The new mental health executive order on speeding the delivery of innovations to treat serious mental illness has sparked a mixed response from advocates. Though researchers and biotech companies would be glad to accelerate getting promising therapies (psychedelics, for example, as well as other newer entrants) out the door faster, the nonprofit Mental Health America and other groups are calling for the administration to couple a desire for speed with robust safeguards and equity considerations. The mental health executive order they maintain must not leave behind those whose access to even the most basic care is lacking.
In its April 21 statement, Mental Health America says it is “encouraged” by the mental health executive order and committed to helping steer innovation toward improving quality, access, and equity. The group points out that for many people with serious mental illness, symptoms are compounded by poverty, bias, unstable housing, and involvement in the criminal/legal system. If the mental health executive order simply spurs research into high-tech remedies without addressing these concerns, the resulting medicine stands to benefit fairly privileged patients and to exclude the most disempowered.
The order mandates all federal agencies to work together to speed medicine development, with HHS as the lead agency and a need for better data sharing, ease of approval and research incentives. Promoters add that as more details are released, they will observe whether the mental health EO provides direction for diverse trial enrollment, affordability, and postapproval tracking in real-world settings. They would also like to see peer supports, psychotherapy and community services remain central to the work, rather than a new focus solely on drugs.
Mental Health America emphasizes the importance of the mental health executive order being incorporated into a comprehensive approach that bolsters parity legislation, upholds safety nets, enhances housing supports and reforms the crisis response system. Serious mental illness is not only a health issue but is profoundly affected by social forces. Without those equal investments, it is likely the best new treatment will not reach its full potential.
For individuals with serious mental illness and their families, the mental health executive order may be a source of both hope for new strategies and fear that all the exciting promises fall flat. We have seen when a groundbreaking new treatment is met with undue enthusiasm, only to be cost-prohibitive, not covered by insurance, or otherwise limited to narrow who is eligible. Guidance from advocacy organizations is urging individuals to stay engaged, sound off in the comment- with-leaders process, and make leaders work to ensurethe new world of innovation offers equal help for those so profoundly affected.
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