Healing the Nation: Advancing Mental Health and Addiction Policy

Well Being Trust recently released a new framework and policy action guide, featuring actionable solutions to improve mental health and well-being has been released. (Executive Summary here). The action guide, Healing the Nation: Advancing Mental Health and Addiction Policy, provides meaningful and actionable solutions to help advance mental health policy in this country. By using a systems framework, the report outlines specific actions policy makers can take to advance mental health and structures solutions in an integrated fashion to achieve maximum benefits for all.

“The continued decline of U.S. life expectancy, largely due to overdoses and suicides, is a grim reminder that we are not doing nearly enough to address mental health and well-being in this country,” said Patrick J. Kennedy, former U.S. Representative (D-R.I.), founder of The Kennedy Forum and Mental Health for US co-chair. “The cycle must be stopped with swift action and thoughtful policies to increase access to care and save lives. Healing the Nation is a critical resource in the roadmap for lasting change.”

Coverage of Services to Promote Children’s Mental Health

A new report from Well Being Trust, California Children’s Trust and Mental Heath America finds that despite advances in health policy, children’s mental health has declined steadily in the US over the past decade and faced further challenges as a result of the COVID-19 pandemic. To address this growing children’s mental health crisis, experts recommend implementation of effective interventions to promote positive family mental health and prevent mental health conditions in children as one critical strategy. The analyses find that current state Medicaid and commercial health insurance payment policies likely fail to adequately reimburse for effective interventions to promote positive family mental health, and that this failure violates current law. States and health insurers need to ensure legal compliance and take steps to remediate historic underinvestment

2019 Well Being Trust Annual Report

The annual report highlights key initiatives from our first few years, presents our strategic directions for the next three years, and paints a picture of the mental health and well-being “movement infrastructure” we are investing in to save lives.

Pain in the Nation

In 2017, with the Robert Wood Johnson Foundation and Trust for America’s Health (TFAH), we co-funded and released the seminal 2017 report Pain in the Nation on “deaths of despair” in America. The report presented 60 evidence-based policy and advocacy strategies to help decrease deaths due to alcohol, drugs and suicide and called for a national resilience strategy.

Since then, Well Being Trust and TFAH continued the Pain in the Nation work by issuing several policy briefs and data updates, focused on alcohol, drug and suicide death rate disparities; the education sector; and healthcare systems.

The Well Being Trust Toolbox: Solutions for advancing mental health and well-being in your community

The Well Being Trust Toolbox, developed with Oregon Health and Science University (OHSU), intends to equip community leaders and decision makers with solutions and resources for improving mental health and well-being outcomes in their organizations and communities. The Toolbox, for health sector leaders (providers, payers, purchasers) as well as policymakers, philanthropy and community leaders, features evidence-informed resources to help everyone improve the mental health and well-being of people and places.

WBT and OHSU assembled the evidence and tools that providers, payers and policymakers need to understand what works when making system changes to integrate behavioral health and medical care as well as connecting patients/families to resources outside the hospital walls. For instance, Well Being Trust convened peer-learning networks to develop blueprints guiding real-world implementation, and shared lessons learned from healthcare institutions that successfully collaborated with community organizations and launched integration efforts, overcoming significant barriers to do so.

Projected Deaths of Despair During COVID-19

More Americans could lose their lives to deaths of despair, deaths due to drug, alcohol, and suicide, if we do not do something immediately. Deaths of despair have been on the rise for the last decade, and in the context of COVID-19, deaths of despair should be seen as the epidemic within the pandemic. The goal of this report, issued with the Robert Graham Center, is to predict what deaths of despair we might see based on three assumptions during COVID-19: economic recovery, relationship between deaths of despair and unemployment, and geography. Across nine different scenarios, additional deaths of despair range from 27,644 (quick recovery, smallest impact of unemployment on deaths of despair) to 154,037 (slow recovery, greatest impact of unemployment on deaths of despair), with somewhere in the middle being around 68,000. However, these data are predictions. We can prevent these deaths by taking meaningful and comprehensive action as a nation.

Improving Behavioral Health Care in the Emergency Department and Upstream

Well Being Trust and the Institute for Healthcare Improvement released Improving Behavioral Health Care in the Emergency Department and Upstream, which provides actionable guidance for hospital emergency departments and their community partners to create an effective system of care that works with patients with mental health conditions and substance use disorders who present to the emergency department (ED). To develop these solutions, IHI, in partnership with WBT, convened eight US hospitals in an 18-month learning community. By the end of the project, participants had tested strategies for improving patient outcomes and experiences of care, while decreasing avoidable repeat ED visits for individuals with mental health and substance use disorders who present to the ED. Additionally, some participants were able to reduce the ED length of stay, the number of patient-to-staff assaults, and the use of restraints.

