Bravo 2022: It Was a Helluva Year (in a Good Way)

Washington’s political theater in the early days of 2023 has already received a lot of attention. But the legislative achievements in December, as the curtain began to close on 117^th Congress, stole the show.

Advocates for those who provide mental health and substance use treatment continue to celebrate one of the most meaningful sessions of Congress in recent memory. Why? Because the legislative gains achieved in December through the spending package will have a lasting impact on treatment, access to care and workforce issues, to name a few.

In no uncertain terms, 2022 provided our field with historic gains. After years of fiscal starvation, so many worthy programs finally received the resources necessary to help people with substance use and mental health challenges – youth, people of color, veterans, people in rural communities and more. Those resources will also help us retain workers and recruit more people to this amazing, though sometimes undervalued, field.

The timing is significant. According to the 2021 National Survey on Drug Use and Health, released January 4 of this year, about one in four adults had a mental illness, more than 16% of the population met the criteria for substance use disorder and nearly 94% of people with substance use disorder (SUD) didn’t receive any treatment in 2021.

Here is some of what Congress included in the year-end spending package:

• $4.2 billion (increase of $203 million) to combat the opioid epidemic.
• $385 million (increase of $70 million) for Certified Community Behavioral Health Clinics (CCBHCs) through Substance Abuse and Mental Health Services Administration (SAMHSA) grants.
• $512 million for SAMHSA suicide prevention activities, including $439.6 million for the 988 Suicide & Crisis Lifeline.
• $1.01 billion (increase of $150 million) for mental health block grants.
• $2.34 billion (increase of $120.9 million) for the National Institute of Mental Health.
• $111 million for school-based mental health grants at the Department of Education.
• $140 million (increase of $20 million) for Project AWARE (Advancing Wellness and Resiliency in Education) to increase awareness of mental health issues among youth, including training.
• $20 million (increase of $10 million) to help communities create mobile behavioral health crisis response teams.
• $40 million for the Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program to educate and train SUD professionals.
• $10 million for grants to states to support parity enforcement.

Lawmakers also tucked some vitally important legislation in the year-end spending package, including:

• Mental Health Access Improvement Act, which expands the Medicare workforce to include marriage and family therapists and mental health counselors.
• Mainstreaming Addiction Treatment (MAT) Act, which removes certain barriers to access for medication-assisted treatment.
• Medication Access and Training Expansion Act, which will boost SUD training for health care providers and help standardize prescriber education practices.
• Expansion of Peer Specialists within the Department of Veterans Affairs, which creates a $13-million program to increase outreach and education about peer specialists, expands virtual peer support platforms and makes a program permanent for hiring at least two peer specialists at every VA primary care facility.

If that’s all Congress achieved in 2022, it would represent a major accomplishment. But that isn’t a comprehensive list of their 2022 legislative achievements. In addition to the opportunities achieved through the year-end spending package, our field received a historic boost earlier in the year with passage of the Bipartisan Safer Communities Act.

That new law will expand access to care and reduce the barriers that prevent many people from getting the treatment they need. Specifically, the new law will increase access to comprehensive mental health and substance use services through expansion of CCBHCs, telehealth services and in-school intervention programs, such as Mental Health First Aid (MHFA). It will provide additional funding for the 988 Suicide & Crisis Lifeline, improving the capacity of our crisis care system.

It’s difficult to recall a more impactful session of Congress than the 117^th that just concluded. It speaks to the importance of advocacy and the need for all of us to be engaged.

So, while the political theater of 2023 has received a lot of attention, Washington gave its finest performance in 2022. Now the stage is set for those who provide substance use and mental health treatment, and new opportunities await.