Health Care Rights and Mental Health Policy in the United States

Session Submission Type: Created Panel

Session Description

The precarity or complete absence of health care rights and access is a tragic hallmark of American health care. The COVID-19 pandemic has both highlighted and exacerbated the inequities in health care rights and access—particularly around mental health services. The papers on this panel examine the health effects and consequences of a lack of health care rights, generally, and the policy response (or lack thereof) to the need to increase access to mental health services as the US confronts a mental health crisis. Kirkland’s paper highlights the US as a rights-based society with very few health care rights. With a focus on Section 1557 of the ACA—the non-discrimination clause that governs health care provision and health care settings—Kirkland uses a broad set of key informant interviews to show that hospitals have been unable to effectively implement substantive rights protections, despite being suffused with ideas and language about rights. Vargas Nunez’s paper looks at the profound impact the COVID-19 pandemic had on undocumented immigrants—a population that is largely excluded from access to government health care programs and under threat of immigration enforcement. Vargas Nunez uses surveys of likely-undocumented immigrants in the American west to understand how undocumented immigrants navigated the COVID-19 pandemic, finding that regardless of state of residence, and despite the massive impact of the pandemic, undocumented immigrants remained most worried about immigration enforcement. Shifting the focus to mental health policy and access, the papers by Callaghan et al. and Haselswerdt look at recent policy implementation and the factors impacting policy support and uptake. With more than 40 million people across the US who identify as having mental illness, and with severe mental health workforce and affordability challenges, there is, Haselswerdt writes, a compelling case for government action to increase access to mental health services. But do Americans see it this way? This is the central question Haselswerdt’s study, which examines public support for policy action to address mental health services. Using the Cooperative Election Study (CES), Haselswerdt hypothesizes that personal experience in seeking treatment will increase support for public action. Callaghan et al. turn our focus to the recently enacted National Suicide Hotline Designation Act—which created the 988 hotline. For a policy meant to reduce suicide, increase access to mental health services, and reduce violent interactions with police during mental health emergencies, little is known about American attitudes towards this relatively new policy. The authors examine public knowledge, public support, and intended use of the 988 hotline. The results show significant variations in knowledge, support, and intended use across partisanship and race, pointing to a critical need for additional interventions to increase use of this new resource and improve mental health outcomes.

Sub Unit

• Division 48: Health Politics & Health Policy

Individual Presentations

• Health Care Civil Rights: Implementing Section 1557 of the Affordable Care Act - Anna Kirkland, University of Michigan-Ann Arbor

• Mental Health Treatment Access: Personal Experience and Public Opinion - Jake Haselswerdt, University of Missouri, Columbia

• Understanding Public Knowledge, Attitudes, and Intended Use of the 988 Lifeline - Timothy Herbert Callaghan, Boston University; Alva Ferdinand, Texas A&M University School of Public Health; Aakriti Shrestha, Texas A&M University; Alee Lockman, Texas A&M School of Public Health; Kristin Kay Lunz Trujillo, Boston College; Matt Motta, Boston University School of Public Health

Chair

• Steven M. Sylvester Utah Valley University

Discussants

• Charley Ellen Willison Cornell University

• Harold Pollack University of Chicago