants on early psychosis prevention through coordinated specialty care. This model encourages collaboration between a team of specialists providing psychotherapy, medication, and education as well as helping patients to succeed in school or work. An additional $5 million will go toward “assertive community treatment,” a similar program providing a team of specialists who are on-call 24/7. The bill also creates an Interdepartmental Serious Mental Illness Coordinating Committee made up of psychiatrists, politicians, and patients to address treatment policies for psychotic disorders.
A primary theme of this bill seems to be accessibility for mental health care, and several new programs will address this issue. While parity laws requiring equal insurance coverage for mental and physical health care are already in place, the bill requires the Department of Health and Human Services to create a plan for enforcing these laws. It also provides grants to encourage integrated care programs between psychiatrists and primary care doctors and to fund the training of new psychologists and psychiatrists to address our current shortage.
The 21st Century Cures Act gives us a vision of what the future of American psychiatry could be, and this future is grounded in accessibility and collaboration. Grants for substance abuse and mental illness treatment programs and the training of new mental health professionals, as well as the enforcement of parity laws, could address the shortage of psychiatric care in rural and low-income areas. New treatment programs like assertive community treatment and coordinated specialty care encourage physicians in various specialties to work together with patients and communities to provide the best care possible. Although we don’t yet know how these policies will be implemented, this model of mental health care is encouraging for mental health advocates and patients throughout the country.