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The Path Forward Releases Guidance for Employers and Health Plans in Anticipation of COVID-19 Mental Health and Substance Use “Second Wave”

Specific recommendations raise bar for behavioral care provided by telehealth, primary care and specialists

WASHINGTON – May 4, 2020 – Rates of suicide and drug-related deaths were at record levels before the global tsunami of COVID-19, and this crisis has only exacerbated the problem. In fact, experts warn of a “second wave” that will manifest with a shock to our mental health and wellbeing that will be just as serious as the coronavirus pandemic itself. To help reduce the impending impact on all Americans, The Path Forward for Mental Health and Substance Use has released new guidance for employers, providers, health plans and other stakeholders. 

“COVID-19 has put unprecedented pressure on a system that already struggled with access and effectiveness of care before the pandemic,” said Michael Thompson, President and CEO of the National Alliance of Healthcare Purchaser Coalitions, a member of The Path Forward collaborative. “The need for mental health services caused by the economic disturbance, fear of the virus and social isolation is growing. All stakeholders must double down to ensure we are prepared for the onslaught of need.” 

Now is the time to improve access to more effective care in order to meet the increased demand and to improve outcomes for mental health and substance use disorders (MHSUD). The Path Forward recommends that employers, unions, and other healthcare purchasers urge third party administrators and providers to implement lasting improvements in three areas with significant evidence of effectiveness:

  • Tele-behavioral health – The need to move to a virtual environment, driven by COVID-19, has had a dramatic, overnight impact on the delivery of telehealth and tele-behavioral health services. Regulatory barriers have rapidly come down and the ability to access care virtually has exploded. These changes should be permanent.
  • Screening and testing for MHSUD just like COVID-19 – Ramp up and expand screening and testing for MHSUDs to identify and track the need for care. Early identification will allow for triage of more serious cases and measurement-based care over the course of treatment has been shown to improve patient outcomes by 20% to 60%.
  • Integration of behavioral health into primary care – As demand for better mental healthcare in primary care escalates the need for integration has never been greater and the shift to virtual tele-behavioral healthcare delivery in response to COVID-19 must be extended to primary care providers. 

“Now more than ever, expanding collaborative care and sustaining rapid expansion of telepsychiatry are essential to meet the projected surge in demand for mental health and substance use disorder treatment,” said American Psychiatric Association CEO and Medical Director Saul Levin, MD, MPA. “Improving access to effective and timely care by focusing in these areas must remain a coordinated and high priority for the healthcare delivery system, health plans and employers.”

To assist employers and others in advocating for increased access to tele-behavioral health in light of COVID-19, The Path Forward also released a new report funded by a not-for-profit subsidiary of The Bowman Family Foundation. Recommendations include: employers and other healthcare purchasers should work with their third-party administrators to ensure that their health plans offer employees choice in the type of behavioral healthcare treatment; reimburse behavioral healthcare providers equivalently regardless of treatment approach; and verify that tele-behavioral health benefits are at parity with physical telehealth benefits. 

The Meadows Mental Health Policy Institute also recently issued an analysis on how an economic recession could increase rates of MHSUD and result in deaths from suicide and substance overdoses. 

Launched in 2019, The Path Forward for Mental Health and Substance Use is focused on executing a disciplined, private sector approach to systematically and measurably improve mental health and substance use care for all Americans. The Path Forward is a collaborative of the National Alliance of Healthcare Purchaser Coalitions, American Psychiatric Association, American Psychiatric Association Foundation Center for Workplace Mental Health, The Bowman Family Foundation and Meadows Mental Health Policy Institute. To learn more, visit

About National Alliance of Healthcare Purchaser Coalitions

The National Alliance of Healthcare Purchaser Coalitions is a nonprofit network of business coalitions, representing more than 12,000 purchasers and 45 million Americans, spending more than $300 billion annually on healthcare. The National Alliance is dedicated to driving innovation, health and value along with its coalition members through the collective action of public and private purchasers. 

About American Psychiatric Association

The American Psychiatric Association (APA), founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 38,500 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. 

About American Psychiatric Association Foundation Center for Workplace Mental Health

The American Psychiatric Association Foundation, a subsidiary of the APA, works to create a mentally healthy nation by advancing mental health, overcoming mental illness and eliminating stigma. The Center for Workplace Mental Health helps employers create a more supportive workplace for their employees and advance mental health at their organizations. 

About The Bowman Family Foundation

The Bowman Family Foundation (BFF) is a private foundation qualifying as a 501(c)(3) nonprofit organization. The primary mission of BFF is to improve the lives of people with mental illness. BFF also provides funding to support the education and welfare of children. 

About Meadows Mental Health Policy Institute

Since its public launch in 2014, Meadows Mental Health Policy Institute (MMHPI) has helped Texas legislators, government officials, members of the judiciary, and local leaders identify systemic mental health needs and solutions, quickly becoming Texas’s most trusted source for data-driven mental health policy. MMHPI is helping Texas leaders address the mental health crisis in our jails and emergency rooms, improve access to care for veterans and their families, shift the focus of new investments toward early intervention, and expand the mental health workforce.

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