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WASHINGTON -- Increasing the mental health workforce and improving parity in mental health coverage are among the mental health issues President Biden plans to address in Tuesday night's State of the Union speech.

"Our country faces an unprecedented mental health crisis for people of all ages, one which COVID has exacerbated but which predates the current challenges," a senior administration official said on a Tuesday morning phone call with reporters. "Two out of five adults today report symptoms of anxiety or depression and children face especially acute challenges as COVID has disrupted routines and relationships ... The president will announce a mental health strategy that marks a major transformation in how mental health is understood, perceived, accessed, treated, and integrated in and out of healthcare settings."

The senior administration official outlined the administration's three-pronged strategy to improve Americans' mental health -- a strategy the president will discuss in the State of the Union speech:

• Increase the mental health workforce. "We do not have enough providers or system capacity to meet Americans' needs," the official said. "One-third of Americans live in areas without adequate behavioral health providers, and our crisis response infrastructure is frayed. We must begin with a major new investment in building our mental health and substance use disorder workforce." According to a , Biden's fiscal year 2023 budget proposal "will invest $700 million in programs – like the National Health Service Corps, the Behavioral Health Workforce Education and Training Program, and the Minority Fellowship Program – that provide training, access to scholarships, and loan repayment to mental health and substance use disorder clinicians committed to practicing in rural and other underserved communities." The official said that the budget "will also propose a transformational expansion of certified community behavioral health centers and community mental health centers to build new capacity." In addition, the new "988" mental health hotline also will launch this summer, giving Americans an easier way to connect to support and resources, the official noted.

• Improve access to care. "Fewer than half of Americans with mental health needs receive treatment," the official said. "Costs and stigma are too often a barrier and care can be inconvenient or confusing to access." The administration is taking steps to more diligently enforce the Mental Health Parity and Addiction Equity Act of 2008, signed into law by President George W. Bush, which requires insurers to offer mental health benefits that are on a par with their physical health benefits. "That standard is too often ignored and this administration is taking important steps to enforce the law," the official said. Biden also will ask Congress to modernize mental health laws "so that all insurance plans are required ... to provide an adequate network of providers for those services." The president also will ask Congress to expand telehealth access and allow for telehealth delivery across state lines, and the Department of Health and Human Services (HHS) "will also build new, easy-to-access, user-friendly online Treatment Locator tools," the official said.

• Foster more supportive environments. This includes social media content aimed at children, the official said. "The president will call for action to address social media's mental health harms, especially for young people ... And we must strengthen privacy and advertising protections for kids on the Internet." To help set up students for success, "the president will call on Americans nationwide to take on roles as tutors and mentors to help our students recover."

Regarding the parity provisions, the official said in response to a question from MedPage Today that the Biden administration hopes to both enforce existing law and to write new rules. The official noted that the departments of Labor, Treasury, and HHS recently that found "widespread failures by plans to comply with requirements related to documenting how they are setting their mental health coverage limits, and restrictive coverage that is oftentimes in violation of the law. The departments are committed to continuing those vigorous enforcement activities, and pursuing companies and plans that are not adequately covering the services" to make sure they comply.

The departments also are planning to begin rulemaking around parity later this year, the official added. And "moving beyond the existing parity requirements, we believe that all types of insurance coverage, including employer health plans, should be required to cover a robust package of behavioral health services ... and that part of that package of services should include access to three behavioral health visits with with no cost-sharing, so people have a way to walk in the front door of the behavioral health system without costs serving as a barrier." The new rules also should include network adequacy requirements, the official said.

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