In April, MMHPI began releasing a series of white papers analyzing the potential effects of a COVID-19 recession on rates of suicide and substance use disorder among the general population and among veterans. In those, we projected that for every 5% increase in the unemployment rate, we could annually lose 4,000 more Americans to suicide, including 300 Texans, and 5,500 more American drug overdose deaths, including 425 in Texas.
In August, we issued a report detailing opportunities to not only mitigate the damage done by COVID-19, but to potentially reduce suicide and overdose death rates to below pre-pandemic levels.
“Even before the COVID-19 pandemic, America was facing an epidemic in rates of suicide and substance use disorder, and the economic turmoil and broader impacts of the coronavirus has only made that crisis worse. While more research is desperately needed to improve care options, we can save thousands of lives annually if we simply invested more in two well-established treatments – collaborative-based care and medication-assisted therapy – to give more people real hope for recovery from depression and opioid addiction.”
– MMHPI President and CEO Andy Keller, PhD
Partnering with the Steinberg Institute in California, MMHPI analyzed the potential of the collaborative care model (CoCM) and medication-assisted treatment (MAT) for reducing deaths from suicide and overdose. The report projects that universal access to collaborative care for every American with depression could prevent between 9,000 and 14,500 deaths from suicide each year, saving between 725 and 1,100 people in Texas. Further, expanding MAT access to everyone with an opioid use disorder could prevent 24,000 overdose deaths nationwide, saving an additional 1,600 people in Texas.
“It’s important to realize that we know what works. Collaborative care and MAT are effective treatments that save lives, yet many Americans die from lack of access to these treatments. We need to close this gap between what we know and what we do for people with behavioral health problems.”
– Thomas R. Insel, MD, Chair, Steinberg Institute
Collaborative care has been demonstrated as effective in treating depression, bipolar and anxiety disorders, and death from suicide in over 90 rigorous research studies and multiple real-world demonstrations. MAT treats substance use disorder by providing medications such as buprenorphine, naltrexone, and methadone, alongside counseling, to reduce the symptoms of withdrawal and to support people in their recovery from opioid addiction.
“We have known for over a decade that best practices in primary care settings like the collaborative care model and MAT work. MMHPI’s analysis models the potential of universal access, and we need health systems and payors to expand access to these life-saving treatments sooner rather than later.”
– American Psychiatric Association (APA) CEO and Medical Director Saul Levin, MD, MPA
Given the projected, positive impact of collaborative care and MAT, this study suggests policymakers should prioritize strategies to expand the capacity of primary care providers to deliver these services. Recommendations include reducing federal restrictions on the capacity of primary care providers to prescribe MAT medications, making the temporary COVID-19 provisions related to telehealth permanent, including allowing for the prescription of MAT medications via telehealth, and providing federal subsidies to accelerate the development of primary care capacity to offer collaborative care.
“Particularly with the stresses associated with COVID-19, employers want to ensure that employees and their families are being diagnosed and treated for issues like depression and addiction. Not only will it save lives, it will improve the wellbeing and productivity of the American workforce.”
– Michael Thompson, President and CEO, National Alliance of Healthcare Purchaser Coalitions
The APA, APA Foundation, National Alliance, and MMHPI are all members of The Path Forward for Mental Health and Substance Use, a national initiative working with health purchasers to expand access to collaborative care and other proven treatments.