Mapping The Monster: It’s Time To Address Behavioral Health Care

We are now in the throes of the 2020 legislative session. This session, expect to hear around 3,000 bills with issues as broad as codifying the protections of the Affordable Care Act, sports betting, criminal justice reform, vaping and e-cigarette regulation, transit projects, public-private partnership regulation, the 100th anniversary of the women’s suffrage movement and, of course, education. So, the challenge is, what should be the focus of this month’s column?

As a freshman, I heard many times from members on both sides of the aisle that I should find my passion, become an expert and develop a reputation as the point of contact on that issue. I’ll admit, as a novice to government, a lifelong artist and educator, and now a member of the Health and Government Operations Committee (HGO), I struggled with how I was going to become an expert in any area so far afield from my wheelhouse.

However, last year, when a group of organized young people called Our Minds Matter reached out to my office and asked for a meeting, I realized that my area of expertise, my passion and the next several years of my life would be adolescent access to behavioral health crisis and preventative care. Despite the fact that I had experienced firsthand our broken behavioral health system, because of the code of silence and stigma around mental illness, for nearly two decades I was under the impression that my experience was unique.

I spent the interim between sessions meeting with colleagues to ensure that I wasn’t reinventing the wheel, or starting the work on issues that were already well underway, and I discovered that this was uncharted territory. Simultaneously I became co-chair of the crisis bed workgroup, created to address widespread disparities in reporting, availability and definition of crisis beds, particularly for adolescent populations. I had the privilege of working with experts in the field of behavioral health, 25 of us under the leadership of HGO Vice Chair Joseline Peña-Melnyk, coming together with a singular purpose – to get our most vulnerable populations out of the emergency departments and into treatment.

During our work sessions, I heard about adolescents sitting in emergency departments for days and even weeks, or being released when no beds could be found, despite the trepidation of nurses and doctors who had no other options. I heard stories of parents who feared for their children, family members who feared for their loved ones or had given up after exhausting what limited options they had for care, dedicated providers who were beaten down and burned-out when they simply couldn’t provide the care they so desperately wished to. I describe this work as “mapping the monster,” trying to understand the flaws in the system and what we as legislators could do to fix it.

Recently, our Anne Arundel County Public Schools superintendent came before our Anne Arundel County delegation and talked about this issue in the schools. He said, “We often say you can’t just throw money at a problem; this is the problem you can throw money at.” He went on to explain what I already knew: we are still doing triage - in the schools, in the emergency departments, in homes, and in communities.

I have often said that when we change the culture, the policy will follow. For the first time in decades, we have public will behind investing in behavioral health care. Everyone is impacted by mental illness - the person, the family, the community - and one of our most impacted, most vulnerable, most needful populations is that of our children.

I have legislation this session to try and slow the crisis, legislation to remove barriers to care, to provide more resources, to re-evaluate and redefine how we identify, address and treat mental illness, particularly for our adolescent population. Now we have to determine if we have the political will to follow through. It doesn’t get us to the point of mental health care as preventative care because it is only the first step on a much longer journey, but we have to start somewhere, and I hope you will help me help our children. For more information about legislation at the Maryland General Assembly, visit www.mdaleg.maryland.gov.