Collaborative Care, Medication-Assisted Therapy Key to Saving Thousands of Lives from COVID-Related Suicide and Overdose

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 Usea national initiative working with health purchasers to expand access to collaborative care and other proven treatments.

You can read the entire report here.
You can read the latest press release here.
The first report in the series is here.

2020 Nantucket Children’s Mental Health Summit

The Hackett Center for Mental Health, along with Meadows Mental Health Policy Institute (MMHPI) and the Massachusetts Association for Mental Health (MAMH) hosted the third annual Nantucket Children’s Mental Health Summit July 28th and 29th. Of course, the Summit had to be held virtually this year; however, that didn’t stop the participants from engaging in lively and meaningful conversations about the significant mental health issues facing children, youth and families during these unprecedented times.

Children’s mental health experts from Massachusetts and Texas, who joined the Summit, represented highly prestigious institutions. From Massachusetts, participants came from the Boston University School of Medicine, Harvard Medical School, Tufts University School of Medicine, and The University of Massachusetts Medical School. From Texas, representatives came from Baylor College of Medicine, Rice University’s Baker Institute for Public Policy, the University of Texas Medical Branch, the University of Texas, and UT Health. Among those facilitating these discussions were MAMH President and CEO Danna Mauch, PhD, MMHPI President and CEO Andy Keller, PhD, MMHPI Executive Vice President of State Policy Michelle Harper, and The Hackett Center Executive Director Gary Blau, PhD.

Building on the success of the first two Summits, which included strategies to promote the integration of physical and mental health care as well as the expansion of tele-mental health in schools, conversations this year took on a more urgent tone. Discussions included how COVID-19 has reshaped the work we do, how the increased awareness of systemic racism has impacted youth and families, and how we can help schools address the mental health needs of students. These innovative dialogues led to plans for collaboration on the continuation and expansion of telehealth, the importance of school-linked and multi-tiered services, the need to educate parents, educators and public officials about the importance of “caring for every child’s mental health,” and strategies to finance and sustain evidence-based practices.

Dr. Laurel Williams from Baylor College of Medicine reflects on the summit:

To me, what makes this conference different and what makes me excited is that it is very action-oriented. I go to other conferences to learn for myself or to teach other people. This one is really more like “okay, what can we possibly do to move the ball down the field?” versus “let’s just talk endlessly and never come up with anything.”

These summits continue to identify the need to improve the integration of mental health services across child serving systems, the importance of addressing social inequities and systemic racism, and how collaborative partnerships can solve complex problems.

As you can tell, the “Virtual Nantucket Summit” was truly a great event! We are so thankful for the support of  Maureen and Jim Hackett for sponsoring the Summit, and for being passionate visionaries about improving the lives of children and youth with mental health conditions and their families.