Feds on mental health: 'We need every state to step up'
Xavier Becerra says the federal government will be there to support mental health services — starting with the new national 988 hotline for suicide prevention — if states also step up.
Becerra, the U.S. secretary of health and human services, made his comment Thursday, May 5, after he and Gov. Kate Brown spoke with six young workers for YouthLine, a peer-to-peer service that is part of the Lines for Life nonprofit based in Portland.
On his brief stop in Oregon, Becerra also took part in a roundtable discussion with three of Oregon's U.S. representatives, state legislators and mental health advocates, and met privately with Planned Parenthood advocates. He also visited the Sylvania campus of Portland Community College, where he met future health care workers and took part in another roundtable.
The HHS budget for 2023 now before Congress proposes $700 million for implementation of the 988 hotline, which is scheduled to start July 16 — the amount is up from the $109 million in the current budget — and a total of $7.5 billion for competitive grants to states to transform their mental health services. The larger amount is part of a 10-year, $51.7 billion commitment that President Joe Biden laid out for mental health in his first State of the Union address on March 1.
"We want to invest with those states that want to do the work. Gov. Brown has made it very clear that Oregon is going to step up and do that," Becerra told reporters after he and Brown met with the YouthLine workers.
"That $700 million-plus would make sure that these wonderful counselors who receive all those calls will be able to do those. We want to make sure that if someone does try to call, they actually get a person — not a busy signal, or be put on hold. When we launch 988 on July 16, It's going to be important that we have a whole bunch of folks who are ready to go. We need every state to step up."
Asked what he learned from the young workers, Becerra said:
"Probably that we've got peers who are doing a great job helping these youths, who are probably the shyest and least likely to come forward quickly. That has got to give you some sense of promise that this will be done well, so long as we invest and provide them with the resources they need."
Becerra said afterward of YouthLine: "I hope we can plant seeds of money for programs like this that make more peer-to-peer support possible. I think if we had more young people at our front line to help youths undergoing mental stress, we'd catch them a lot faster."
Brown said it was not her first visit to Lines for Life, which specializes in crisis intervention and treatment for addiction.
"But to hear from the young people doing the work is extraordinary," she said. "It makes me hopeful for the future and committed to fight for President Biden's $50 billion investment in behavioral health services across this country."
Brown signed a $470 million commitment by the 2021 Legislature with a mix of state and federal dollars to boost capacity for mental health, reorganize services, and expand and diversify the workforce.
According to a 2020 national survey, the share of adults who reported a mental health issue rose from 18.3% in 2016 — the rate had been stable for years — to 21% in 2020. The increase was attributed to a surge by young adults ages 18 to 25.
In a 2019 survey of high school students preceding the coronavirus pandemic, one of every three students reported persistent feelings of sadness and hopelessness — and one in five reported seriously considering suicide.
May is Mental Health Awareness Month.
Prospects for money
Among the guests were U.S. Reps. Earl Blumenauer, Suzanne Bonamici and Kurt Schrader, all of whom served with Becerra, a 24-year veteran of the House before he succeeded Kamala Harris as California attorney general in 2017. Harris, elected to the Senate, became vice president with Biden's election in 2020, and Becerra was Biden's pick to lead one of the largest federal agencies in 2021.
Schrader sits on the Energy and Commerce Committee, which deals with health care legislation in the House. He said he thinks Biden can prevail on mental health funding, despite thin Democratic majorities and sharp partisan divisions in the current Congress.
"We argue about a lot of things, but this is not one of them," he said.
"Nothing is an easy sell. We have spent a lot of money over the past four or five years just trying to keep America alive. But the tale of COVID is pretty obvious. These young people here see it daily. we need to make that investment to make sure our kids grow up in a little better world and feel comfortable and are taken care of."
Bonamici leads one of the subcommittees on the Education and Labor Committee. She said a frequent topic is school nutrition.
"We know that students cannot learn when they are hungry. We also know students can't learn if they are suffering with mental health challenges," she said. "Our students deserve it, and we will work to make sure we get that funding. I applaud the president for his bold budget proposal that we know we need."
Blumenauer did not take part in the press gathering, but he echoed those sentiments during the panel discussion. Like Becerra, Blumenauer is a longtime member of the House Ways and Means Committee, the tax-writing panel in that chamber.
'We can do better'
Becerra's visit was the fourth to Oregon by a Cabinet-level official in recent weeks — the others were Labor Secretary Marty Walsh, Housing Secretary Marcia Fudge and U.S. Trade representative Katherine Tai — and Biden himself stopped in Portland on April 21.
During the roundtable discussion, advocates urged Becerra to support more federal money. Becerra said Biden's commitment in his State of the Union address was easily the largest by any president in recent times toward true parity of mental health with treatments for physical illnesses and injuries.
"We know we have a president who puts his money where his mouth is," he said. "The president is putting forth a budget that actually lets us do that."
Among those he heard from were Roberto Aguilar, a counselor at Milwaukie High School, who spoke for the Oregon School Counselor Association — he was Oregon counselor of the year in 2017 — and Karley Strouse, a bilingual psychologist in the Salem-Keizer School District, who spoke for the Oregon School Psychologists Association.
Both said schools lack the trained specialists to deal with mental health issues that predate the onset of the pandemic. Aguilar said if Oregon were to adhere to a stand of one counselor for every 250 students, schools overall would have to hire 744 more of them.
Becerra said there is a reason why the proposed $7.5 billion in his agency's budget is for competitive grants for states to explore new approaches to mental health.
"I can't just fund new people," he said. "But I can fund an idea that shows we can do better."
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