What We Can Learn From Mental Health Care Reform During a Public Health Crisis

The COVID-19 pandemic response had significant negative impacts on the mental health of Americans, with a 25 percent increase in anxiety and depression being reported among both adults and adolescents. 

In response, some states expanded access to mental and behavioral healthcare services. As states examined how to effectively expand access to needed healthcare, governors and lawmakers consistently looked to occupational licensing reform and the deregulation of telehealth services as a solution. 

States that partook in these policy decisions worked to ensure that practitioners could more easily move to and practice within a multitude of states, that practitioners could provide patient care across state lines via telehealth, or that practitioners were allowed to perform an expanded set of duties. 

While it is important to understand that these broad changes took place, it is also important to delve into the specific and important policy changes that together make up the above-mentioned themes of broader reform. 

Some of these specific changes include:

• Increasing the portability of individuals who are licensed psychologists. In fact, twenty-nine states and the District of Columbia enacted executive orders that allow for the recognition of psychologist licenses from other states.
• Better allowing psychologists to provide talk therapy to patients via telehealth. 
• Forty governors signing executive orders to expand the recognition and reciprocity of psychiatrist licensing.
• Nine states allowing for psychiatrists to begin servicing patients through telepsychiatry. 
• Thirty-seven states and the District of Columbia further expanding the recognition of out-of-state nursing licenses, beyond the shorter path to interstate licensing reciprocity provided through the Nurse Licensure Compact. 

These were critical policy changes that lawmakers felt comfortable and confident making to save lives and help patients. 

Unfortunately, several of these changes ended between mid-2020 and late 2021. This is baffling as these changes were deemed safe enough to enact and were seen as beneficial to the citizenry of the states in which they were made. 

Instead of repealing these policies or letting them expire, states must continue to evaluate the benefits of maintaining or reinstating expanded licensing and telehealth deregulation for mental and behavioral health professionals. By deregulating occupational licensing and telehealth, states can increase the supply of mental healthcare providers and reduce costs, while also increasing the availability of care for patients in areas with provider shortages.