Mental health advocates applaud the proposals, which they say offer much-needed federal leadership on a growing national crisis. But they worry about getting sustainable funding for the efforts.



The mental health crisis is escalating in the U.S. So when President Biden spoke specifically about children's mental health and the need to expand services for all Americans struggling with mental illness in the State of the Union address last night, mental health advocates took notice. Here to talk more about the White House's plan is NPR health correspondent Rhitu Chatterjee. Hey, Rhitu.


SHAPIRO: So what are advocates excited about from what they heard last night?

CHATTERJEE: Well, you know, they're excited, mainly because this is the first time in, really, decades that the White House has prioritized mental health and is taking leadership in addressing the problem. Here's Dr. Tami Benton. She heads the psychiatry department at the Children's Hospital of Philadelphia.

TAMI BENTON: This is the first time that I've ever seen this level of interest and investment on a national level in mental health, specifically children's mental health.

CHATTERJEE: And she said this is timely because the pandemic has really exacerbated the mental health crisis, especially for kids. And it's been brewing for years before.

SHAPIRO: So what are some specifics of the Biden plan?

CHATTERJEE: Well, first of all, it's a multipronged and comprehensive plan. It includes proposals for funding increase, policy changes, regulations. For example, Dr. Benton pointed out that the president talked about addressing the effects of social media on kids.

BENTON: There are many benefits to social media, but one of the things that we know for sure is that for adolescents who are at risk anyway, social media can have significantly damaging effects.

CHATTERJEE: And the White House is asking Congress to ban excessive data collection and targeted online advertising for children and young people. And then Dr. Benton said she was also glad to see a commitment to making sure that kids and families get access to mental health services when and where they need it. So, for example, the CARES Act and the American Rescue Act have already given schools money to hire more mental health professionals so that schools can do more to address students' mental health needs. And the president is proposing another $1 billion in the 2023 budget to help schools hire more providers. And in fact, last night, the president talked about improving access to mental health services for everybody.


PRESIDENT JOE BIDEN: And let's get all Americans the mental health services they need. More people can turn for help and full parity between physical and mental health care if we treat it that way in our insurance.


SHAPIRO: Rhitu, what would full parity between physical and mental health care in insurance really look like?

CHATTERJEE: So, Ari, you know, we have a mental health parity law that requires insurers to have the same sort of services and benefits for both mental and physical health. So, for example, insurance plans aren't allowed to require pre-authorizations for mental health or have fewer number of providers in their networks compared to physical health. But that's not the reality on the ground. The law is poorly enforced, and the president wants to change that. He's proposing that insurance companies be required to cover at least three visits annually without co-pay. I spoke with Dr. Tom Insel - he's the former director of the National Institute of Mental Health - about this.

TOM INSEL: That's a pretty big step forward. We haven't seen anything like that in a previous proposal.

SHAPIRO: As promising as all that sounds, what are the chances that Congress supports it?

CHATTERJEE: So I asked Dr. Insel the same question, and here's what he told me.

INSEL: If you had asked me about Congress five years ago, 10 years ago, I would say there were points of light but no real energy for this topic.

CHATTERJEE: But now, he says, there's a lot of bipartisan interest and congressional support that's been building for a few years, actually, so he's hopeful we will be seeing some real changes.

SHAPIRO: NPR's Rhitu Chatterjee, thank you.

CHATTERJEE: Thank you, Ari. Transcript provided by NPR, Copyright NPR.