Clinton Wants to Spend Billions on Mental Health, and the GOP May Just Agree
Policy + Politics

Clinton Wants to Spend Billions on Mental Health, and the GOP May Just Agree


There isn’t much that Democratic presidential nominee Hillary Clinton and Republicans can agree on, whether it’s tax policy, Social Security, immigration policy or college tuition assistance.

House Speaker Paul Ryan (R-WI) was dismissive of Clinton’s domestic agenda during his speech to the Republican National Convention in July, saying that at a time when voters were clamoring for fundamental change, the Democrats “are offering a third Obama term brought to you by another Clinton.”

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However, if the former secretary of state defeats Republican nominee Donald Trump in the race for the White House in November, there may be at least a few areas of agreement.

Clinton and Republicans, for example, are in broad agreement over the need for hundreds of billions of dollars in new infrastructure construction.

There may be other areas of agreement centered on education, such as doing more to address onerous college debt and promoting alternatives to four-year colleges. And while Clinton and Ryan are miles apart on approaches to combating poverty, there may be room for compromise on expanding the earned income tax credit.

On Monday, Clinton unveiled her latest major policy initiative: an overhaul and reform of the nation’s troubled mental health system. Although the two parties are far apart on Obamacare and health care reform more generally, they have been trying for months to find common ground on mental health issues in the wake of numerous mass shootings and terrorists attacks in recent years.

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Although the federal government currently spends about $130 billion a year to underwrite more than 100 mental health programs, more than 11 million Americans suffer from severe schizophrenia, bipolar disorder and major depression, according to government figures.

Prisons and jails have long been used as dumping grounds for profoundly mentally ill people, resulting in unspeakable abuse and treatment. Health care experts and professionals for years have been wrestling with an epidemic of suicides, especially among military veterans and college students, that defy solution.

And beyond the human tragedy, the economic impact of mental illness is staggering. By one estimate, it is costing the country nearly $200 billion a year in lost earnings and productivity.

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Clinton’s campaign provided a detailed summary of her plan, which would:

  • Encourage early diagnosis and intervention, including launching a national initiative to prevent suicides.

  • Integrate federal mental and physical health care systems to take a more holistic approach to treatment.

  • Support the creation of comprehensive health centers in every state that would offer a wide range of physical and mental health services. Clinton would invest $5 billion over ten years to create new centers or upgrade existing ones.

  • Find ways to address a severe shortage of mental health providers. Currently there are only 8,300 practicing child and adolescent psychiatrists in the country, which works out to just one provider for every 38,000 children.

  • Increase spending to help train law enforcement officers in responding to encounters involving persons with mental illness, and increase support for law enforcement partnerships with mental health professionals.

The plan would also more strictly enforce mental health parity, requiring for example that mental health benefits under group health plans provide benefits that are equal to benefits for other medical conditions.

Finally, Clinton vowed, if elected, to hold a White House conference on mental health during her first year in office. The conference would highlight the importance of better integrating mental and behavioral treatment in the health care system and encourage more collaborative models in the operation of Medicare, Medicaid and other federal health care programs.

As Roll Call and Morning Consult reported on Tuesday, Clinton’s proposals have much in common with a series of Republican and Democratic legislative measures pending on Capitol Hill.

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The House overwhelmingly passed a far-ranging mental health bill in early July, but the Senate is still mulling a number of proposals. With time running out before the November election, it’s highly unlikely Senate GOP leaders will bring a bill to the floor this fall, after Congress returns from a long August recess facing a slew of urgent spending issues.

While theoretically a post-election lame duck Congress could try to pass compromise mental health legislation, it’s more likely that the issue will be put aside until after a new president and a new Congress are sworn in.

Under the House-passed mental health bill that was sponsored by Rep. Tim Murphy (R-PA), a newly minted assistant secretary for mental health would be responsible for coordinating federal programs, authorizing new grants for community treatment centers and clarifying privacy regulations. In many ways, Clinton’s new plan echoes this House approach.

The Senate’s mental health bill is aimed at improving mental health coordination and encouraging evidence-based treatments of mental health care. That bipartisan measure was drafted by Sens. Lamar Alexander (R-TN), Patty Murray (D-WA), Bill Cassidy (R-LA) and Chris Murphy (D-CT). It would also update block grants for states offering high-quality mental health care and expand access to care.

Debbie Stabenow (D-MI) and Roy Blunt (R-MO) are also sponsoring a bipartisan companion piece that would expand a behavioral health clinics program that was launched in eight states. Stabenow praised Clinton’s approach, especially her willingness to spend $5 billion to expand or create health centers in every state.

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Linda Rosenberg, president and CEO of the National Council for Behavioral Health, said in an interview Tuesday that Clinton’s plan offers a comprehensive approach that could provide the basis for bipartisan action next year, if she is elected president.

“I think it was clear she talked to a lot of people, they did a lot of homework, and came up with a solid plan,” Rosenberg said. “I think it’s very aligned with many of the issues that have been discussed on the Hill,” although the Clinton camp decided to avoid getting too detailed in its proposal.

“We’re always hopeful there will be bipartisanship,” she added. “I think certainly elements of the plan that Tim Murphy put forward very early are consistent with this. I think her plan goes beyond that, however. I think what her plan does that nothing on the Hill does right now is spend money. Unfortunately, we can call anything we want reform, but when there is no money behind it, it’s hard to see how there can be much change.”