Shining a Light on Mental Health and Substance Use Disorders

As we reflect on and commemorate Mental Health Month, one thing is clear: shining a light on mental health and substance use disorders (SUD) does not exacerbate these conditions; it helps dissolve the stigma often attached to them.

Mental Health First Aid (MHFA) is a leader in that regard. It’s an evidence-based public education program that teaches people how to help someone with a mental health problem or crisis. Mental Health First Aid trains participants to identify people who may need help with a mental illness, effectively communicate with them, and guide them to appropriate professional help. The goal of this training is to make responding to a mental health crisis as common as using CPR in a cardiac emergency.

The Edward-Elmhurst Health team led efforts to develop MHFA in the Naperville, Illinois region, and recently the organization reached a key milestone. We have now trained more than 10,000 individuals in Mental Health First Aid. Using a collaborative approach with more than 50 community partners, we are changing the conversation in our community. We believe we have helped to reduce the stigma often associated with mental illness and substance use disorders and encouraged students, teachers, coaches, ministers, police and first responders, health care providers and others to reach out and speak up about the importance of mental health and the benefits of treatment.

However, we must do more on the national thinking surrounding these issues. It’s time to amend 42 CFR Part 2, an outdated law that prevents federally-assisted substance use disorder treatment programs from sharing patient records without the expressed written consent of the patient. This law is standing in the way of comprehensive, coordinated, safe patient care that treats the whole person.   

One bipartisan bill now moving through Congress, the Overdose Prevention and Patient Safety Act (H.R. 5795) would amend 42 CFR Part 2 to allow health care providers access to their patients’  substance use disorder treatment records while maintaining the privacy protections guaranteed by HIPAA and strengthening penalties for unauthorized disclosures.  

Segregating substance use disorder treatment records from the rest of the patient’s medical record only serves to compromise care, perpetuate stigma and prevent the integration of physical and behavioral health care. Knowledge of a patient’s substance use history is critical for clinicians to avoid adverse drug reactions, prevent the inappropriate prescribing of potentially addictive medications, such as opioids, understand factors that may interfere with compliance, and recommend treatment protocols that address the patient’s overall health. Further, as long as the health care system continues to treat SUD records as different and deserving of a higher degree of confidentiality, it perpetuates the stigma associated with substance abuse. 

And let’s face it, SUDs do not discriminate. They affect people from all walks of life—like you and me. As a person in long-term recovery, I value receiving comprehensive care and maintaining my sobriety more than hiding my history from the providers responsible for helping me manage my health.

By: Mary Lou Mastro, FACHE, System CEO, Edward-Elmhurst Health and 2018 Council Chair, AHA’s Section for Psychiatric and Substance Abuse Services. Edward-Elmhurst Health is comprised of three hospitals — Edward Hospital, Elmhurst Hospital and Linden Oaks Behavioral Health — and provides comprehensive healthcare to residents in the west and southwest suburbs of Chicago.