telehealth psychologist computer

At least eight states have established or updated interstate compacts allowing counselors and other behavioral health service providers licensed in their own states to practice telehealth in other states.

Trends in Behavioral Health Legislation for 2022

By Riley Judd | Sept. 29, 2022 | State Legislatures News | Print

The COVID-19 pandemic has exacerbated challenges affecting the U.S. behavioral health system, and state legislatures have stepped up to address them.

Youth Mental Health

In December 2021, U.S. Surgeon General Vivek Murthy issued an advisory, “Protecting Youth Mental Health,” in which he called for urgent action to address increasing rates of anxiety, depression and suicidal ideations among kids and teens. States have responded with a variety of innovative policies. Virginia passed legislation to create a mobile app with suicide prevention resources; seven other states, including New Hampshire and Oklahoma, have introduced bills requiring public schools to include mental health hotline numbers on student ID cards. There has also been a wave of new measures to integrate mental health supports in education and training into school curricula.

Behavioral Health Workforce

To address widespread workforce shortages, state legislatures have adopted policies to recruit and retain behavioral health service providers and professionals. Several states, including Arizona, Colorado and Illinois, have established loan repayment and scholarship programs to bolster their workforces. Additionally, at least eight states have established or updated interstate compacts allowing counselors and other behavioral health service providers licensed in their own states to practice telehealth in other states.

Behavioral Health Crisis Response

Several states have passed legislation to better understand the role of law enforcement in mental health crises and have taken steps to improve behavioral health care and treatment options for incarcerated individuals. Some states have passed bills with new or updated provisions governing court-ordered mandatory behavioral health treatment. Kentucky expanded the criteria for court-ordered assisted outpatient treatment to include individuals who have had challenges remaining in mental health treatment programs, who may require hospitalization or who have been arrested at least twice within 48 hours due to a risk of serious self-injury.

Opioid and Substance Use Disorder

While drug overdose deaths were on the rise in the months preceding the pandemic, the rate accelerated during the crisis, hitting a record of over 100,000 deaths in the 12-month period ending in June 2021, according to the Centers for Disease Control and Prevention. Lawmakers are responding with a multipronged strategy including education, awareness, prevention and treatment. This year, there has been an increased focus on opioid use and the influences of fentanyl. Several states, including Florida and Connecticut, have authorized qualified professionals—pharmacists, school nurses, educators—to administer emergency opioid antagonists under some circumstances. Across the country, from Colorado to West Virginia, lawmakers are considering bills that increase funding for fentanyl risk-awareness campaigns and policies that would increase penalties for its possession or distribution.

Maternal Behavioral Health

Perinatal and postpartum depression and anxiety disorders are the most common complications of pregnancy and childbirth, affecting 1 in 7 U.S. mothers. National figures indicate that for 50%-70% of women with perinatal depression, the disease goes undetected and undiagnosed, and only about 15% receive treatment. Untreated mental health conditions are a leading contributor to maternal mortality. Several states have addressed the issue this year, from extending postpartum Medicaid coverage to requiring hospitals and birthing centers to inform pregnant women and their family members about perinatal mood and anxiety disorders.

988 Crisis Hotline and Crisis Response

Another priority for state legislatures has been to bolster their behavioral health crisis response systems and implement the new national 988 Suicide and Crisis Lifeline, which replaces the 10-digit National Suicide Prevention Lifeline number (800-273-8255). In 2021, several states established surcharge fees and other funding mechanisms to support the 988 hotlines. This year, more states, including West Virginia, Maryland and Kansas, have acted to support the 988 transition and their crisis response systems.

NCSL continues to track related mental and behavioral health legislation in the Injury Prevention, Substance Use Disorder Treatment and Maternal and Child Health legislation databases.

Riley Judd is an intern with NCSL’s Health Program.

This project is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services as part of a financial assistance award totaling $200,000 with 100% funded by the CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, the CDC/HHS or the U.S. government.

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