CPMH's Opinion on the 21st Century Cures Act

A Message on the 21st Century Cures Act from James A. Smith, III, MD,
Medical Director of Carolina Partners in Mental HealthCare, PLLC

The 21st Century Cures Act was recently signed by President Obama, to both praise and scrutiny. Most think this act is related to cancer and Alzheimer’s disease, but deep into the 1000-page bill Congress went after the dilapidated state of our mental health system, allowing for many benefits to improve the current state of mental health treatment and research.

The first big change is that Congress accepted the fact that SAMHSA (Substance Abuse and Mental Health Services Administration) has failed individuals with serious mental health illnesses; wherefore, the bill establishes an assistant secretary for Mental Health and Substance Abuse to oversee SAMHSA. Many, including the National Alliance on Mental Illness, view this as a step in the right direction.

The act designates a new Interdepartmental Serious Mental Illness Coordinating Committee, which will be charged with summarizing advances in diagnosing and treating serious mental illness, and reporting to Congress; this group will also evaluate the impact of federal programs on public and private mental health services. The act specifically allows grants to local governments, which will provide funding to improve crisis intervention services and to build a registry of available inpatient psychiatric beds. The act increases training programs to foster “integrated care” as the most efficient model of health care — embedding mental health providers into the broader landscape of primary care. The act also includes funding for a nationwide hotline and an online tool for accessing mental health providers with greater ease. Crucially, the act will offer grants to address mental health accessibility for the homeless and those trapped in the criminal justice system, who have both been egregiously overlooked by the mental health system at large.

An inmate in the La Crosse County men's jail has little to do but rest in his cell in a jail-issued uniform. PETER THOMSON photo

This act does not amend HIPAA, but it does improve a clinician’s ability to share information with a patient’s family. It also promises to go after insurers who skirt around the Mental Health Parity Act to avoid covering mental health care services. The act also will improve and enforce information interoperability within electronic health systems, improving patient care nationwide.

Carolina Partners stands ready to move forward as one of the few private practices that accept insurance, assisting thousands of patients each year who would otherwise have very limited access to quality mental health services. While the 21st Century Cures Act contains no magic within its pages, it is an important step in reforming a broken system that has excluded so many with a serious mental illness — shunting people out onto the streets and into our prison system — while closing hospitals and withholding much needed funding from our communities. We stand in full support of this act — let’s give it a year!