In summary

Assembly Bill 638 increases funding for people with serious mental illness and substance use disorders. It will help counties reach people in the early stages of illness and prevent mental health problems from worsening, and could ease the burden on family members and caretakers.

By Steve Pitman, Special to CalMatters

Steve Pitman is a board member of the National Alliance on Mental Illness, the Mind OC and the Proxy Parent Foundation, stevepitman1@gmail.com.

Even before the pandemic, mental health disorders were among the most common chronic illnesses Californians face.

The COVID-19 crisis — and the resulting isolation and economic downturn many have experienced — have intensified these challenges. More than one in five American adults reported symptoms of anxiety and/or depressive disorder in the last year — a 20% to 40% increase from the pre-COVID period.

The good news is that mental health parity laws have significantly expanded private and public health insurance coverage for mental health conditions. All health insurance plans offered through the Affordable Care Act, for example, now cover mental health and substance abuse services at the same level as other health conditions — a much-needed development.

Due to the pandemic, the Affordable Care Act marketplace opened a special enrollment period, which California has extended till the end of the year. 

In addition, Assembly Bill 638 increases Mental Health Services Act funding for people with serious mental illness and substance use disorders. This will allow counties to utilize prevention and early intervention funds to reach people in the early stages of illness and prevent mental health problems from worsening. It has the potential to ease the burden on caretakers, most often family members.

The National Alliance on Mental Illness estimates that roughly 51 million Americans experience mental illness each year, but only about half seek treatment. According to a March survey, nearly 22% of Californians who experienced symptoms of anxiety and/or depression reported needing therapy but had not received it in the prior four weeks.

Barriers to mental health treatment have a high human cost: Americans with serious mental illnesses have life expectancies 25 years shorter than average, in part due to untreated health conditions. But when people have access to insurance that helps cover the cost of care, they are far more likely to seek it.

Many tools are available that can improve mental health conditions, including medication, therapy and education. Health coverage helps to consistently provide patients with access to these tools, typically covering treatment options ranging from inpatient hospitalization and outpatient mental health care to emergency care and prescription drugs.

Increased availability of telehealth services can also help people dealing with mental health challenges. Nothing can replace face-to-face intervention and interaction with a supportive therapist, and the pandemic created intense challenges for those seeking treatment. But members of Congress, national and local advocacy groups, and health insurers are working together to ensure that telehealth care is available to all Americans, wherever they live and whatever their health status.

Everybody deserves accessible, affordable and comprehensive health care coverage, and those with mental health conditions deserve appropriate care. 

We urge all Californians without health insurance to sign up for Affordable Care Act coverage, take advantage of expanded financial assistance and seek treatment for all health needs, including those involving mental health.

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