Mass. Senate Passes Mental Healthcare Overhaul

A legislative package just passed by the Massachusetts Senate would revamp access to mental healthcare. One of its backers is State Senator Julian Cyr of the Cape and Islands. Cyr spoke with WGBH News’ All Things Considered anchor Arun Rath about the legislation. This transcript has been edited for clarity.

Arun Rath: The legislation is called the Mental Health ABC Act. Give us a quick run-through of what it would do and why you think it’s needed.

Julian Cyr: Too many people in Massachusetts struggle to access the mental health services they desperately need and deserve, and the reasons are many and they’re intricate. Mental healthcare is treated differently than physical health. It’s often not covered by insurance. And it’s hard to talk about. And so what we did with the Mental Health ABC Act is really live up to this promise that Senate President Karen Spilka has made, that we’re going to begin to truly reform how Massachusetts addresses mental health. And we do it through three broad ways. We look at parity and other insurance reforms — requirements around essentially treating coverage for mental health the same as we treat physical health. We look to plant the seeds of a greater workforce for mental healthcare and then we get at whole host of access barriers. So, it’s a pretty comprehensive bill. But we have a mental health system. … We really don’t have a system at all. We have fragmented parts of mental health services and the system is so broken that it’s going to take more than one bill and one session to fix this. But this is a really critical start in laying the foundation.

Rath: You mentioned right out that this is something that is difficult for people to talk about. And you’ve been straightforward and personal in talking about your own mental health.

Cyr: Absolutely. And I think that’s almost just as important as the policy. I’m someone who’s struggled with anxiety and depression since adolescence. From an early age, people knew I was different. I was bullied. At a point, I had panic attacks. I had disordered eating. But for me, therapy really helped me manage my anxiety. It’s helped me do things I never dreamed I could, including the job I have today. Yet, I still can’t get my health insurance to cover my outpatient mental healthcare. I’m a pretty savvy consumer. I’m a 34-year-old state senator and before doing this I was a health policy wonk in public health. If I can’t navigate the barriers to accessing treatment, imagine how many other people in Massachusetts can’t get the mental health care they need. This is really important, particularly for vulnerable populations. You know, in Massachusetts, we’re all about healthcare, and we believe that mental healthcare is for everyone and so this is what this bill is trying to do.

Rath: I have to imagine you’re hearing similar things from your constituents.

Cyr: Once a week we probably get a call from someone who, maybe they have a child who has an urgent mental health need, they’re stuck in the emergency department and they can’t get a bed. People don’t know where to start on this issue. There’s no sort of clear door to get services. People don’t know what to do and they don’t know where to turn. And often when I get those calls, I don’t know what to do, which I think is just reflective of how fragmented and broken mental health is.

Rath: So, to fix all of this, how much is all of this going to cost and where will the money come from?

Cyr: There’s two aspects of this. On the parity component of this, parity laws have been on the books in Massachusetts for over 20 years and have been on the books federally for over 12 years. Mental health parity means that the process through which benefits that are determined and insurance for mental health care has to be an equivalent process of benefits that are received for folks for physical health, medical, surgical care. And although we’ve had these laws on the books, we have not seen the true intent of this law realized. So, what we do in the bill is we really strengthen the reporting requirements and transparency. We add penalties to insurers who are not truly providing parity. So, those costs are going to be within the existing insurance structure. There’s about $6-million in other programs that are funded through the bill — a pilot program for behavior health services in schools and getting more nurse practitioners who have psychiatric experience into community health centers. Those are all paid for by a trust account that was established in the Fiscal Year 2020 budget.

Rath: Where does this go from here? Are there any process concerns? Worries that this might stall in the House, having cleared the Senate?

Cyr: I’m really fortunate on this issue. I have a terrific partner in Representative Marjorie Decker. She and I chair the Joint Committee on Mental Health, Substance Use and Recovery. I think it’s likely the committee will be putting out a bill a little more focused on children, and so we’re hoping that with that vehicle, we can get this taken up. I think we’ve hit a nerve here and I hope that this means that we can get this legislation over the finish line to the governor’s desk and signed into law. We’re going to keep at this until we make it right.

Rath: And in terms of the final stage of this, Governor Baker has spoken about these issues. It seems like he’s generally supportive. You expect support at that level as well?

Cyr: We have a terrific partnership with the Baker-Polito administration. Their partnership has been critical and I think will be critical in getting this bill signed into law, and then implemented.

Rath: So, best case scenario, when would you expect this to be good to go?

Cyr: Well, we’ve got to get it done before July 31, when the formal sessions conclude. It means a lot to people and I hope that means that we can get it done.

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