Trump’s health plan doesn’t go far enough

At a time when the director of the National Institutes of Health wants to maintain or even increase access to mental health care, patient advocates are watching with great interest. Last week, the Trump administration proposed a budget that would cut many popular NIH priorities by 12 percent, including cancer research, stem cell research, and essential parts of the agency’s ambitious research agenda, which aims to find cures for a wide range of diseases and keep people who are ill active in their communities.

While NIH does more than any other agency to contribute to efforts to prevent illness and reverse the effects of illness, it remains under intense pressure to make deep cuts to current programs at a time when community mental health organizations are on the brink of financial collapse, and patients and mental health professionals are more isolated than ever.

Thankfully, NIH is trying to respond to this crisis by devoting a portion of its next $25 billion budget to support mental health research and services. This was a central part of the Director’s budget proposal last year, but Congress largely passed legislation to continue funding what the administration also funded with its national health budget, which happens to be the largest budget in the history of the agency.

Nevertheless, Congress appears likely to reject the administration’s current plan for a 15 percent across-the-board cut to all NIH priorities. At the same time, there are indications that lawmakers are interested in enhancing these efforts in a way that addresses key needs in the mental health services world while also balancing other important needs. I hope these efforts bear fruit for the betterment of the nation.

As patient advocates learn more about the Trump administration’s planned cuts, we are finding that funds in the agency’s fiscal year 2018 budget, now under debate in Congress, cannot fully address the needs of this vulnerable population. The proposed cuts of $1.6 billion are just half of the nearly $3 billion needed. Much more, especially given the unmet need, must be done.

Part of the answer must come from ensuring that new dollars going to mental health research do not come at the expense of improving access to care. New funding for preventive measures must be used to increase and improve access to mental health care, and to ensure that safety nets for patients who are in need and whose disorders have become more severe are created and staffed. This budget proposal proposes curtailing nearly $1 billion in baseline funding for these safety nets, something that must be rejected.

And it is crucial that Congress also understands that mental health has such a broad range of health issues that must be addressed if we are to transform the lives of our fellow citizens and provide their community organizations with sufficient resources to provide treatment. For example, cutting the Federal Workers’ Health Program — which assists employees of the Federal Emergency Management Agency to be mentally prepared for the devastation of a disaster or other emergency — would only serve to put our communities at greater risk. We can’t have resources cut for the sake of overdoing it in the areas where they will actually make a difference.

It is in the essential work of this important agency, working in concert with our nation’s leading scientific research universities, that we can best address the growing number of Americans who are living with chronic mental health disorders. It is in the scientific research that will stimulate long-term and meaningful progress in finding cures for serious illness while simultaneously helping to promote and reduce the mental health burden. But in order to do this, we need greater support for these efforts by Congress.

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