Chair DeLauro Statement at COVID-19 and the Mental Health and Substance Use Crises Hearing

House Appropriations Committee Chair and Labor, Health and Human Services, Education, and Related Agencies Appropriations Subcommittee Chair Rosa DeLauro (CT-03) delivered the following remarks at the Subcommittee's hearing on COVID-19 and the Mental Health and Substance Use Crises:

With that, I want to acknowledge Ranking Member Cole and all of our colleagues for joining us today.

Before I begin, I would just like to take a moment to recognize that today is March 11th, that marks exactly one year since the World Health Organization declared COVID-19 a global pandemic. Since that day one year ago almost every aspect of American life has changed. Our economy has floundered, cities have shut down, thousands of businesses have closed, rates of food insecurity and poverty have grown, and more than 525,000 Americans have lost their lives. And with each passing day the wide-ranging and enduring consequences of this terrible catastrophe are becoming horribly and more devastatingly clear.   

For example, not too long ago an 11-year-old girl came into the Connecticut Children’s Emergency Department. She was there for something unrelated to mental health. But recently the hospital had made it a policy to give all patients as young as 10 years old a universal suicide screening. When doctors asked the girl if she had had any thoughts about killing herself in the past few weeks, she said “yes.” She said she had been thinking about suicide for quite some time but did not know who to talk to about it. Her mother was shocked.

The issue of mental health and substance use was already a growing concern in this country before the COVID-19 pandemic. But the isolation, the school closures, the economic anxiety, and challenges to obtaining childcare have only exacerbated these already existing problems and created new barriers to treatment. 

In 2019 1 in 10 adults reported symptoms of anxiety or depression. In 2020 that number increased to 4 in 10. Some surveys have shown over 50 percent of people reporting that the pandemic has negatively impacted their mental health. And it is our nation’s most vulnerable who are the most at risk.

According to data published in the Official Journal of the American Academy of Pediatrics, suicidal thinking among young patients is up 25 percent or more from similar periods in 2019. Another CDC report found that in 2020 pediatric emergency admissions for mental problems like anxiety, and panic, have increased by 24 percent for young children and 31 percent for adolescents compared to 2019.

In addition to our nation’s children, this pandemic has been especially difficult for minorities, young adults, and essential workers. Women with children are more likely to report symptoms of anxiety and/or depression than men with children. Black and Hispanic adults are more likely to report symptoms of anxiety or depression than White adults. Those who are essential workers are particularly affected. In addition to reporting symptoms of anxiety and depression during this pandemic, essential workers are also more likely to say they are starting or increasing substance use, and having suicidal thoughts compared to non-essential workers. Finally, young adults are reporting higher than average levels of anxiety, depression, and substance use as a result of this pandemic.

Certainly, the COVID-19 pandemic has been difficult for all of us. But it has been especially difficult for these groups. And it is leading to even greater problems like substance misuse, drug overdoses, and domestic violence. For example, there has been a double digit increase in domestic violence hotline calls since the beginning of this pandemic. And the kids in those families are experiencing ongoing trauma without the respite and support they might previously have gained through school. Meanwhile, drug overdoses are up 42 percent, and overdose deaths are up 24 percent in 2020 compared to 2019. Alcohol sales and consumption have skyrocketed. And while it is too soon to know how the pandemic has affected suicide rates, we do know there have been considerable increases in the number of people who report thinking, thinking about committing suicide, just like that 11-year-old-girl in my home state of Connecticut.

But we are not sitting on the sidelines. For quite some time we have been working to provide more funding and resources for mental health and behavioral health programs. We have, this committee has, on a bipartisan basis, provided significant funds for the Substance Abuse and Mental Health Services Administration (SAMHSA) to address this emergency through the CARES Act, the December emergency bill, and the American Rescue Plan, which we passed yesterday. That includes additional funding for both the National Child Traumatic Stress Network and Certified Community Behavioral Health Clinics. I look forward to President Biden signing the American Rescue Plan into law tomorrow so that these resources can get out the door to our communities. I also want to note that the Affordable Care Act was integral in expanding Medicaid, which in many states is the most significant source of coverage and funding for substance use treatment.

And working together with the Members of this committee, we have supported a number of investments to improve the mental health of children and young people. This includes a landmark new federal investment in Social-Emotional Learning, investments in the so-called “whole child” approaches to education, and investments in community schools. We have also invested in Project AWARE and Healthy Transitions, which were part of the “Now Is the Time” initiative following the tragedy in Newtown, Connecticut. And I am particularly proud to say we have increased funding for the National Child Traumatic Stress Network by $25 million over the last five years, an increase of more than 50 percent. As part of the investment in the National Child Traumatic Stress Network, we also directed resources to provide counseling and trauma services to unaccompanied immigrant children. We need to do more.

I also agree we must recognize these issues do not exist in isolation from each other, which is why we created a new pilot program last year to help State and local health departments to develop plans to address the social determinants of health in their communities.

But while these investments are a step in the right direction, the behavioral health system has been underfunded for years. We need to be thinking on a more long term scale, and provide the funding and resources needed not only to help weather the immediate effects of this pandemic but also to help treat what, I expect, will become an exponentially increasing mental health crisis in the next few years. This simply is not something that is going to go away as soon as everyone gets a COVID-19 vaccine. Without proper treatment, trauma, and complex trauma like the kind we are seeing in so many kids and adults during this pandemic can last and compound for years, even generations. Our kids, our essential workers, our most vulnerable are suffering. We owe it not only to them, but to the health and resilience of our economy, our workforce, and our society to ensure these people get the mental, as well as physical health care that they need.

We are fortunate to have an incredible group of experts with us, and I look forward to hearing your recommendations on how to build a stronger behavioral health system that is capable of meeting those needs in the years to come.  In many respects you all seem to be in general agreement on the need for greater investments in the Substance Abuse Prevention and Treatment Block Grant and to expand the behavioral health workforce so that we can meet the demand for services. We look forward to hearing how you have responded to the crisis over the past year and what you see as our top priorities as we move forward.