Stories of Change: How We’re Transforming Clinical Practices to Better Treat Mental Health and Substance Use

Well Being Trust is led by clinical experts who’ve dedicated their lives and careers to improving the well-being of patients and communities. We know the challenges patients, practitioners, and health systems face when it comes to addressing mental health and substance use disorders. Just as importantly, we know there are solutions and opportunities for change, and we understand the nation must work together to transform the way mental health care is provided and ensure everyone has access to high quality care. To that end, one of the first things we did after our founding in 2016 was work with Providence St. Joseph Health to create, fund, and lead the Clinical Performance Group, a system-wide learning collaborative that aims to improve care and delivery.

These efforts are building exciting momentum. In these pages, we share four stories of what the group has achieved and learned so far.

Evaluating State Mental Health and Addiction Parity Statutes

At an event recognizing the 10th anniversary of the Mental Health Parity and Addiction Equity Act (MHPAEA), the Kennedy-Satcher Center for Mental Health Equity in the Satcher Health Leadership Institute at Morehouse School of Medicine, The Kennedy Forum, The Carter Center, and Well Being Trust (WBT) jointly released “Evaluating State Mental Health and Addiction Parity Statutes,” with 32 states receiving a failing grade for statues designed to ensure equal access to mental health and addiction treatment.

The state-by-state report cards assess the strength of mental health and substance use disorder parity laws. Wyoming (F, 10), Arizona (F, 26), Idaho (F, 36), and Indiana (F, 38) received the lowest scores, while Illinois (A, 100), Tennessee (C, 79), Maine (C, 76), Alabama (C, 74), Virginia (C,71), and New Hampshire (C, 71) scored the highest.

California’s Health Care Paradox: Too Much Health Care Spending May Lead to Poorer Community Health

As California spending on health care skyrockets, state spending on programs and services that keep people healthy and prevent illness has grown far slower, according to a new report by the Lown Institute and Well Being Trust.

The report, California’s health care paradox: Too much health care spending may lead to poor community health, shows that from 2007 to 2018, state budget spending on health care (including Medi-Cal, health care for state employees and retirees, and health care for the incarcerated) grew by 146 percent, while spending on community conditions increased by just 39 percent, on average. California now spends just $0.68 on social services, public health, and environmental protection for each $1.00 spent on health care—down from $1.22 in 2007.

Advancing Adolescent Flourishing: Moving Policy Upstream

Adolescent brain science shows the teen years are a critical developmental period—a time that’s malleable enough that investments at this age can make a difference for teens today and the rest of their lives, according to a new analysis by AcademyHealthACT for Health and Well Being Trust (WBT). The report, Advancing Adolescent Flourishing: Moving Policy Upstream, found that enhanced teen-focused health policies at local, state and federal levels of government will contribute greatly to the larger enterprise of healing the nation for all. Yet, current national investment in adolescents is lacking.

Digital Health Practices, Social Media Use, and Mental Well-being Among Teens & Young Adults in the U.S.

A national survey of 14- to 22-year-olds provides new evidence on the growing mental health crisis affecting young people. The survey, sponsored by Hopelab and Well Being Trust (WBT), finds that large numbers of teens and young adults experiencing moderate to severe symptoms of depression are turning to the internet for help, including researching mental health issues online (90 percent), accessing other people’s health stories through blogs, podcasts, and videos (75 percent), using mobile apps related to well-being (38 percent), and connecting with health providers through digital tools such as texting and video chat (32 percent).

Integrating Clinical and Mental Health: Challenges and Opportunities

Bipartisan Policy Center released this report to examine the major barriers to integrating clinical health care and mental health services in the United States, including insurance coverage and payment disparities, workforce shortages, and administrative challenges. The report, Integrating Clinical and Mental Health: Challenges and Opportunities, also identifies federal and state policy options that could help remove these barriers and advance evidence-based treatment for mental health care.

Evidence Review Examines Interventions Aimed at Improving Teen Well Being

This Rapid Evidence Review, from AcademyHealth, ACT for Health, and Well Being Trust, reports on findings from recent systematic reviews and selected major studies to address the question of whether teen flourishing can be enhanced.Appendices for the review including key definitions, methods, narrative summary of findings, findings by outcome, evidence tables, and a list of excluded reviews can be found here.

2018 Well Being Trust Annual Report

This is a time of historic opportunity to turn the tide on the diseases and deaths of despair, and to increase well-being for all in America. Every one of us is touched by the suffering, and every one of us is essential to the solution. In playing our unique roles, we get to bring our pain, our joy, our lived experience, and our diversity as our greatest gifts. As Dr. King reminds us: Everybody can be great, because everybody can serve.