Voters hungering for substance in a style-heavy presidential race ought to take a new look at one of the most praiseworthy but overlooked policy proposals of the campaign: Hillary Clinton's intelligent framework for mental-health reform.
Mental illness is far more common than many people realize, which is why the Democratic nominee's decision to make this one of her signature issues is laudable and, given the stigma around these conditions, courageous. About 18 percent of U.S. adults reported having a mental illness, according to the National Institute of Mental Health. Regrettably, fewer than half received treatment, according to the federal Substance Abuse and Mental Health Services Administration (SAMHSA). Access to care is also a huge concern for adolescents.
The proposed Clinton reforms are notable for their practical prescriptions to improve care both now and in the future. Rather than champion an idealized but politically impassable version of health care — as Democratic primary rival Bernie Sanders did with government-run insurance for all — Clinton builds on the current system.
Her changes are not revolutionary, but they are focused and eminently doable. The level of detail also stands in welcome contrast to the stale talking points about health savings accounts and buying health insurance across state lines on Republican Donald Trump's website.
The myriad improvements Clinton calls for include bolstering federal funding for brain and behavioral science research, leveraging federal resources and programs to educate more mental-health specialists, tapping the U.S. surgeon general to lead a national suicide prevention initiative, and expanding innovative mental-health screening models for schoolchildren, college students and new mothers.
The reforms also call for scaling up a demonstration project that would help people access treatment at community health centers, expanding housing options for those with mental illness, and improving training and resources for law-enforcement officers. Many of these ideas address concerns long raised by Minnesota mental-health advocates and law-enforcement officers. Hennepin County Sheriff Rich Stanek, for example, has been prominent nationally in calling for improved resources for officers and courts working with patients in crisis.
The plan's backbone, however, is enforcing an existing law: the landmark Mental Health Parity and Addiction Equity Act of 2008. Jim Ramstad, a former Minnesota Republican congressman, was the U.S. House bill's chief cosponsor. The act requires insurers to cover mental-health treatment the same way they do other conditions. The problem is that enforcement has lagged, according to Ramstad and Patrick Kennedy, a former Democratic congressman from Rhode Island who also championed the bill.
Both Ramstad and Kennedy praised Clinton's call to crack down on insurers skirting the parity law and denying coverage. Randomized compliance audits are a good idea, Ramstad said. So is the push for a national hot line for consumers to report violations. The framework is a "well-conceived, pragmatic and comprehensive" response to parity concerns and other needs, he added.
Kennedy also praised the plan in an interview and added that Clinton deserves credit for her willingness to take on the health insurance industry, which has a financial stake in limiting costly mental-health care.
In an election year where so many voters say they want a president willing to take on entrenched interests, the Clinton reforms ought to be seen as an actual battle plan to do so. Said Kennedy: "This was not the politically correct thing to do if you wanted to cozy up to the most powerful lobby in Washington.''
