We asked Senator Kamala Harris to get on the record about mental health and addiction. Here's what she had to say:
1. Suicide is the 10th leading cause of death in the US and the second leading cause of death for American youth. Every day, 20 Veterans die by suicide. What steps will you take to prevent suicide?
We must do better at prioritizing mental health and making sure it is available for anyone who needs it. Mental health care should not be a privilege just for those that can afford it. That’s why my Medicare for All plan would ensure that people are enrolled in a health plan that covers mental health care and substance abuse treatment. Ensuring that people have access to these services throughout their lives is an important step in reducing suicide deaths.
We should also be implementing common-sense gun safety measures to keep guns away from people who might harm themselves. As I have made clear in this campaign, I won’t wait for Congress to take action on that front. We can and should take immediate steps to stop suicides involving firearms, including by expanding Extreme Risk Protection Order petitions.
In addition, we need to open up more access to mental health services for veterans, particularly those who need these services the most, but have a hard time getting them. For example, veterans who have “other-than-honorable” discharges often have challenges (such as PTSD) that necessitate mental health services, but are currently deprioritized from receiving care through the V.A. We need to change this and make sure that these veterans can access mental health services as soon as they need them.
2. Every hour, eight people in America die of drug overdose, from opioids and increasingly from other drugs as well. What would your administration do to turn the tide on the addiction crisis?
Our response to the addiction crisis must start by tackling the very thing that fueled it in the first place…reckless pharmaceutical companies that marketed dangerous drugs they knew could be highly addictive in order to profit. The federal government, in turn, did not do enough to regulate the distribution of these drugs.
In addition to holding these companies accountable, we must make sure that the government does more to regulate how medications are marketed and ensure that doctors have the information they need to prescribe them responsibly. I introduced the Accountability in Opioid Advertising Act to create more robust FDA enforcement of promotional materials for opioids and drugs used for medication-assisted treatment. And I co-sponsored the Comprehensive Addiction Reform, Education, and Safety Act to strengthen federal penalties on drug companies that fail to monitor and report suspicious opioid distribution practices.
At the same time, we must do more to get communities on the front lines the services they need. This means treating the addiction crisis – both for opioids and other drugs – as a public health issue. I am a co-sponsor of the Comprehensive Addiction Resources Emergency (CARE) Act which would provide state and local governments with $100 billion in federal funding over the next ten years to deploy strategies to help people currently struggling with addition and who are in recovery. The bill is modeled off the success of the Ryan White Act, which empowers communities to make decisions about the best treatments and responses. As president, I will fight to sign that bill into law.
3. Rates of anxiety, depression and suicidal behavior are all rising among our teens and young adults, but the time from first symptoms (usually around age fourteen) to treatment continues to be almost a decade for many people. What would you do to make sure that more individuals get the help they need when they first need it?
My Medicare for All plan would ensure that people are enrolled in a health plan that covers mental health care and substance abuse treatment from birth. We must ensure that cost is not a barrier for young people to access treatment and mental health services as soon as they experience symptoms.
And we should be empowering parents and educators to help young people get treatment as soon as they show signs of symptoms. As part of this, we need to make sure our schools have adequate health resources. According to the National Association of School Nurses, about 40% of schools across the country only have enough money to support a part-time nurse, and 25% can’t afford a nurse at all. We have to reverse this trend and make sure our schools have access to medical professionals who can help provide mental health resources to our students and their families.
4. Our nation is experiencing a shortage of mental health and addiction care providers—including both traditional mental health professionals and paraprofessionals like certified peer support specialists and recovery coaches—and other barriers to treatment, especially in rural and underserved areas. What is your position on improving access to mental health and addiction care for these communities?
We must do more to get mental health services into underserved areas. I believe we need mental health care on demand and have made fighting for more access a priority in the Senate. Last year, I introduced the Mental Health Telemedicine Expansion Act that would utilize telemedicine to increase access to mental health services. That would make a real difference for many people who struggle to access mental health services, but particularly in communities without easy access to mental health providers. I also introduced the Mental Health Professionals Workforce Shortage Loan Repayment Act to authorize a new educational loan repayment program for mental health professionals that agree to practice in areas with a shortage of mental health professionals.
5. For many people, the initial point of care for their mental health condition or substance use disorder begins with the criminal justice system. What is your plan to advance crisis intervention services in the community while also providing treatment and alternatives to incarceration for those already involved in the criminal justice system?
