Behavioral health providers have been urging Congress to expedite action on a $38.5 billion stimulus bill to boost up their profession in the midst of the COVID-19 pandemic.

Dr. Frank Ghinassi, CEO of Rutgers Health University Behavioral Health Care, said that since 1 in 5 people are affected by a behavioral health disorder, those diagnoses are not just a national but a personal crisis, and contacting state and federal representatives to get the stimulus pushed through is one of the only ways to protect treatment facilities' most valuable resource: people.

"These community mental health centers are threatened, and these are not institutions that run with large machines," Ghinassi said. "Their principal capital is human capital."

According to Ghinassi, all behavioral health centers, but particularly those which are not-for-profit, operate on "razor-thin" margins when business runs as usual. But the last few months have been anything but usual, with volume dropping not only because of safety concerns, but because people's mental health concerns may have been usurped by worries about shelter, food, other family members, or their own physical health.

"The good news has been that Medicaid, Medicare, and many, many commercial insurance companies are rapidly adapting to allow mental health centers to provide services on these more virtual platforms," Ghinassi said, making sure to note that that also means the centers are still able to be reimbursed.

The switch from face-to-face treatment to virtual has gone smoother than might have been expected. While meeting platforms must remain HIPAA-compliant, remote communication is a skill already mastered by anyone under 30 and, Ghinassi said, truthfully most people under 50.

The usual therapeutic benchmarks of active listening, empathy, authenticity, and the ability to form a joint treatment agenda are still able to be conveyed when clinician and patient are in separate settings, and he said a "skilled clinician" can even make those connections in a telephone session.

Ready and consistent access to virtual or digital platforms seems to be the bigger hurdle.

"While I think it's a new challenge, I do not believe it's a barrier to those ingredients that have typically happened in the room," Ghinassi said. "It's a challenge for many individuals who might have severe and persistent disorders who may not have ready access to internet."

The next challenge for behavioral health centers may come after the pandemic has ended, as Ghinassi predicts many who worked on the front lines and saw the perils of the sick up close will be at risk for developing something like post-traumatic stress disorder. Also, those with an existing need for mental health treatment may see those needs intensify the longer the crisis lasts, as he said many people even now are still running on adrenaline.

Ghinassi said every state has a department of mental health — New Jersey's is the Division of Mental Health & Addiction Services, under the auspices of the Department of Human Services — that those in need can contact at any time. He also suggested visiting thenationalcouncil.org for more on what can be done to help behavioral health centers right now.

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