Letter from BrainFutures’ Interim Executive Director: Mental Health Parity, Policy, and PAT Training

Monday, April 29, 2024

Today, BrainFutures is proud to announce the release of our latest issue brief, A Path Toward Parity: Ensuring Equitable Access to Psychedelic-Assisted Therapy. This paper helps stakeholders understand how the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA) can be used as a key lever to ensure widespread insurance coverage for psychedelic-assisted therapies, once they become available post FDA-approval. Broadly, MHPAEA requires that health plans (insurers) apply the same standards to behavioral health benefits as medical and surgical benefits. As evidence mounts that insurers aren’t facilitating equal access for mental health patients, BrainFutures is committed to shining a light on this important issue so that patients are not left paying the bill for these potentially life-changing treatments.

Today’s parity report comes at a time when there is an increasing spotlight on insurers’ lack of progress toward equitable coverage over the last decade.        

Recently, RTI released a blockbuster report that demonstrates unequivocally the degree to which health insurance plans have not removed barriers to accessing mental health and substance use care for their members. Despite the passage of MHPAEA 16 years ago and recent updates to the law meant to streamline enforcement, it is clear that payers are continuing to apply more stringent standards to their behavioral health benefits compared to medical and surgical benefits for the same plans. As a result, patients had to seek out-of-network care 3.5 times as often for behavioral health office visits (for example, seeing a therapist) compared to when they needed care for a medical or surgical issue. At the same time, plans paid (reimbursed) behavioral health providers far less than medical and surgical clinicians, creating a strong disincentive for behavioral health providers to accept insurance. All of this means that patients are unfairly forced to shoulder a larger burden of the costs of mental health and substance use care. In some cases, this barrier is enough to prevent patients from accessing care at all.

BrainFutures was proud to sign on as a supporter of the RTI report, titled Behavioral Health Parity – Pervasive Disparities in Access to In-Network Care Continue. We are also proud that our board member and advisor, Dr. Henry Harbin—who is a nationally recognized expert on MHPAEA—played a pivotal role as an advisor to the Bowman Family Foundation that commissioned this report.

We were not alone in showing our support for the report’s findings, and for a more equitable future. More than two dozen national behavioral health organizations joined us in signing on, including the American Psychiatric Association, the American Psychological Association, the National Council for Mental Wellbeing, and the Kennedy Forum. Equally important, more than a dozen employer coalitions also signed on as supporters of the report and its recommendation for stronger parity enforcement. These self-insured employers recognize a need for change: surveys have shown that employers see unequal access to behavioral health coverage for their employees as a serious problem.

You can view the full list of supporters here. Of note, these are many of the same organizations that BrainFutures is engaging and building relationships with because they are going to be key voices for advocating for equitable coverage of psychedelic-assisted therapy.

BrainFutures is focused on clearing a path to reimbursement for psychedelic-assisted therapy, and we strongly believe that today’s report and our work to educate stakeholders about MHPAEA will be an important piece of this puzzle. We are grateful to our donors, the Steven and Alexandra Cohen Foundation, the Darla Moore Foundation, the Cammack Family Charitable Gift Fund, and an anonymous donor for supporting this project as well as our extensive work over the past three years to pave the way for equitable access to psychedelic-assisted therapies.

Along with the release of A Path Toward Parity, April has been a busy and exciting month for BrainFutures. On the 9th, we co-hosted a briefing for members of Congress and staffers in partnership with the Bipartisan Mental Health and Substance Use Disorder Task Force. This briefing provided a broad overview of several key issues, including the history and science behind clinical psychedelic research, advocacy from the veterans’ community, and upcoming policy issues that will shape access to clinical psychedelic care, from the FDA approval process and beyond.

Additionally, on April 17th and 18th, BrainFutures convened nine university faculty from eight different institutions to discuss their work to bring psychedelic-assisted therapy curriculum into existing graduate- and resident-level training programs for mental health professionals, including nurses, social workers, and psychiatrists. Our discussions dived deep into both the challenges they are facing and innovative solutions they are creating. A robust training pipeline for clinicians will be key to realizing broad access to psychedelics once approved by the FDA, and this is just one of the projects we are working on to help the provider community prepare to adopt these new therapies. We look forward to sharing some of the meeting’s key findings in upcoming releases this summer and are excited to be partnering with some of the most cutting-edge thinkers and educators in this field!

On a final note, I wanted to acknowledge my deep gratitude for David Esselman’s leadership over the past two years at BrainFutures. During his time as Executive Director, BrainFutures has seen significant growth into new areas, including educating policymakers about medical access to psychedelics and a renewed focus on training pipelines for psychedelic-assisted therapy clinicians. As David transitions to a new role as a Senior Advisor at BrainFutures, I have moved into the role of Interim Executive Director. I am honored to be working with an incredible team of staff, advisors, and consultants, who are among some of the best in the business. Our collaborators include experts in psychiatry, managed care, mental health parity, and health policy. We are excited to have recently added Dr. Jonathan Book as Senior Medical Advisor and Michael Yuhas as Senior Healthcare Policy Advisor to our roster, both of whom have deep experience in behavioral healthcare systems.

We are grateful to everyone who has supported our work, and look forward to sharing much more to come over the next few months!

Jazz Glastra
Interim Executive Director, BrainFutures