AHA Urges Congress to Address Behavioral Healthcare Provider Shortage

The American Hospital Association (AHA) has asked Congress to lift the caps on physician residency positions and increase financial support programs to help health systems address the shortage of behavioral healthcare providers.

In a statement to the Senate Finance Committee, AHA highlighted how the COVID-19 pandemic exacerbated the behavioral health crisis and increased the demand for care. Individuals—children and adolescents in particular—are experiencing high rates of anxiety, depression, substance use disorder, and other mental health conditions. Yet, they also face barriers to accessing proper care.

AHA has joined the Sound the Alarms for Kids initiative, which aims to raise awareness and prompt action to support the mental health of children and adolescents.

Hospitals and health systems are struggling to provide adequate behavioral healthcare services to youths due to psychiatric bed and provider shortages.

Individuals may show up to the emergency department with suicidal ideation or seek treatment for an urgent mental health condition but must wait days or weeks to receive treatment due to bed shortages, AHA said.

The organization also cited the ongoing provider shortage as a barrier to mental healthcare services. Even before the pandemic, there was a shortage of psychiatrists. In 2019, there were 8,300 child and adolescent psychiatrists in the country and more than 15 million youths in need of services, according to the Academy of Child and Adolescent Psychiatry.

Patients in rural areas face significant barriers to care, as 61 percent of areas with mental healthcare provider shortages are rural or partially rural, AHA noted.

To help address this shortage, AHA has asked Congress to increase the number of Medicare-funded residency slots for all physicians, including psychiatrists. According to the statement, officials have only increased the number of spaces by 1,000 since 1996.

Lifting the caps on residency positions would present more opportunities for individuals to enter the physician workforce and help mitigate the shortage.

Additionally, AHA requested that Congress establish scholarships, strengthen loan forgiveness programs, and provide other financial support to encourage providers to specialize in children’s behavioral healthcare.

Congressional leaders should also review payment rates to ensure that behavioral healthcare providers are receiving fair reimbursement for the services they provide, AHA recommended.

AHA voiced its support for several funding initiatives that would assist groups that focus on recruiting and retaining underrepresented groups in the behavioral healthcare workforce, such as the Centers of Excellence and the Health Careers Opportunity Programs.

To help reduce suicide risk factors, AHA has endorsed the Child Suicide Prevention and Lethal Means Safety Act, which would fund training programs to help healthcare workers identify youths who may be at high risk for suicide or self-harm. The legislation would also provide grants to medical schools for suicide prevention training.

In addition, AHA urged Congress to pass the Preventing and Addressing Trauma with Health Services (PATHS) Act, which would provide funds for trauma support and mental services in communities affected by violence. The funds would also help hospitals further their hospital-based violence intervention programs (HVIPS), which aim to reduce retaliation with patients during their recovery.

Finally, AHA asked Congress to increase oversight of the federal agencies responsible for ensuring that health plans comply with the Mental Health Parity Compliance Act (MHPEA), as health plans have not received penalties for noncompliance.

MHPEA requires “health plans and issuers that cover mental health and substance use disorder services as well as medical and surgical benefits to create a comparative analysis of any [Non-Quantitative Treatment Limits] that apply, and to provide such analyses whenever requested by federal agencies,” AHA wrote.

Some health plans apply NQTLs to much-needed mental healthcare services, which can lead to harmful delays in care for patients, the organization said.

“America’s hospitals and health systems recognize that our collective efforts today to protect the mental health of children and adolescents can have a lasting impact on their lives and the overall health of our communities well into the future,” the statement concluded.