Sept. 9 Federal Update: Surgeon General Issues Advisory on the Mental Health and Well-Being of Parents

On Aug. 28, U.S. Surgeon General Dr. Vivek Murthy, released an advisory highlighting the immense stress caregivers report and the urgent need to better support parents, caregivers, and families to help our communities thrive. The report follows new and emerging challenges, including the complexity of managing social media, the youth mental health crisis, and an epidemic of loneliness that disproportionately affects young people and parents.

The surgeon general’s advisory details the relationship between parental stress and mental health, its impact, and pathways for action. Murthy recommended expanding community programs to ensure affordable child care, reliable mental health care, paid time off, spaces for social connection to build community, and encouraging communities to speak openly about the challenges parents face. He further spoke of a value shift to truly recognize the extraordinary impact of caregivers and collectively envision raising children as a shared responsibility through our policy, programs, and behavior.

The advisory highlights heightened stressors parents and caregivers face, including financial strain and economic instability, time demands, concerns over children’s health and safety, isolation and loneliness, difficulty managing technology and social media, and cultural pressures. The American Psychological Association reported that 41% of parents say that most days they are so stressed they cannot function, while 48% say that most days their stress is completely overwhelming compared to other adults.

Chronic and excessive stress experienced by parents and caregivers can adversely affect their mental and physical health, especially when considering the multiple sources of stress. Parental stress is often experienced by children, as parental mental health can influence the emotional climate, responsiveness, and consistency of caregiving, all of which are essential for a child’s emotional and cognitive development and long-term health.

The advisory stresses the importance of addressing parental mental health conditions and the underlying stressors and causes to decrease exposure to chronic or severe parental stress, empower parents to meet both their needs and the needs of their children, and reduce the likelihood of mental health conditions. The recommendations spanned community-wide from governments to employers, community organizations, health and social service systems and professionals, researchers, and families.

Biden Administration Announces Funding Awards to Advance the President’s Unity Agenda

The Biden administration recently directed significant funding toward integrating primary and behavioral health care, supporting mental health care, expanding substance use disorder treatment, and enhancing maternal mortality research and prevention efforts. The grants and funding opportunities reflect key pillars of President Biden’s Unity Agenda, including increasing the affordability and accessibility of mental health care.

Grants for Navigators to Increase Access to Health Care
The administration announced $100 million in awards to navigators to assist millions of Americans in registering for health care coverage through HealthCare.gov. The grants are awarded through the Centers for Medicare & Medicaid Services and directed toward 44 Navigator grantees in states utilizing HealthCare.gov. The grants will be offered with extended grant periods and in advance of Marketplace Open Enrollment, which will begin Nov. 1. They will be directed toward organizations working with underserved communities, consumers, and small businesses.

Funding to Integrate Primary and Behavioral Health Care and Expand Drug Treatment Court Capacity
The Substance Abuse and Mental Health Services Administration (SAMHSA) announced $81.3 million in grant awards. Approximately $16 million is directed to support the integration of primary and behavioral health care, while $24 million will expand the capacity of drug treatment courts. Additional awards will support tribal behavioral health, advance prevention science, support communities of recovery, and increase access to care through the screening, brief intervention, and referral to treatment public health model.

Prevention, Treatment, and Workforce Enhancement Awards
An additional $65.7 million in grant awards and notices of funding opportunities were announced through the Strategic Prevention Framework – Partnerships for Success program. The funds are intended to assist tribes, state and local governments, colleges, and universities in developing and delivering substance use prevention services. Additional awards will support youth with unmet behavioral health needs and increase access to behavioral health care for people who are or are at risk of becoming unhoused. The grants further aim to enhance the behavioral health workforce by supporting substance use disorder (SUD) training for graduate-level healthcare professionals.

Funding to Support Maternal Health and Home Visiting Programs
The U.S. Department of Health and Human Services announced more than $558 million in funding to improve maternal health. The vast majority, $440 million, will be directed to expand voluntary, evidence-based maternal, infant, and early childhood home visiting services. Additionally, the Centers for Disease Control and Prevention (CDC) will utilize $118.5 million across five years to expand Maternal Mortality Review Committees (MMRCs) from 46 to 52 states and U.S. territories and freely associated states.

Sector Updates from the Judiciary

Growing Challenges to Accessing Health Care for Transgender Adolescents
The 11th U.S. Court of Appeals recently upheld an Alabama bill restricting access to gender-affirming care when it declined a request to reconsider bill. Among the bill’s comprehensive provisions, it designates the prescription of puberty blockers or hormones to aid in the gender transition of individuals younger than 19 as a felony, punishable by up to 10 years in prison.

Four judges dissented, stressing the harm of restricting parents’ fundamental right to obtain medical treatment for their children. They further expressed concern for future access to broader medical care, especially if families have restricted pathways to bring legal challenges as with the 11th Circuit.

Alabama stands as one of 26 states that have adopted laws restricting or banning gender-affirming medical care for transgender youth. The U.S. Supreme Court and the 6th U.S. Circuit Court of Appeals have allowed Idaho, Kentucky, and Tennessee to enforce their bans as litigation continues. Nevertheless, a definitive ruling is largely dependent upon the Supreme Court, which has agreed to hear a lawsuit questioning the constitutionality of restricting gender-affirming care following challenges to a Tennessee bill. The legislation restricts the use of state funds for gender-affirming care and prohibits gender-affirming surgical care for minors.

Meanwhile, 16 states and the District of Columbia, have adopted shield laws to safeguard access to gender-affirming care, including by preventing providers and patients from facing civil or criminal charges from another state where care is prohibited.

Alongside the Supreme Court decision, elections are likely to significantly impact adolescents’ access to gender-affirming care. A critical example is Arizona’s election of Gov. Katie Hobbs, who issued an executive order guaranteeing insurance coverage for surgeries among state employees and protecting individuals from investigations initiated by other states. The order was issued one year after Arizona’s legislature banned gender-affirming surgeries for minors.

Mental Health Care Order Within California Prisons
The Ninth Circuit recently upheld a lower court’s ruling, affirming the right of inmates experiencing mental illness in California to have access to a minimum of 20 hours of mental health treatment per week for in-patient programs. California argued that the order did not comply with the Prison Litigation Reform Act of 1995, which requires the relief to go no further than is needed and be as non-intrusive as possible. The state also maintained that U.S. District Court Chief Judge Kimberly Mueller lacked evidence to support a 20-hour minimum.

A previous recommendation declined to set a minimum number of hours for treatment, alternatively requiring clinical assessment and treatment teams to determine all treatment decisions. Nevertheless, Judge Mueller rejected the absence of a minimum time requirement, establishing a key protection through a baseline level of care. The 20-hour minimum additionally reflects the minimum treatment levels mandated by the Department of State Hospitals, California’s state hospital system.

The decision is a key step to safeguarding the right of incarcerated individuals to access mental health care. Nevertheless, the order arrives during severe shortages of mental health professionals and despite Gov. Gavin Newsom’s longstanding efforts to expand care and recruit and retain mental health professionals.

Subscribe to the Policy and Advocacy Radar to receive our biweekly policy roundup, which includes commentary on issues in Social Current’s federal policy agenda, opportunities to take action, and curated news and opportunities.