We absolutely need to do more to provide comprehensive health services in our criminal justice system and this starts by prioritizing treatment over incarceration for those with mental illness. Given the shortcomings in our mental health care system, our criminal justice system continues to be tasked with frontline interactions with people whose primary need is mental health care. We should be supporting efforts by law enforcement and other community officials in getting people the treatment and other health resources they need rather than responding with traditional law enforcement interventions. So, instead of simply incarcerating individuals because of drug addiction issues, we should look at alternatives to incarceration such as drug courts and other treatment programs.
And for individuals who have been incarcerated, it is critical that we provide those individuals with mental health and addiction treatment both in and out of custody — so that returning citizens have the greatest possibility of reintegrating into society.
6. The Mental Health Parity and Addiction Equity Act (Federal Parity Law) was enacted in 2008, yet some insurers continue to illegally deny coverage of care for mental health and addiction treatment services. How will you ensure enforcement of the Federal Parity Law?
It is unacceptable that mental health and substance abuse coverage discrimination continues. That’s why I am a co-sponsor of the Behavioral Health Care Coverage Transparency Act, which would increase oversight and enforcement to ensure that health insurance companies cover behavioral health benefits. I will fight to sign it into law and my administration will prioritize civil enforcement of it to hold insurers accountable and make sure they provide these benefits.
My Medicare for All plan will also ensure parity for mental health and addiction treatment services. And it will include robust mental health coverage including expanded access to telehealth and early diagnosis and treatment.
7. How will you fulfill the intent of the Community Mental Health Act of 1963, a law that meant to ensure that people have access to mental health and developmental disability care within their communities rather than in institutions?
My Medicare for All plan will cover comprehensive long term services and supports to ensure that people are able to access mental health and developmental disability care within their communities. These long-term services and supports will be consumer-directed and provided in home-and community-based settings, unless individuals choose otherwise.
8. Poverty is associated with very poor outcomes for people with mental health or substance use disorders, primarily due to lack of secure housing and employment opportunities. What will you do to ensure that income is not a barrier to recovery?
How much money you have should never dictate the quality of care you receive in this country. Under my Medicare for All plan, every American will have access to comprehensive health care that includes mental health and substance abuse services. Individuals making less than $100,000 a year will never be taxed income-based premiums, and there will be no deductibles, no co-pays for high quality care, and strong caps on out-of-pocket expenses. And I will also fight to pass my Rent Relief Act and my LIFT act to provide immediate relief to families who are rent burdened and help people stay in their homes.
9. People of color, immigrants, Veterans, people living in poverty, people who identify as LGBTQ+, and others have unique needs and challenges as it relates to mental health and addiction. What will you do to ensure that these and other underserved groups have access to the mental health and addiction resources and supports that they need?
I intend to fight vigorously to pass my Medicare for All plan which will ensure that every American has access to mental health services. That has to be where we start, making sure that everyone as equal access to mental health services, as my Medicare for All plan would do.
We also need to do more to open up mental health services to veterans by making sure that we don’t put unnecessary barriers in the way of accessing care through the V.A. And we need to make sure we get more providers in underserved areas which is why I introduced the Mental Health Professionals Workforce Shortage Loan Repayment Act to authorize a new educational loan repayment program for mental health professionals that agree to practice in areas with a shortage of mental health professionals.
10. Given that overdoses and suicides are decreasing US life expectancy, evidence-based treatment options are critical, but treatment options are still limited. What role do you see research playing in improving mental health and addiction treatments?
We absolutely need to ensure that there is robust funding for research into treatment for addiction and mental health issues. In the Senate, I have supported increasing funding for important federal research institutions including the National Institutes of Health, which encompasses the National Institute of Mental Health. As president, I will work with Congress to ensure that institutions have robust funding and that our country’s brightest minds are able to innovate and find novel treatments to mental health conditions that so many Americans struggle with.
11. Is there anything else you’d like to share with the mental health and addiction community?
For too long, we have failed to devote the proper resources to mental health care in this country. Every American deserves to have mental health services that are accessible and affordable for them in the communities where they live. As president, I will fight to make this a reality.
I will fight to pass my Medicare for All plan which would cover mental health services and substance abuse treatment. I will work to expand options for the provision of mental health services, including through telemedicine. I will fight every day to make sure that mental health resources are prioritized and that every American is able to access them in the setting that works best for them.