Addressing Mental Health

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January 12, we will gavel in for the 444th Maryland General Assembly session, once again in the shadow of a COVID surge that has taxed our hospital system like never before, and as we not only navigate the challenges of COVID but the necessity and urgency of the people’s work. For anyone who follows my writing, my commitment to behavioral health is no mystery, and with the ever-changing landscape of COVID and the disruptions to so many aspects of our lives, the toll to our constituents in the recovery community as well as those suffering from mental health issues has been significant, and the wave of overdoses and mental health crises is not yet cresting.

When I started working in the House of Delegates and I met with the students from Our Minds Matter, I reflected on my own experiences from my youth and the challenges to accessing mental health resources, knowing how many families are touched and impacted by behavioral health issues and the stigmatization of mental illness, how many people have suffered the loss of a family member, friend, or colleague to suicide, and I was determined to make things better. At the same time, I attended a talk about some really innovative programs for behavioral health being piloted in our prerelease incarcerated communities. It was a session that stayed with me because although I was grateful we were providing services, and that the outcomes were extraordinarily impressive, I just couldn’t stop thinking, “Why do we have to wait not only until someone is in the legal system but until right before they are coming out to get them help?”

I know it’s an unfair question, because we do have many dedicated people doing this work every day, and we’ve seen the value of diversion programs and drug courts. But we lack a system of care, because as a nation we have been disinvesting in behavioral health care since the repeal of the Mental Health Systems Act, creating an equitable and often cost-prohibitive patchwork of providers, and relying on the legal system, the school system, and the nonprofit world to provide for the social-emotional needs of our communities. Even as the cries and demand for services grow louder, the price tag remains an impenetrable barrier not only for many seeking help but also from cynical legislators who claim they want mental health services, just not the services we seek to fund.

Three years ago, I sat down with my colleagues who were working in the behavioral health sphere, laid out my idea for a coordinated system of preventative mental health care, and the response was, “Go for it, but this is going to take at least six years, so you’d better be here for at least two terms.”

For three years we’ve been mapping the monster, as I call it, identifying gaps in service, barriers to care, and strategies to coordinate care, the “warm handoff” as our crisis intervention team would describe it. I sponsored the bill, which identifies emergency facilities that could more readily intake, assess and treat emergency petitions. I co-chaired the Crisis Bed Registry Workgroup and sponsored the bill to pilot a dynamic database to better identify and coordinate with state hospitals and behavioral health providers. I sponsored the bill to expand the use of behavioral health telehealth and ensure that reimbursable services would be equitable, and, of course, I sponsored the Mental Health Access Initiative, which came from that meeting with Our Minds Matter, to remove a barrier to care for adolescents in need of mental health services.

It’s year four and despite the challenges and delays of COVID, this year, I, along with my behavioral health champion and partner Senator Malcolm Augustine, am sponsoring the Behavioral Health System Modernization Act, a comprehensive bill to make statewide coordination of behavioral health resources a reality. It isn't going to be easy and it will not be cheap, but the cost of doing nothing is too great. I promised four years ago that I would ensure my time here made a difference for however long I have the honor of serving you. I hope regardless of what happens in November, that a comprehensive, effective, robust, world-class behavioral health system will be my legacy.

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