On April 12, we adjourned Sine Die on the 2021 legislative session. This is my third and was once again an historic session without precedent. I’m never sure where to start, especially in a session which saw landmark legislation in pandemic relief; criminal justice, unemployment and police reforms; telehealth and health equity expansion; environmental resiliency; and so many other areas. However, this month I knew what I wanted to write about, because it is a bill so close to my heart, and of which this community was the impetus.
Anyone who read the Voice last year knows well of Our Minds Matter, a youth-led advocacy group dedicated to mental health access, destigmatization and suicide prevention. Last year, after multiple meetings not only with these young people but also adults in our community asking for solutions to help keep their children safe following a rash of youth suicides, I introduced the Mental Health Access Initiative, which corrects a troubling disparity between how we address substance use disorder (SUD) and mental illness. In response to the opioid crisis, under the health occupations statute, the floor age for consent to services for SUD was undefined, but the floor age for mental health services was 16, which creates a grey area for services because not only are the providers often the same, but also SUD and mental illness can be co-occurring. Because behavioral health is a broad umbrella, depending on what avenue the adolescent enters, they may or may not be able to get help. Additionally, because this consent restriction applies only to licensed health providers under statute, without a change in the law, any adult can speak to an adolescent about their mental health except one who is licensed and trained to do so.
Last year I worked with Senator Malcolm Augustine and multiple stakeholders in the field of behavioral health to craft this bill. Initially we tried to align the two arms of behavioral health, but in attempting to address some of the concerns raised, we compromised at lowering the age from 16 to 12. We also amended the bill to clarify that consent did not extend to medication, that the minor had to be determined “mature and capable” of informed consent, which is a recognized standard in health care, that the bill did not extend to consent to refuse treatment ordered by the parents, nor did it require services be provided, and explicitly clarified that billing for services could occur only with parental consent to incentivize parental involvement. We were attempting to remove a barrier to care, and that barrier was fear – fear of retribution, rejection and disappointment.
Nothing in the bill prohibits parental involvement unless it would be detrimental to the minor, but this bill gives flexibility to the provider as to how and when seeking consent is most appropriate. There are a myriad reasons why adolescents wouldn’t talk to their parents about their mental health issues. Asking for help can be hard, but I was determined that if and when our students were brave enough to ask for help, there would be someone on the other side, trained and qualified to provide it.
Last year, we moved the bill out of the Senate, but due to the truncated session, we weren’t able to pass it. This year we did. Anytime we are dealing with consent, it is always going to be challenging, but this is a commonsense solution that will save lives.
The debate was not pleasant and the attempts to promote this bill as something that it isn’t have been many. Two months ago, I wrote about inflammatory rhetoric and misinformation, and one might think I was precognitive to the debates we would experience. For the record, House Bill 132/Senate Bill 41 do none of the following: allow providers to prescribe psychotropic drugs or puberty blockers, gender reassignment surgery, breast augmentation, hormone therapy, strip away parental rights; it is not a step toward communism. All of these are accusations lobbed at me and this bill — frustratingly, mostly by members not only of the Health and Government Operations Committee who know better but also by members of this community who know why I introduced it in the first place.
Some of you may be aware of the controversy another delegate created when on Holocaust Remembrance Day he compared providing mental health care by licensed health providers to the torture of Jewish children. Our children heard that. It is any wonder they would be afraid to ask for help?
Even now, there is a campaign to have the governor veto this essential, lifesaving, commonsense bill, and to ensure that I lose my seat for sponsoring it. If saving the lives of our children, if working to expand access to mental health resources for minors, and eliminating the stigma which still pervades mental health care is the reason this district wishes to replace me, than that is fair, but it’s important that you know what this bill is and why we need it. This bill isn’t going to end suicide, but it will save lives. As our crisis intervention team says, “There is no wrong path to care,” and I’m proud to have opened the door.
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