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Mental health access should top post-pandemic priorities

2022 is shaping up to be the Year of Health Care on Beacon Hill.

Senate President Karen Spilka speaks at the Massachusetts State House in Boston on March 26.Nicolaus Czarnecki/Pool

Stepping up the state’s game on mental health care — making it more accessible and affordable — was always a priority for Senate President Karen Spilka. And so it was no surprise when, back in February 2020, senators gave unanimous approval to a sweeping mental health parity bill.

It was a good bill at the time, and a much-needed one.

Then came the pandemic, which stalled all but the most essential lawmaking, and at the same time strained every aspect of the state’s world-class health care system.

It was a tsunami of trouble, and when COVID began to ease up, the holes in Massachusetts’ health care infrastructure became that much more apparent. One such gaping hole was in mental and behavioral health coverage and availability.


Remote learning, fractured careers, and fractured relationships took their toll on families and on the mental health of countless individuals. Some were frustrated in their search for scarce services. But many others chose avoidance as their only “treatment.”

“Mental health and behavioral health has become so acute with [the] COVID-19 pandemic,” Spilka told reporters Tuesday. “Everybody is concerned, practically, about the lack of, the fragmentation of, the mental health services currently.”

So the Mental Health ABC Act now has a 2.0 version that would mandate coverage for annual mental health checkups on a par with annual physical checkups.

“I’ve wanted to do this for years, actually,” Spilka said. “I’ve never understood why it was so accepted that people, particularly adults, get access to one physical at no cost, but not a mental health assessment at no cost.” Indeed, Colorado already has a similar mandate.

The bill also attempts to address the state’s emergency room boarding crisis — which, post-pandemic, has gone from bad to worse. Emergency room boarding increased as much as 400 percent during the pandemic. Patients, particularly young patients, often have to wait days or longer before an appropriate psychiatric bed can be found. The bill would exempt health care facilities looking to expand psychiatric services and beds from the state’s Determination of Need vetting process — a process aimed at controlling health care costs by curtailing unnecessary expansions.


The Senate bill would provide American Rescue Plan funds for an online portal so that health care professionals could more easily locate available psychiatric beds. It would also require all hospital emergency departments to have a qualified behavioral health clinician available during all operating hours.

But those provisions, and fulfilling the long-ago promise of mental health parity — assuring the same level of treatment and coverage for mental health as for physical health — will remain an empty promise without more clinicians. And so the Senate bill would also put some $122 million in federal rescue plan funds into recruiting and retaining some 2,000 behavioral health professionals. It would also set a rate floor so that mental health providers are reimbursed in a manner “consistent with primary care.”

At least parts of the sweeping proposal got a tentative okay from Lora Pellegrini, president and CEO of the Massachusetts Association of Health Plans. Those included support for the proposed annual mental health exams, efforts to reduce emergency room boarding, and, generally, the effort to “end the stigma associated with behavioral health treatment.”


The Senate is expected to take up the bill Nov. 17, and, yes, that would be the last day of formal sessions for the current calendar year, teeing it up for consideration in the House in early 2022.

House Speaker Rob Mariano, in a recent op-ed in the Globe, also telegraphed his concerns about the health care industry — chiefly mergers and expansions of larger hospital systems and the perilous futures of many community hospitals.

“The trend of consolidation that has defined the current market is nothing short of an arms race,” Mariano wrote.

Governor Charlie Baker, pre-pandemic, proposed his own bill aiming to get health care facilities to focus on primary and behavioral health care, be more transparent about costs to consumers, and control rising drug costs. He is widely expected to get back to those issues in the coming year.

So 2022 is shaping up to be the Year of Health Care on Beacon Hill. Presumably, the state’s political leaders will have taken the right lessons from what went right — and what went wrong — in the way Massachusetts dealt with the pandemic and its aftermath.

In this mecca of modern health care, where more than 97 percent of Massachusetts residents have health insurance, pockets of inequality and access to treatment remain. Finding a long-term cure for those lingering health care ailments ought to top next year’s political agenda.

Editorials represent the views of the Boston Globe Editorial Board. Follow us @GlobeOpinion.